Translating research findings into practice--the implementation of kangaroo mother care in Ghana.
BACKGROUND
Kangaroo mother care (KMC) is a safe and effective method of caring for low birth weight infants and is promoted for its potential to improve newborn survival. Many countries find it difficult to take KMC to scale in healthcare facilities providing newborn care. KMC Ghana was an initiative to scale up KMC in four regions in Ghana. Research findings from two outreach trials in South Africa informed the design of the initiative. Two key points of departure were to equip healthcare facilities that conduct deliveries with the necessary skills for KMC practice and to single out KMC for special attention instead of embedding it in other newborn care initiatives. This paper describes the contextualisation and practical application of previous research findings and the results of monitoring the progress of the implementation of KMC in Ghana.


METHODS
A three-phase outreach intervention was adapted from previous research findings to suit the local setting. A more structured system of KMC regional steering committees was introduced to drive the process and take the initiative forward. During Phase I, health workers in regions and districts were oriented in KMC and received basic support for the management of the outreach. Phase II entailed the strengthening of the regional steering committees. Phase III comprised a more formal assessment, utilising a previously validated KMC progress-monitoring instrument.


RESULTS
Twenty-six out of 38 hospitals (68 %) scored over 10 out of 30 and had reached the level of 'evidence of practice' by the end of Phase III. Seven hospitals exceeded expected performance by scoring at the level of 'evidence of routine and institutionalised practice.' The collective mean score for all participating hospitals was 12.07. Hospitals that had attained baby-friendly status or had been re-accredited in the five years before the intervention scored significantly better than the rest, with a mean score of 14.64.


CONCLUSIONS
The KMC Ghana initiative demonstrated how research findings regarding successful outreach for the implementation of KMC could be transferred to a different context by making context-appropriate adaptations to the model.
MRC Unit for Maternal and Infant Health Care Strategies, University of Pretoria, Private Bag X323, Arcadia 0007, Pretoria, South Africa. anne-marie.bergh@up.ac.za
Anne-Marie
AM
Bergh
Rhoda
R
Manu
Karen
K
Davy
Elise
E
van Rooyen
Gloria Quansah
GQ
Asare
J Koku Awoonor
JK
Williams
McDamien
M
Dedzo
Akwasi
A
Twumasi
Alexis
A
Nang-Beifubah
D003159:Community-Institutional Relations; D005869:Ghana; D006284:Health Plan Implementation / Q000379:methods* / Q000458:organization & administration; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D060127:Kangaroo-Mother Care Method; D017146:Models, Organizational; D017064:Process Assessment, Health Care; D057170:Translational Research, Biomedical / Q000379:methods* / Q000458:organization & administration