Early kangaroo mother care in preterms weighing ≤1250 grams: before and after training program in neonatal nurses

Background: Kangaroo mother care (KMC) is an evidence based approach to reduce mortality and morbidity in preterm neonates. Knowing nurses’ perception to early initiation of KMC will help scale-up this intervention. This study aimed to know barriers to early initiation of KMC in neonates weighing ≤1250 grams among nurses and effect of structured training programme on their perception and KMC provision.Methods: A prospective COHORT study was conducted at level three NICU where 40 nurses were interviewed by a predesigned questionnaire followed by KMC training and practice phase. Repeat survey was conducted at the end of the study to know change in nursing perception.Results: Two themes identified from the pre KMC training questionnaire were: Infant related barriers and nursing practice related barriers. Among infant related barriers KMC training significantly reduced nurses’ hesitation for KMC initiation in neonates with gestation age <28 weeks (45% to 20%), invasive ventilation (55% to 25%), UVC in situ (70% to 50%) and PICC in situ (52.5% to 22.5%). Nurses also felt more confident to continue KMC for longer hours (p value 0.002). Post KMC training initial day of KMC provision improved from 4.8 (±0.89) to 3.8 (±0.83).Conclusions: Identification of barriers to early KMC initiation and addressing them by standardized comprehensive training programme improves nurses’ perception and