Postnatal mothers’ perceptions and experiences of kangaroo care: A qualitative study in a low-resource setting
Abstract
Background & Aim: Prematurity is the leading cause of death among children under five years of age globally. Alarmingly, in low-income countries, more than 90% of extremely preterm-born babies die within the first few days of life. Kangaroo care is an effective method in the management of preterm babies. The study aimed to explore perceptions and experiences of postnatal mothers on Kangaroo care at a selected hospital in Sri Lanka.
Methods & Materials: This exploratory descriptive qualitative study was carried out with seventeen purposively selected postnatal mothers who were practicing Kangaroo care in the Neonatal Care Unit at District General Hospital in Kalutara, Sri Lanka. Data collection was done through in-depth interviews using an interview guide between the period of July 2021 and November 2021. The interviews were recorded and transcribed verbatim. The inductive content analysis method described by Graneheim and Lundman was employed for data analysis.
Results: Participants were mainly Sinhalese, married, and aged between 20-40 years. The analysis revealed one overarching theme: ‘Despite the obstacles, Kangaroo care is a blessing,’ which was further characterized by two main categories: positive perceptions and experiences, and negative perceptions and experiences. Positive perceptions and experiences are described under good practice, supportive role, and benefits. Negative perceptions and experiences are described under separation and obstacles.
Conclusion: The participating mothers’ perceptions and experiences of Kangaroo care blended with both positive and negative dimensions, which were shaped by contextual factors; hence, addressing these factors is imperative for the successful implementation of Kangaroo care.
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8. Al-Shehri H, Binmanee A. Kangaroo mother care practice, knowledge, and perception among NICU nurses in Riyadh, Saudi Arabia. International Journal of Pediatrics and Adolescent Medicine. 2021;8(1):29-34. https://doi.org/10.1016/j.ijpam.2019.11.003
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12. Hagen IH, Iversen VC, Svindseth M. Differences and similarities between mothers and fathers of premature children: A qualitative study of parents’ coping experiences in a neonatal intensive care unit. BMC Pediatrics. 2016;16:1-9.
13. Fowler C, Green J, Elliott D, Petty J, Whiting L. The forgotten mothers of extremely preterm babies: A qualitative study. Journal of Clinical Nursing. 2019 Jun;28(11-12):2124-34.
14. Campbell-Yeo ML, Disher TC, Benoit BL, Johnston CC. Understanding kangaroo care and its benefits to preterm infants. Pediatric Health, Medicine and Therapeutics. 2015 Mar 18:15-32. https://doi.org/10.2147/PHMT.S51869
15. Liyanage G. Kangaroo mother care. Sri Lanka journal of Child health.2005; 34(1), 13 – 17.
16. Rowel D, Cooray K, Silva SD. Available at: http://www.ideassonline.org/pdf/sriLankaAlbaniaMKDocument.pdf. Accessed October 25, 2020.
17. Polit DF, Beck CT.. Nursing Research: Generating and Assessing Evidence for Nursing Practice (Tenth Edition). Delhi, India: Walters Kluwer. 2016.
18. Blomqvist Y T, Nyqvist KH. Swedish mothers’ experience of continuous Kangaroo Mother Care. Journal of Clinical Research. 2010; 20, 1472 - 1480.
19. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today. 2004;24(2):105-12.
20. Lincoln YS, Guba EG. Naturalistic inquiry. Sage; 1985.
21. McLeod S. John Bowlby’s attachment theory. Simply Psychology. 2007.
22. Kanodia P, Bora R, Gupta, A. Kangaroo Mother Care- A Cost-Effective and an Alternate Method to Manage Hypothermia in Low Birth Weight Babies for Better Clinical Outcome. Value in Health. 2016; 19(7). doi:10.1016/j.jval.2016.09.338.
