INTRODUCTION:

About 25 million infants (17%) are born with a low birth weight (LBW) globally and most of these occur in low-income countries. These low birth weight infants suffer from high rates of morbidity and mortality and often remain underweight, stunted or wasted from the neonatal period through childhood. That’s why low – income countries promote the kangaroo mother care (KMC) to promote positive health of neonates in adverse condition.

The WHO has defined KMC as early, continuous, and prolonged skin-to-skin contact (SSC) between the mother and preterm babies; exclusive breastfeeding or breast milk feeding; early discharge after hospital-initiated KMC with continuation at home; and adequate support and follow-up for mothers at home¹.

KMC is also identified by WHO as a biologically sound method of care for all new-borns, particularly for low birth weight infants as part of their strategy to decrease the morbidity and mortality of premature infants^2,3.

KMC has three components the first is the kangaroo position. Once the premature infant has adapted to extra uterine life, he is positioned on the mother's chest, in an upright position, with direct skin-to-skin contact. The second component is kangaroo nutrition. The third component is the clinical control; infants are monitored on a regular basis, daily until they are gaining at least 20 g per day⁴.

LBW infants need extra care and warmth. KMC is a practical and inexpensive option of this and therefore the best way to provide this care and warmth especially during incidence of power failing and in households who do not have access to electricity. KMC is care of preterm infant carried skin to skin contact with the mother. It is a powerful, Easy to use method to promote the help and well – being of infant born preterm as well as full term and also reduces the workload of the health care workers. Considering the benefits of KMC education for nurses and mothers is seen to be critical to its successful implementation.

RESEARCH METHODOLOGY:

A cross sectional descriptive study was conducted to assess the knowledge regarding kangaroo mother care among postnatal mothers. Data was collected regarding knowledge of kangaroo mother care by structured knowledge questionnaire. In this study the sample were through simple random sampling. The study was conducted in mothers whose babies were admitted to neonatal intensive care unit (NICU) of different hospital of Azamgarh U.P. Mothers were enrolled after getting informed consent.

Inclusion criteria:

· Postnatal mothers who were willing to participate in the study.

· Postnatal mother who were available during the time of study.

Exclusion criteria

· Postnatal mother who were previously undergone this study.

Research variables were knowledge and demographic variables were age, educational status, occupation, type of family, type of residence and number of children.

Objectives of the research were to assess the knowledge of kangaroo mothers on KMC, to assess the attitude of post-natal mothers towards KMC and to assess the KMC practices of mothers with new-born premature and/or low birth weight infants.

RESULT:

Majority of the mothers 55% were between age group of 18 to 25 year old, 35% were between 26 to 34 year age group and remaining 10% were belonging to 35 to 40 year age group. Maximum mothers (55%) are educated up to 12^th standard and 25% up to 10^th while 20% mothers were graduate. Maximum of the mothers 70% were from rural area and remaining 30% were from urban area. The ratio of occupation that is house wife: working was 9:1 and ratio between type of family joint: nuclear was 3:1. Maxim mothers 50% have at least child and 20% having more than one child while 30% was of first conception. (Table-1).

Table No. 1. Demographic variables

Variable

Frequency

Percentage

Age (in year)

18 – 25

26 – 34

35 – 40

55%

35%

10%

Education

10^th

12^th

Graduate

25%

55%

20%

Type of residence

Urban

Rural

30%

70%

Occupation

House wife

Working

90%

10%

Type of family

Joint family

Nuclear family

75%

25%

Number of children

First conception

One child

More than one child

30%

50%

20%

In study we found that 16.66% having good, 50% have average, and 33.33% were having poor knowledge regarding kangaroo mother care before implementation of teaching module with mean value of 8.00.

There was an improvement seen in the post test 53.3% mothers nurses scoring good, 46.6% were average, no body have been found to be poor knowledge score grade regarding kangaroo mother care with mean value of 11.00. (Figure no. 1).

DISCUSSION:

In the present study there was significant difference between the mean of pre-test and post-test score. That indicate the structured teaching programmed was effective method to improve the knowledge of postnatal mother regarding kangaroo mother care.

Majority of the postnatal mothers were having average 50% (15), and 16.66% were good and 33.33% (10) having poor knowledge on kangaroo mother care before implementing structured teaching module. After implementing teaching module majority of the postnatal mothers were having good [53.3% (16)], 46.6% (14) were average while not any have been found to be poor knowledge on kangaroo mother care. Hence it can have interpreted that structured teaching programmed is effective method the increase the knowledge of postnatal mothers regarding kangaroo mother care. There was no any significance association between post test knowledge score with selected demographical variable such as age, education, residence, occupation ant type of family.

A similar study was conducted by Kalpana Badhei, her finding showed that the overall mean score in the pretest was (7.82+2.77) while overall post test knowledge score was (35.12+2.01). Highly significant difference was found between pre and post test knowledge scores. No Significant association was found between post test knowledge scores with their selected demographic variables. Statistical analysis of data revealed that STP was effective in improving knowledge of the mother regarding care of newborn to prevent hypothermia⁵.

Neha Joshi1 et. al. stated in their study that the overall mean pre-test knowledge score of postnatal mothers was 19.8±2.98 and mean post-test knowledge score of postnatal mothers was 26.28±1.89 and the mean difference was 6.48. This revealed that the STP was an effective method in improving mother’s knowledge on postnatal care⁶.

Kanchan Bala, RajKumari Sylvia Devi, Gomathi B. showed that overall mean pre-test knowledge score of postnatal mothers was (30±4.3) which reveals that mothers had good level of knowledge and mean post-test knowledge score of postnatal mothers was (42±1.1) which revealed that mothers had very good level of knowledge and ‘t’ value for total pretest and posttest was 22.22⁷.

