Journal Article

Anthropological overview of kangaroo care in community settings in Madagascar

Al-Rashid, Azzah, Andrianarisoa, Vonimboahangy Rachel, Brazy-Nancy, Emilia, Mattern, Chiarella, Rakotonandrasana, Brigitte Irene, Norolalao, Patricia

2023

Overview

The management of preterm births remains a major challenge in Madagascar, given the lack of equipped facilities in rural areas, and the absence of precise data concerning the incidence of such births. The World Health Organization (WHO) recommends the kangaroo method (skin-to-skin contact) for the management of preterm infants. In this article, we examine the conditions for success and the obstacles facing kangaroo care in community settings in Madagascar. We performed a qualitative research, collecting data from the districts of Antananarivo and Mahajanga in 2021. In total, 54 semi-structured interviews and two focus group sessions were conducted with the parents of preterm infants and healthcare professionals. The obstacles identified by the research included incomplete and inaccurate knowledge, leading to heterogeneity in the practice of kangaroo care: arbitrary duration, lack of kangaroo care at night, exclusive breastfeeding, and only partially practiced skin-to-skin contact. We found that the conditions for success depended on: (1) the healthcare system, (2) local interpretations of pregnancy, and (3) the structure of the infant’s family. Failings of the medical system, cultural habits going against kangaroo care, and “nuclear” and/or “single parent” family structures undermine the application of this practice, jeopardizing upscaling efforts. We hope that the results of this research will guide community strategies for the management of preterm infants and kangaroo care.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Anthropology / Birth weight / Breast Feeding / Breastfeeding & lactation / Caregivers / Child / Child development deviations / Curricula / Data collection / Developmental disabilities / Families & family life / Female / Gynecology / Health care / Health facilities / Heterogeneity / Humans / Infant / Infant, Newborn / Infant, Premature / Infants / Kangaroo care / Kangaroo-Mother Care Method - methods / Low income groups / Madagascar / Maternal and Child Health / Medical personnel / Medicine / Medicine & Public Health / Mothers / Newborn babies / Obstetric care / Obstetrics / Pregnancy / Premature babies / Premature birth / Preterm birth / Prevention / Professional ethics / Professionals / Public health / Qualitative Research / Quality improvement in maternal and reproductive health services / Reproductive Medicine / Risk factors / Rural areas / Statistics / Womens health