23. Narciso LM, Beleza LO, Imoto AM. The effectiveness of Kangaroo Mother Care in the hospitalization period of preterm and low birth weight infants: Systematic review and meta-analysis. Jornal de Pediatria. 2022; 98(02):117-25. doi:10.1016/j.jped.2021.06.004
24. Eksirinimit T, Punthmatharith B, Bansopit N, Kusola K. Effects of Kangaroo Care on body temperature of premature infants and maternal satisfaction at Maharaj Nakhon Si Thammarat hospital, Thailand. Journal of Neonatal Nursing. 2023; 29(2):302-6. doi:10.1016/j.jnn.2022.07.005
25. Sharma D, Murki S, Oleti TP. To compare cost cost-effectiveness of ‘Kangaroo Ward Care’ with ‘Intermediate intensive care’ in stable very low birth weight infants. Italian Journal of Pediatrics Volume. 2016; 42(64). doi:10.1186/s13052-016-0274-3
26. Tarus TK. Mothers' experiences and perceptions of Kangaroo Mother Care during hospitalization of their preterm babies. [Ph.D. thesis]. 2008. Available at: http://wiredspace.wits.ac.za/handle/10539/5721. Accessed on December 16, 2020.
27. Boundy EO, Dastjerdi R, Spiegelman D, Fawzi WW, Missmer SA, Lieberman E, Kajeepeta S, Wall S, Chan GJ. Kangaroo Mother Care and Neonatal Outcomes: A Meta-analysis. Pediatrics.2016; 137(1). doi:10.1542/peds.. 2015-2238
28. Salimi T, Khodayarian M, Bokaie M, Antikchi M, Javadi S. Mothers’ experiences with premature neonates about Kangaroo care: Qualitative approaches. International Journal of Pediatrics. 2014;2(1):75-82.
29. Parsa P, Karimi S, Basiri B, Roshanaei G. The effect of kangaroo mother care on physiological parameters of premature infants in Hamadan City, Iran. The Pan African Medical Journal. 2018;30. doi:10.11604/pamj.2018.30.89.14428
30. Mirnia K, Osborne JW, Sharif-Nia H, Sánchez-Teruel D, Fomani FK, Mirzaei N. The effects of kangaroo care on delirium management in neonates under non-invasive mechanical ventilation: A randomized controlled trial. Nursing Practice Today. 2025;12(1):85-97.
31. Blomqvist YT, Frölund L, Rubertsson C, Nyqvist KH. Provision of Kangaroo Mother Care: supportive factors and barriers perceived by parents. Scandinavian Journal of Caring Sciences. 2013;27(2):345-53. https://doi.org/10.1111/j.1471-6712.2012.01040.x
32. Seidman G, Unnikrishnan S, Kenny E, Myslinski S, Cairns-Smith S, Mulligan B, Engmann C. Barriers and enablers of kangaroo mother care practice: A systematic review. PloS one. 2015;10(5):e0125643. https://doi.org/10.1371/journal.pone.0125643
33. Mathias CT, Mianda S, Ginindza TG. Facilitating factors and barriers to accessibility and utilization of kangaroo mother care service among parents of low birth weight infants in Mangochi District, Malawi: A qualitative study. BMC Pediatrics. 2020;20:1-2.
34. Asmare MG, Murugan R, Adimasu M. Perceived Enablers and Barriers of Kangaroo Mother Care among Mothers and Nurses in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Qualitative Study. Iranian Journal of Neonatology. 2021;12(4). doi:10.22038/IJN.2021.53431.1976
35. Smith ER, Bergelson I, Constantian S, Valsangkar B, Chan GJ. Barriers and enablers of health system adoption of kangaroo mother care: A systematic review of caregiver perspectives. BMC Pediatrics. 2017;17:1-6. doi:10.1186/s12887-016-0769-5
36. Robertson AE, Crowley T. Adolescent mothers’ lived experiences whilst providing continuous kangaroo mother care: A qualitative study. Health SA Gesondheid. 2020;25. doi: https://doi.org/10.4102/hsag.v25i0.1450
37. Naloli M, Ssenyonga LV, Kagoya EK, Nteziyaremye J, Nekaka R. Kangaroo mother care: a qualitative study on the practice and experiences of mothers of preterm neonates in a tertiary teaching hospital in eastern Uganda. International Journal for Research in Health Sciences and Nursing. 2021 Nov;7(11):1890.
38. Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review. 1977 Mar;84(2):191.
2. UNICEF. World Prematurity Day 2022. Available at: https://www.unicef.org/vietnam/press-releases/world-prematurity-day-2022.
3. Evereklian M, Posmontier B. The impact of kangaroo care on premature infant weight gain. Journal of Pediatric Nursing. 2017 May; 1;34:e10-6. https://doi.org/10.1016/j.pedn.2017.02.006
4. Sivanandan S, Sankar MJ. Kangaroo mother care for preterm or low birth weight infants: a systematic review and meta-analysis. BMJ Global Health. 2023 Jun 1;8(6):e010728.
