Holding hope: maternal experiences of kangaroo mother care within sociocultural contexts in Ethiopia

Kangaroo mother care (KMC) is a crucial method for improving the health outcomes of preterm and low birth weight (LBW) infants, particularly in resource-limited settings. However, barriers hinder mothers from effectively practicing KMC. This study aims to explore mothers' perceptions, hopes, and buy-in regarding KMC in a tertiary care center in Ethiopia.

A semistructured interview guide was developed on the basis of a literature review. In-depth interviews were conducted with a purposive sample of mothers who had practiced KMC within the past two years at Saint Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia. The interviews, which were originally conducted in Amharic, were transcribed and translated into English. Thematic analysis was performed independently by three coders, who met regularly to resolve discrepancies and refine the codebook. Thematic saturation was reached after 20 interviews.

The participants were from diverse educational, occupational, and religious backgrounds. Three major themes emerged: (1) personal awareness and acceptance of KMC, where mothers highlighted its advantages for both infants and themselves; (2) Community awareness and acceptance of KMC, where, while Ethiopian culture and religion value mother‒child bonding, specific awareness of KMC was low. Skepticism from family and community members often discourages mothers, adding to their mental burden; and (3) Hope impacts KMC care, with subthemes such as factors that threaten hope, consequences of hopelessness, and factors that support hope. Mothers described how limited awareness and lack of support from partners, families, or communities negatively affected their hope, sometimes leading them to leave against medical advice.

While mothers recognize the benefits of KMC, their ability to sustain it is influenced by external factors, particularly social support. Addressing these barriers through targeted awareness campaigns and emotional and practical support and fostering a supportive environment are essential for improving maternal commitment and enhancing KMC uptake. Future research should explore interventions to strengthen maternal engagement and improve outcomes for preterm and LBW infants.