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Table 4 Key lessons regarding the institutionalization of KMC

From: Implementing facility-based kangaroo mother care services: lessons from a multi-country study in Africa

Theme Facilitating factors Challenges
Training and orientation Pre-service curricula include KMC Lack of clarity of what transpires during training
In-service training Trainers lack knowledge, skills and experience
Non-optimal workplace implementation of KMC
Supportive supervision Project-driven interventions bring additional resources for supervision Supervision not sustained because of
- staff workload
- lack of transport
- distances
- decentralization
Integrating KMC into quality improvement Use of KMC registers No standardized reporting on KMC required at a higher level
Inclusion of KMC in mortality and morbidity review meetings
Available data aggregations not used
Poor quality of record keeping
Recommendations from review meetings not followed up
Continuity of care beyond the facility KMC included in antenatal care KMC not included in antenatal care
  Adequate follow-up system for KMC babies Poor follow-up of KMC babies due to:
Use of community health workers to encourage caregivers to go for follow-up - poverty
- travel distances
Governmental and institutional support Existence of national KMC policy documents or guidelines Unavailability of guideline documents at facility level
KMC champions at different levels in the health system
Support from district and facility management
Client-oriented care Promotion of companions in the care of mother and baby Low uptake in the use of maternal and newborn services
   Cultural beliefs (e.g. baby should be carried on the back)