title: Kangaroo care for well low birth weight infants at Harare Central Hospital Maternity Unit--Zimbabwe.
abstract: OBJECTIVE
  To describe the experience in a newly established Kangaroo Care Unit (KCU) at a tertiary level hospital and to identify factors associated with poor outcome in this unit.
  
  
  METHODS
  Cross sectional study.
  
  
  METHODS
  Kangaroo Care Unit at Harare Central Hospital, Zimbabwe.
  
  
  METHODS
  Mothers admitted to the KCU and their well preterm infants.
  
  
  METHODS
  Discharge home or referral back to the Neonatal Unit (NNU) for conventional care.
  
  
  RESULTS
  613 mother infant pairs were studied from May 1994 to December 1996. The median age for all mothers was 23 years (Q1 = 15, Q3 = 26). Fifty four percent of the infants were female. Median age at admission to KCU was 12 days (Q1 = 1, Q3 = 25). Seventy two percent of infants were discharged home from the KCU. The rest (28%) were referred back to NNU for conventional care. The odds of being referred back to the NNU were significantly higher if the infant was male OR = 1.82 (95% CI: 1.25 to 2.66); if the birth weight was < 1 500 gms OR = 1.52 (95% CI: 1.04 to 2.22); if the admission weight to the KCU was < 1500 grams OR = 2.16 (95% CI: 1.42 to 3.29) or if the age on admission to KCU was 14 days or more OR = 2.15 (95% CI: 1.44 to 3.29). These factors remained significant after adjusting for confounding. Mother's age, parity, booking status or whether admission was during the cold months or not had no significant bearing on the outcome in this unit. Reasons for referral back to NNU included apnoea (27%); respiratory distress (27%); aspiration pneumonia (18%); neonatal jaundice (8%); poor feeding (7%); ill mother (5%); sepsis (4%) and diarrhoea (3%). On multivariate analysis birth weight was the strongest predictor for being referred back to the NNU OR = 10.753 (95% CI: 6.026-19.186).
  
  
  CONCLUSIONS
  Establishment of a KCU at a tertiary level hospital is feasible. Kangaroo care for well preterm infants is suitable for most mothers and their preterm infants. Infants were more likely to be referred back for conventional care if they were male, very low birth weight and if the age at admission was greater than two weeks. Further studies are needed to determine the long term survival of these infants.
authors.affiliation: Department of Paediatrics and Child Health, University of Zimbabwe Medical School, Harare, Zimbabwe.
authors.forename: R A
authors.initials: RA
authors.lastname: Kambarami
authors.forename: O
authors.initials: O
authors.lastname: Chidede
authors.forename: D T
authors.initials: DT
authors.lastname: Kowo
mesh_terms: D000328:Adult; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007224:Infant Care / Q000379:methods*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009034:Mother-Child Relations; D016017:Odds Ratio; D012307:Risk Factors; D016896:Treatment Outcome; D015030:Zimbabwe