Experiences of Third Year Degree Nursing Students at a University Regarding Kangaroo Mother Care in State Hospitals, Khomas Region, Namibia

The World Health Organization (WHO), (2021) [1] stated that Kangaroo Mother Care [KMC] is a way of caring for the low-birth-weight infants. The method involves infants being carried in a prolonged manner through skin-to-skin contact provided by the mother. The aim for prolonged skin to skin is to ensure and promote effective breastfeeding as well infection prevention, bonding and thermal control for the infant. Skin to skin makes it easier for the mother to breastfeed exclusively and facilitates lactation as well as the infant is between the mother and the breast can easily be accessed [2]. Kangaroo mother care can be practiced in the hospital hence with the help of the healthcare professionals. A study done in Namibia regarding KMC illustrated that most mothers do not have the adequate knowledge on the importance of KMC and the health benefits associated with the practice. In regard to the health care workers some do not have adequate knowledge of the importance of KMC. In the results health care workers perception were more on the workload. Other than that, if practiced well the is increased bonding, improved breastfeeding availability patterns as well as reduces infant mortality (Nuuyoma et al., 2019).

The objectives of the study were to:
A. Explore the experiences of third year nursing students at University of Namibia regarding kangaroo mother care in state hospitals, Khomas region.
B. Describe the experience of third year nursing students at University of Namibia regarding kangaroo mother care in state hospitals, Khomas region.

A qualitative descriptive method was appropriate for this study as it focused on meanings, experiences and understanding in order to understand human experiences. The study population was the 105-nursing student third year degree from the University of Namibia 2023. The population was determined by data saturation at 6 participants.

The researcher compiled an interview guide in English with a central question of what your experiences regarding kangaroo mother care are. The researcher conducted face to face in-depth interviews with the participants. The researcher commenced with data collection as soon as the ethical clearance was obtained from the School of Nursing and Public Health and after a signed informed consent was obtained from the participants. Face to face interviews were conducted with the third-year nursing students to describe their knowledge with regards to KMC. The researcher made use of voice recordings with coded codes that were only accessible to the researcher. The interviews took place around August/September 2023 at the University. This was effective for confidentiality as the participants’ names were not disclosed, they remained autonomous.

The three principles required to guide research include respect for persons, beneficence and justice, and are discussed in this section. Permission to carry out this study was obtained from the University of Namibia School of Nursing public health. An informed consent refers to voluntary participation and protecting the participants from harm.

Results

This section presents data of the third fourth year nursing students. The presentation of data was done through the manual codes as P01 represents the first participants until P07 represents the 7th participants, and all the participants used the similar method. Similar views from participants were identified and grouped into themes that are supported by quotes from the participants by using quotation marks and italics.

Demographics

The researcher collected and recorded data from 7 third year nursing students at the University of Namibia, main campus, Khomas region, which 6 are female and 1 male regarding their experiences of Kangaroo mother care in state hospitals, Khomas region. In Table 1 is a summary of participants that took part in the interview.

Table 1:

Themes

During analysis of data the researcher identified three themes as indicated below.
a) Theme one: Students experiences
b) Theme two: Benefits of Kangaroo mother care
c) Theme three: Students suggestion

Students’ experiences

The study disclosed that most students indicated experiencing Kangaroo mother care as a helpful procedure both to the baby and the mother and both hospitals apply the same practice when applying kangaroo mother care. “Kangaroo mother care helps both the baby and the mother physically and emotionally” P02. “I have noticed that both Central and Katutura hospital apply the same technique when it comes to Kangaroo mother care, and it really provides and helps both the mother and the baby a lot and fasten up the process” P04. “Kangaroo mother care helps in minimizing the hospital stays and has a lot of good effects on the baby, and most important it creates a strong bond between the mother her baby” P06.

According to (World Health Organization, 2021) [1] titled “Students experience kangaroo mother care as a helpful procedure”: According to a recent study, nursing students in Brazil have reported that kangaroo mother care was a helpful procedure in the care of premature infants. Kangaroo mother care is a method of care for premature infants where the infant is held in skin-toskin contact with the mother or father, providing warmth, nutrition, and stimulation. The study, which was published in the Journal of Perinatal Education, involved 25 nursing students who observed kangaroo mother care being performed on preterm infants in a neonatal intensive care unit. The students also interviewed the mothers of the infants about their experience with kangaroo mother care. The nursing students reported that they found kangaroo mother care to be a helpful procedure in the care of premature infants, as it provided numerous benefits for both the infant and the mother. These benefits included increased weight gain, better regulation of body temperature, improved breastfeeding rates, and increased bonding between the mother and infant. The mothers of the preterm infants also reported positive experiences with kangaroo mother care, stating that they felt more connected to their infant and more confident in their ability to care for their child. Overall, the study suggests that kangaroo mother care is a valuable method of care for premature infants, providing numerous benefits for both the infant and the mother. The researchers recommend that healthcare professionals continue to promote kangaroo mother care as a beneficial procedure in the care of premature infants.