5. Lanerolle S, Ranatunga RM. Reducing the Burden of Prematurity–The Obstetric Perspective. Sri Lanka Journal of Perinatal Medicine. 2020 Dec 1;1(1).
6. Lawal TV, Lawal DI, Adeleye OJ. Determinants of Kangaroo Mother Care among low-birth-weight infants in low-resource settings. PLOS Global Public Health. 2023 Sep 12;3(9):e0002015.
7. Kostandy RR, Ludington‐Hoe SM. The evolution of the science of kangaroo (mother) care (skin‐to‐skin contact). Birth Defects Research. 2019 Sep 1;111(15):1032-43. https://doi.org/10.1002/bdr2.1565
8. Al-Shehri H, Binmanee A. Kangaroo mother care practice, knowledge, and perception among NICU nurses in Riyadh, Saudi Arabia. International Journal of Pediatrics and Adolescent Medicine. 2021;8(1):29-34. https://doi.org/10.1016/j.ijpam.2019.11.003
9. Aldirawi A, El-Khateeb A, Mustafa AA, Abuzerr S. Mothers’ knowledge of health care for premature infants after discharge from neonatal intensive care units in the Gaza Strip, Palestine. Open Journal of Pediatrics. 2019;9(03):239. http://creativecommons.org/licenses/by/4.0/
10. Nirubaa U, Sathiadas MG. Maternal stress level when a baby is admitted to the neonatal intensive care unit at Teaching Hospital Jaffna, and the influence of maternal and infant characteristics on this level. Sri Lanka Journal of Child Health, 2016; 45(2), 90-94.
11. Norén J, Nyqvist KH, Rubertsson C, Blomqvist YT. Becoming a mother- Mothers’ experience of kangaroo mother care. Sexual & Reproductive Healthcare. 2018; 1;16:181-5. https://doi.org/10.1016/j.srhc.2018.04.005
12. Hagen IH, Iversen VC, Svindseth M. Differences and similarities between mothers and fathers of premature children: A qualitative study of parents’ coping experiences in a neonatal intensive care unit. BMC Pediatrics. 2016;16:1-9.
13. Fowler C, Green J, Elliott D, Petty J, Whiting L. The forgotten mothers of extremely preterm babies: A qualitative study. Journal of Clinical Nursing. 2019 Jun;28(11-12):2124-34.
14. Campbell-Yeo ML, Disher TC, Benoit BL, Johnston CC. Understanding kangaroo care and its benefits to preterm infants. Pediatric Health, Medicine and Therapeutics. 2015 Mar 18:15-32. https://doi.org/10.2147/PHMT.S51869
15. Liyanage G. Kangaroo mother care. Sri Lanka journal of Child health.2005; 34(1), 13 – 17.
16. Rowel D, Cooray K, Silva SD. Available at: http://www.ideassonline.org/pdf/sriLankaAlbaniaMKDocument.pdf. Accessed October 25, 2020.
17. Polit DF, Beck CT.. Nursing Research: Generating and Assessing Evidence for Nursing Practice (Tenth Edition). Delhi, India: Walters Kluwer. 2016.
18. Blomqvist Y T, Nyqvist KH. Swedish mothers’ experience of continuous Kangaroo Mother Care. Journal of Clinical Research. 2010; 20, 1472 - 1480.
19. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today. 2004;24(2):105-12.
20. Lincoln YS, Guba EG. Naturalistic inquiry. Sage; 1985.
21. McLeod S. John Bowlby’s attachment theory. Simply Psychology. 2007.
22. Kanodia P, Bora R, Gupta, A. Kangaroo Mother Care- A Cost-Effective and an Alternate Method to Manage Hypothermia in Low Birth Weight Babies for Better Clinical Outcome. Value in Health. 2016; 19(7). doi:10.1016/j.jval.2016.09.338.
