Community Leaders’ Perspectives on Barriers and Facilitating Factors to Kangaroo Mother Care in Mangochi, Malawi: A Qualitative Study

Abstract Background Low-and middle-income countries widely utilize Kangaroo Mother Care (KMC) to care for the Low-Birth Weight Infants (LBWIs). Worldwide, LBWIs is the leading cause of neonatal and child mortality. In Malawi, the government and the notable non-governmental organizations coordinate and collaborate in implementing KMC interventions to reduce neonatal deaths due to LBWIs’ complications. The incorporation of the community leaders’ (CLs) views on KMC access and utilization is optimal in the effective KMC implementation. Therefore, this study aimed to assess CLs perspectives on barriers and facilitating factors to KMC utilization by parents of low birth weight infants (PLBWIs) in Mangochi District, Malawi. Methods The study used purposive and simple random sampling to identify twelve CLs (N = 12) who participated in the two focused group (n = 6) discussions (FGD) conducted in April 2018 in Mangochi district. A structured FGD guide used to obtain the CLs’ perspectives on barriers and facilitating factors to KMC access and utilization by PLBWIs. Thematic content analysis used to analyse the findings. Results Four major themes and sub-themes were established from the study. These included Access (availability of KMC providers, place of delivery, strengthen referral systems, cost, health seeking behaviour, women empowerment and quality of obstetric care), Buy-in (KMC knowledge, causes of LBWIs birth, advantages/outcomes of KMC, attitude towards LBWI and KMC, stigma towards mother with a LBWI and preference of LBWI care), Medical issues (safety and maternal health) and traditional/cultural norms (social obligation and gender roles). Conclusions Despite the identified facilitating and barriers to KMC utilization, the CLs indirectly supported PLBWIs access to KMC by their influential and participatory role in the Malawi National Safe Motherhood approaches, which facilitated women deliver by the skilled birth attendants and utilized KMC. As such, incorporating the CLs in KMC implementation through KMC capacity building and strengthening linkage of local government structures to health local government structures may enhance KMC access and utilization by the community, through the CLs’ influential role in the communities’ uptake of health services. In a way strengthening the Malawi National Community Health Strategy 2017–2022 approaches.