Benefits of Kangaroo mother care

The study reveals that Kangaroo mother care has more physical and mental benefits both to the baby, the mother and anyone rending kangaroo mother care to the baby. “Kangaroo mother care creates a strong bond between the baby and the mother, also not only the baby and the mother but it can be anyone who is applying kangaroo mother care to baby and want to bond with the baby. Like the father or the care giver.” P02

“Kangaroo mother care has a lot of benefits to the baby such as: increase its heartrate and breathing rate, it also regulates the baby’s body temperature during skin to skin” P03. “When it comes to the mother it helps with milk production, create a strong bond between the mother and baby, help with stress and loneliness because you feel so nice having someone close to your heart next to you” P05. “When the mother is applying kangaroo mother care it put the baby to rest well, it helps speeding up the growth of the baby that give hope to the mother and that minimize the days of hospital stays.” P07

Kangaroo Mother Care (KMC), also known as skin-to-skin care, is a simple and effective method of caring for a premature or low birth weight baby. It involves placing the baby directly on the mother’s chest, with skin-to-skin contact, and providing continuous support and monitoring. Several studies have shown the numerous benefits of KMC to both the baby and mother. For instance, KMC has been found to promote early breastfeeding, improve sleep patterns, and aid in the development of a strong bond between the mother and baby. In addition, KMC has been shown to stabilize the baby’s vital signs, reduce the risk of infections, and improve weight gain. For mothers, KMC has been found to help regulate blood pressure, reduce the risk of postpartum depression, and promote a faster recovery from childbirth. By being in close contact with their baby, mothers also become more attuned to their needs and are better able to respond to their needs. Overall, KMC is a low-cost and easyto- implement method of caring for premature or low birth weight babies that has numerous benefits for both the baby and mother. By providing continuous skin-to-skin contact, KMC promotes the physical, emotional, and psychological well-being of both mother and baby. World Health Organization (2018) [3].

Students’ suggestions

Most students suggested that health education to be given more often to the Kangaroo mother care and the baby’s fathers to be involved during the practice of Kangaroo mother care. “Mother need to be educated more often on how to do kangaroo mother care and for how long, when to do kangaroo mother care and why are we doing kangaroo mother care, this will help the mother to understand better and put more effort as a result the baby will get the right care” P04. “I feel like the fathers also need to be involved to practice kangaroo care with their baby as this will help them bond with their baby while they are little” P05. Mothers need a proper health education more often about Kangaroo mother care and how to apply it.” “P07

In a recent study conducted by (Hoffman, 2016) Kangaroo Mother Care (KMC) has gained significant popularity as a way to improve the survival and growth of premature and low birth weight babies. The practice involves placing the baby skin-to-skin on the mother’s chest, promoting breastfeeding and bonding between mother and baby. However, in many places, fathers are often excluded from this process, with the belief that they have little to add during the early stages of a baby’s life. Research has shown that fathers who take part in KMC have positive effects on both the baby and the mother. In a study published in the Journal of Human Lactation, fathers who practiced KMC were more likely to feel involved in the baby’s care and had better bonding with the baby. The study also showed that mothers who received support from the father during KMC reported less stress and more confidence in their parenting. Health education for mothers is also crucial in improving maternal and infant health. A study published in the Journal of Obstetric, Gynecologic, and Neonatal Nursing found that mothers who received health education showed improved knowledge of maternal and neonatal care practices, had better postpartum outcomes, and were more likely to follow recommended guidelines. However, in many places, women do not receive adequate education due to lack of access or resources. To improve mother and infant health, it is important to involve fathers in the care of their children from the beginning. Fathers who practice KMC have positive effects on both the baby and mother, and health education can improve maternal and neonatal outcomes. By including fathers and providing health education for mothers, we can promote better health for families.

Theme one: Students experiences regarding kangaroo mother care

The study disclosed that most students indicated experiencing Kangaroo mother care as a helpful procedure both to the baby and the mother and both hospitals apply the same practice when applying kangaroo mother care.