Sumanpreet Kaur and Harmanpreet Kaur stated in their study that pre-test shows nearly three- fourth 80(80%) of the subjects had average level of knowledge as compared to those with good level of knowledge 17.5(17.5%), poor level of knowledge was shown by very few subjects 2.5(2.5%). Where as in post–test the frequency and percentage distribution of students according to level of knowledge. It shows that about 87.5(87.5%) of the subjects had good level of knowledge and 12.5(12.5%) have average level knowledge. No one from subject lies in poor level of knowledge⁸.

A similar study conducted by J. Karpagam and D. Shangeetha. And showed that a significant difference between pre-test and post-test knowledge was found (t =27.94, p<0.05). Which indicate that educational programmed has been an effective method of increasing the knowledge of the mothers⁹.

The finding of the Gayathri et.al. revealed that there was a marked increase in overall knowledge score of post test than the pre test score which represent the effectiveness of STP (t=3.04; p<0.005)¹⁰.

Santosh Kumar et. al. showed that 53% of post natal mothers had poor knowledge regarding kangaroo mother care followed by 45% had average knowledge and least i.e. 1 % had good knowledge regarding kangaroo mother care. The knowledge scores ranged from 01-23. Mean knowledge score was 9.18 with a standard deviation of ±4.45¹¹.

Payal T Vaghela found in her study after implementing the structured teaching plan there was increase knowledge of “Kangaroo Mother Care”¹².

Use of this technique would humanize the practice of neonatology, promote breastfeeding, and shorten the neonatal hospital stay without compromising survival, growth, or development¹³. Mother is the best caretaker for a child¹⁴.

CONCLUSION:

On the basis of study finding it was concluded that most of the mothers had good knowledge regarding kangaroo mother care after implementation of Structured Teaching Programme. So structured teaching programme was effective for improving the knowledge of postnatal mothers regarding kangaroo mother care. Organization of educational program in community on KMC would increase the knowledge and become effective to reduce the mortality rate of neonates and work load of health care worker too.

REFERENCES:

1. Sachdev HP. Low birth weight in south Asia. Int J Diab Dev Countries. 2001;21:13-31.

2. World Health Organization DoRHaR. Kangaroo mother care: a practical guide. WHO Library. Geneva: World Health Organization, 2003. Available at http://apps.who.int/iris/bitstream/handle/10665/4258 /9241590351.pdf;jsessionid=55AE8DABEF71949 616732F5F6B170300?sequence=1.

3. Brett J, Staniszewska S, Newburn M, Jones N, Taylor L. A systematic mapping review of effective interventions for communicating with, supporting and providing information to parents of preterm infants. BMJ Open. 2011;1(1):e000023. Ludington-Hoe SM. Evidence-based review of physiologic effects of kangaroo care. Curr Womens Health Rev. 2011;7:243-53.

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5. Kalpana Badhei. Impact of Structured Teaching Programme (STP) on knowledge among the mothers of Newborn Regarding Prevention of Neonatal Hypothermia in a Selected Hospital, Bhubaneswar, Odisha, India. Int. J. Adv. Nur. Management. 2016; 4(2): 111-114.

6. Neha Joshi, Gomathi B, Kanchan Bala, Mahalingam V. Effectiveness of structured teaching programme on knowledge about postnatal care among mothers. Int J Res Med Sci. 2017 Nov;5(11):4993-4997.

7. Bala Kanchan, Devi Sylvia Kumari Raj, B. Gomathi. Effectiveness of an ‘Instructional Teaching Programme’ (ITP) on the Knowledge of Postnatal Mothers regarding Newborn Care. IOSR 2013;2(2):24-30.

8. Sumanpreet Kaur,Harmanpreet Kaur. A Pre-Experimental Study to assess the Effectiveness of Demonstration Method and Structure Teaching Programme on Knowledge of Kangaroo Mother Care among B.sc Nursing 3rd year students of Royal Institute of Nursing Gurdaspur, Punjab. Int. J. Nur. Edu. and Research. 2016; 4(4): 465-473.

9. Karpagam J. Importance of Birth Spacing Among Primi Post Natal Mothers. Nursing. 2014;1:2.

10. Gayathri S., Sampada S., Hiral R., Manisha, Silvi R., Yashvanti V. A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge Regarding Kangaroo Mother Care among Mothers of Low Birth Weight Babies at Selected Hospital at Rajkot Dist. Int. J. Nur. Edu. and Research 4(1): Jan.-Mar., 2016; 45-46.

11. Santosh Kumar, Sheela Willimas. A study to assess the knowledge regarding kangaroo mother care among postnatal mothers at JSS Hospital, Mysuru. Int. J. Adv. Nur. Management. 2016; 4(2): 139-140.

12. Payal T Vaghela. A study to assess the effectiveness of structured teaching programme regarding Kangaroo Mother Care (KMC) among antenatal mothers of selected hospital in Mehsana city. Asian J. Nursing Education and Research. 2020; 10(3): 305-307.

13. Sanjay S. Shinde. Kangaroo Mother Care (KMC). Int. J. Nur. Edu. and Research 4(1): Jan.-Mar., 2016; Page 61-63.

14. Arti Madhukar Wasnik. Efficacy of Skilled based Teaching Program on Kangaroo Mother Care among Postnatal Mothers in a Rural Tertiary Care Teaching Hospital of Central India. Asian J. Nur. Edu. and Research. 2016; 6(3): 331-336.

Received on 19.01.2022 Modified on 16.06.2022

Asian J. Nursing Education and Research. 2022; 12(4):419-422.

DOI: 10.52711/2349-2996.2022.00090