23. Narciso LM, Beleza LO, Imoto AM. The effectiveness of Kangaroo Mother Care in the hospitalization period of preterm and low birth weight infants: Systematic review and meta-analysis. Jornal de Pediatria. 2022; 98(02):117-25. doi:10.1016/j.jped.2021.06.004
24. Eksirinimit T, Punthmatharith B, Bansopit N, Kusola K. Effects of Kangaroo Care on body temperature of premature infants and maternal satisfaction at Maharaj Nakhon Si Thammarat hospital, Thailand. Journal of Neonatal Nursing. 2023; 29(2):302-6. doi:10.1016/j.jnn.2022.07.005
25. Sharma D, Murki S, Oleti TP. To compare cost cost-effectiveness of ‘Kangaroo Ward Care’ with ‘Intermediate intensive care’ in stable very low birth weight infants. Italian Journal of Pediatrics Volume. 2016; 42(64). doi:10.1186/s13052-016-0274-3
26. Tarus TK. Mothers' experiences and perceptions of Kangaroo Mother Care during hospitalization of their preterm babies. [Ph.D. thesis]. 2008. Available at: http://wiredspace.wits.ac.za/handle/10539/5721. Accessed on December 16, 2020.
27. Boundy EO, Dastjerdi R, Spiegelman D, Fawzi WW, Missmer SA, Lieberman E, Kajeepeta S, Wall S, Chan GJ. Kangaroo Mother Care and Neonatal Outcomes: A Meta-analysis. Pediatrics.2016; 137(1). doi:10.1542/peds.. 2015-2238
28. Salimi T, Khodayarian M, Bokaie M, Antikchi M, Javadi S. Mothers’ experiences with premature neonates about Kangaroo care: Qualitative approaches. International Journal of Pediatrics. 2014;2(1):75-82.
29. Parsa P, Karimi S, Basiri B, Roshanaei G. The effect of kangaroo mother care on physiological parameters of premature infants in Hamadan City, Iran. The Pan African Medical Journal. 2018;30. doi:10.11604/pamj.2018.30.89.14428
30. Mirnia K, Osborne JW, Sharif-Nia H, Sánchez-Teruel D, Fomani FK, Mirzaei N. The effects of kangaroo care on delirium management in neonates under non-invasive mechanical ventilation: A randomized controlled trial. Nursing Practice Today. 2025;12(1):85-97.
31. Blomqvist YT, Frölund L, Rubertsson C, Nyqvist KH. Provision of Kangaroo Mother Care: supportive factors and barriers perceived by parents. Scandinavian Journal of Caring Sciences. 2013;27(2):345-53. https://doi.org/10.1111/j.1471-6712.2012.01040.x
32. Seidman G, Unnikrishnan S, Kenny E, Myslinski S, Cairns-Smith S, Mulligan B, Engmann C. Barriers and enablers of kangaroo mother care practice: A systematic review. PloS one. 2015;10(5):e0125643. https://doi.org/10.1371/journal.pone.0125643
33. Mathias CT, Mianda S, Ginindza TG. Facilitating factors and barriers to accessibility and utilization of kangaroo mother care service among parents of low birth weight infants in Mangochi District, Malawi: A qualitative study. BMC Pediatrics. 2020;20:1-2.
34. Asmare MG, Murugan R, Adimasu M. Perceived Enablers and Barriers of Kangaroo Mother Care among Mothers and Nurses in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Qualitative Study. Iranian Journal of Neonatology. 2021;12(4). doi:10.22038/IJN.2021.53431.1976
35. Smith ER, Bergelson I, Constantian S, Valsangkar B, Chan GJ. Barriers and enablers of health system adoption of kangaroo mother care: A systematic review of caregiver perspectives. BMC Pediatrics. 2017;17:1-6. doi:10.1186/s12887-016-0769-5
36. Robertson AE, Crowley T. Adolescent mothers’ lived experiences whilst providing continuous kangaroo mother care: A qualitative study. Health SA Gesondheid. 2020;25. doi: https://doi.org/10.4102/hsag.v25i0.1450
37. Naloli M, Ssenyonga LV, Kagoya EK, Nteziyaremye J, Nekaka R. Kangaroo mother care: a qualitative study on the practice and experiences of mothers of preterm neonates in a tertiary teaching hospital in eastern Uganda. International Journal for Research in Health Sciences and Nursing. 2021 Nov;7(11):1890.
38. Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review. 1977 Mar;84(2):191.
| Issue | Articles in Press | |
| Section | Original Article(s) | |
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| kangaroo-mother care method premature birth newborn Sri Lanka | ||
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How to Cite
1.
de Silva GS, Jayathilake MRS. Postnatal mothers’ perceptions and experiences of kangaroo care: A qualitative study in a low-resource setting. Nurs. pract. today. 2025;:X-X.