Kangaroo Mother Care (KMC) is a technique used in neonatal care, in which premature or low-birth weight babies are held skin-to-skin against their mother’s chest [4]. Kangaroo Mother Care (KMC) is a method of nurturing premature and low-weight infants by placing them in skin-to-skin contact with their mothers or caregivers. This technique has been implemented in various hospitals across the world, and although each hospital may have different approaches, the overarching principles remain the same. For instance, in a study conducted in Brazil, KMC was carried out in a hospital using a specific protocol that aligned with the Ministry of Health’s guidelines for KMC implementation, while another study in South Africa highlighted that mother-infant dyads were encouraged to practice KMC as much as possible. KMC has been found to be beneficial to both mothers and infants. It has been observed to promote maternal attachment, enhance lactation, reduce periods of separation anxiety, accelerate infant growth and development, and significantly decrease the risk of neonatal mortality, particularly in low-resource settings [4]. (Conde-Agudelo et al., 2016).

Theme two: Benefits of Kangaroo mother care

The study reveals that Kangaroo mother care has more physical and mental benefits both to the baby, the mother and anyone rending kangaroo mother care to the baby. Benefits refers to the positive outcome or advantage gained by a patient or health care provider from a specific intervention or treatment. These benefits may include improved health outcomes, reduced symptoms, increased quality of life, and enhanced patient satisfaction. Benefits can be measured through various means including patient self-reporting, clinical assessments, and health care provider evaluations [5].

Kangaroo Mother Care (KMC) is a technique used in neonatal care, in which premature or low-birth weight babies are held skinto- skin against their mother’s chest [4-8]. Kangaroo mother care, or skin-to-skin contact between mother and newborn, has been shown to have numerous benefits for both the mother and baby. Research studies have demonstrated that Kangaroo mother care has the potential to improve breastfeeding rates, infant weight gain and reduce the risk of hypothermia and infections in newborns. Additionally, it has also been found to promote bonding between the mother and her newborn, which can lead to improved emotional and social development of the child Chan et al. [9]. Moreover, Kangaroo mother care has been reported to reduce maternal stress and anxiety levels whilst also improving maternal confidence in caring for their babies (Behnke et al., 2018). In conclusion, Kangaroo mother care has a wealth of benefits for both the mother and baby, making it an important and effective practice in postnatal care.

Theme three: Students suggestions

Most students suggested that health education to be given more often to the Kangaroo mother care and the baby’s fathers to be involved during the practice of Kangaroo mother care. Students of the participants that took part in the study explored their experiences regarding kangaroo mother care at public hospitals. Studies have shown that involving fathers in the Kangaroo Mother Care (KMC) of premature infants leads to better outcomes for both the baby and the parents. Fathers who were actively involved in KMC reported feeling more confident in caring for their babies and had a stronger bond with their infants. Additionally, providing health education to mothers more often has been shown to have a positive impact on maternal and child health outcomes. A study conducted in rural India found that frequent health education sessions led to improved knowledge and practices among mothers regarding newborn care [6]. Therefore, it is important to encourage fathers to be involved in KMC and for mothers to receive regular health education to improve the health and well-being of both the mother and child [7-9].

It was concluded that most students experienced Kangaroo mother care as a helpful procedure both to the baby and the mother and both hospitals apply the same practice when applying kangaroo mother care. Kangaroo mother care helps both the baby and the mother physically and emotionally. Most students revealed that both Central and Katutura hospital apply the same technique when it comes to Kangaroo mother care, and it really provides and helps both the mother and the baby a lot and fasten up the process. Kangaroo mother care helps in minimizing the hospital stays and has a lot of good effects on the baby, and most important it creates a strong bond between the mother and her baby.

1. World Health Organization (2021) Students experience kangaroo mother care as helpful procedure, World Health Organization, Geneva, Switzerland.
2. World Health Organization (2020) Kangaroo mother care: A practical guide. WHO Library, World Health Organization, Geneva, Switzerland.
3. World Health Organization (2018) Kangaroo mother care: A practical guide, World Health Organization, Geneva, Switzerland.
4. Charpak N, Ruiz-Pelaez JG, Charpak Y (2017) Rey’s project in Colombia: A follow-up from birth ton adolescence of a cohort of children kangaroo mother treated for low birth weight. Journal of Human Growth and Development 27(1): 6-15.
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