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Peer-reviewedCC BY-NC-NDBMC health services research

Barriers and facilitators to utilisation of KMC among preterm babies on CPAP.

  • Tom Didimus Ediamu1
  • Innocent Ayesiga2
  • Victoria Nakibuuka3
  • Ritah A Nazziwa3
  • Richard Idro4
  • Sheba Gitta Nakacubo5
  • Lillian Edith Nalwanga6
  • Cissy Nampijja3
  • Janipher Nakyanzi3
6 affiliations
  1. 1Department of Pediatrics, Makerere University College of Health Sciences, Kampala, Uganda. [email protected].
  2. 2Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda.
  3. 3Department of Paediatrics and Neonatology, St. Francis Hospital Nsambya, Kampala, Uganda.
  4. 4Department of Pediatrics, Makerere University College of Health Sciences, Kampala, Uganda.
  5. 5Department of Research, Global Health Partnerships/THET, Kampala, Uganda.
  6. 6Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda.
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Abstract

Introduction

Preterm births are a leading cause of death and illness, with rates rising in Uganda. CPAP helps with respiratory problems, and kangaroo mother care (KMC) stabilises temperature, encourages bonding, and supports health. Yet, KMC for preterm infants on CPAP is rarely used in countries like Uganda. This study explores challenges and enablers for KMC in these cases.Methods

The study used a cross-sectional design with qualitative methods at St. Francis Hospital Nsambya. NICU healthcare workers were conveniently sampled and interviewed until saturation. Data was transcribed, coded, and analysed thematically in Atlas.ti Version 9.Results

The study included 8 respondents with an average age of 34 years (range: 26-48 years). Barriers and facilitators were categorised into factors related to parents, babies, health workers, and health systems. A total of 22 themes and 20 subthemes emerged, covering both barriers and facilitators. Key barriers included issues such as mothers being sick, misinformation about KMC and CPAP, lack of maternal knowledge, negative attitudes towards KMC, and maternal fear. Additional barriers involved critically ill babies, poor attitudes and limited knowledge among health workers, absence of protocols, staffing shortages, equipment limitations, and timing of KMC. Facilitator themes highlighted paternal involvement and awareness efforts, such as education and counselling to improve maternal knowledge; fostering positive health worker attitudes; training; incentives; functional systems; access to information; early CPAP application; availability of KMC spaces in neonatal units; and integrating KMC into routine quality improvement projects.Conclusion and recommendation

Multiple barriers categorised as health worker, baby, maternal, and health system factors still hinder the effective implementation of KMC among preterm babies on CPAP. Understanding these factors and developing category-specific interventions can enhance the utilisation of KMC, thereby improving outcomes for preterm babies.Clinical trial number

Not applicable.

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Cite

BibTeXRIS
BibTeX
@article{ediamu2026barriers,
  title = {{Barriers and facilitators to utilisation of KMC among preterm babies on CPAP.}},
  author = {Tom Didimus Ediamu and Innocent Ayesiga and Victoria Nakibuuka and Ritah A Nazziwa and Richard Idro and Sheba Gitta Nakacubo and Lillian Edith Nalwanga and Cissy Nampijja and Janipher Nakyanzi},
  journal = {BMC health services research},
  year = {2026},
  month = jul,
  doi = {10.1186/s12913-026-15153-2},
  url = {https://europepmc.org/article/MED/42902377},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Barriers and facilitators to utilisation of KMC among preterm babies on CPAP.
AU  - Tom Didimus Ediamu
AU  - Innocent Ayesiga
AU  - Victoria Nakibuuka
AU  - Ritah A Nazziwa
AU  - Richard Idro
AU  - Sheba Gitta Nakacubo
AU  - Lillian Edith Nalwanga
AU  - Cissy Nampijja
AU  - Janipher Nakyanzi
PY  - 2026
DA  - 2026/07/01
JO  - BMC health services research
DO  - 10.1186/s12913-026-15153-2
UR  - https://europepmc.org/article/MED/42902377
AB  - Introduction  Preterm births are a leading cause of death and illness, with rates rising in Uganda. CPAP helps with respiratory problems, and kangaroo mother care (KMC) stabilises temperature, encourages bonding, and supports health. Yet, KMC for preterm infants on CPAP is rarely used in countries like Uganda. This study explores challenges and enablers for KMC in these cases.Methods  The study used a cross-sectional design with qualitative methods at St. Francis Hospital Nsambya. NICU healthcare workers were conveniently sampled and interviewed until saturation. Data was transcribed, coded, and analysed thematically in Atlas.ti Version 9.Results  The study included 8 respondents with an average age of 34 years (range: 26-48 years). Barriers and facilitators were categorised into factors related to parents, babies, health workers, and health systems. A total of 22 themes and 20 subthemes emerged, covering both barriers and facilitators. Key barriers included issues such as mothers being sick, misinformation about KMC and CPAP, lack of maternal knowledge, negative attitudes towards KMC, and maternal fear. Additional barriers involved critically ill babies, poor attitudes and limited knowledge among health workers, absence of protocols, staffing shortages, equipment limitations, and timing of KMC. Facilitator themes highlighted paternal involvement and awareness efforts, such as education and counselling to improve maternal knowledge; fostering positive health worker attitudes; training; incentives; functional systems; access to information; early CPAP application; availability of KMC spaces in neonatal units; and integrating KMC into routine quality improvement projects.Conclusion and recommendation  Multiple barriers categorised as health worker, baby, maternal, and health system factors still hinder the effective implementation of KMC among preterm babies on CPAP. Understanding these factors and developing category-specific interventions can enhance the utilisation of KMC, thereby improving outcomes for preterm babies.Clinical trial number  Not applicable.
SN  - 1472-6963
ER  -