title: Implementation of kangaroo mother care: a randomized trial of two outreach strategies.
abstract: OBJECTIVE
  To test whether a well-designed educational package on the implementation of kangaroo mother care (KMC) used on its own can be as effective in implementing KMC in a healthcare facility as the combination of a visiting facilitator used in conjunction with the package.
  
  
  METHODS
  Thirty-four hospitals in KwaZulu-Natal Province, South Africa.
  
  
  METHODS
  The hospitals were paired with respect to their geographical location and annual number of births at the facility. One hospital in each pair was randomly allocated to receive either the implementation package alone (group A) or the implementation package and visits from a facilitator (group B). Hospitals in group B received three facilitation visits. All hospitals were evaluated by a site visit 8 mo after launching the process and were scored by means of a progress-monitoring tool.
  
  
  RESULTS
  Successful implementation was regarded as demonstrating evidence of practice (score>10) during the site visit.
  
  
  RESULTS
  Group B scored significantly better than group A (p<0.05). All 17 hospitals in group B demonstrated evidence of practice, with the median score of the group being 15.44 (range 10.29-22.94). Twelve of the hospitals in group A demonstrated evidence of practice and the median score was 11.33 (range 1.08-21.13).
  
  
  CONCLUSIONS
  Successful implementation was achieved in most of the hospitals irrespective of the strategy used. However, facilitation with an implementation package was clearly superior to using a package alone. Some sites do not need facilitation for successful implementation.
authors.affiliation: MRC Research Unit for Maternal and Infant Health Care Strategies and Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Pattinson
authors.forename: Irmeli
authors.initials: I
authors.lastname: Arsalo
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Bergh
authors.forename: Atties F
authors.initials: AF
authors.lastname: Malan
authors.forename: Mark
authors.initials: M
authors.lastname: Patrick
authors.forename: Noel
authors.initials: N
authors.lastname: Phillips
mesh_terms: D000488:Allied Health Personnel / Q000193:education*; D006780:Hospitals, Rural; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000379:methods*; D007318:Inservice Training; D015397:Program Evaluation; D013019:South Africa