title: Introducing home based skin-to-skin care for low birth weight newborns: a pilot approach to education and counseling in Ghana.
abstract: Skin-to-skin contact (STSC) for low birth weight newborns in community settings may greatly improve survival, especially where access to health facilities is limited. Community STSC has been implemented in large-scale trials in Asia and is recommended by WHO and UNICEF. In countries where the practice is entirely new, such as Ghana, STSC may need special educational approaches.
  
  
  OBJECTIVE
  The dual aims of this study were to understand the acceptance and barriers to STSC in an African community setting and to use in-depth formative research to contribute to the success of a behavior-based health intervention.
  
  
  METHODS
  A rapid qualitative study with an intentionally small sample.
  
  
  METHODS
  Kintampo, Ghana, a predominately rural, agrarian area in the center of the country with diverse ethnic groups in a forest-savannah transition zone.
  
  
  METHODS
  Key informants were consulted through in-depth interviews and focus group discussions to develop the pilot. Five mothers participated in pilot instruction (four refused), which included counseling and used a trials-of-improved-practices methodology; data from group discussion with traditional birth attendants were also included.
  
  
  RESULTS
  It was difficult to overcome barriers to the practice (post partum pain, fear of harming the umbilicus), and less intractable barriers (traditional carrying practices, fear of causing harm, lack of back support, time constraints, breast feeding issues) were reported.
  
  
  CONCLUSIONS
  Some study participants tried STSC but none did it continuously. As promotion of STSC could be vital for improving newborn survival in low resource settings, tackling perceived barriers may be an important way to increase acceptability of this practice.
authors.affiliation: Tulane University School of Public Health and Tropical Medicine, New Orleans, United States.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bazzano
authors.forename: Zelee
authors.initials: Z
authors.lastname: Hill
authors.forename: Charlotte
authors.initials: C
authors.lastname: Tawiah-Agyemang
authors.forename: Alexander
authors.initials: A
authors.lastname: Manu
authors.forename: Guus
authors.initials: G
authors.lastname: Ten Asbroek
authors.forename: Betty
authors.initials: B
authors.lastname: Kirkwood
mesh_terms: D003376:Counseling; D005260:Female; D005869:Ghana; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D060127:Kangaroo-Mother Care Method; D009035:Mothers / Q000193:education*; D010865:Pilot Projects; D036301:Qualitative Research
keywords: community; formative research; kangaroo mother care; low birth weight; newborn; qualitative methodology; skin-to-skin contact