Health facility support and its influence on weight gain for neonates under Kangaroo Mother Care in Western Kenya

Abstract Introduction Kangaroo Mother Care (KMC) is a recommended cost-effective intervention for low birthweight neonates that promotes neonatal growth, and survival. Its effectiveness is dependent on several factors. This study examines facility factors that influence outcome of KMC in Western Kenya. Methods This was a mixed methods study that examined facility support factors influencing KMC outcomes in Western Kenya. A multi-stage sampling approach was used attain the sample size (275). Data collection involved structured questionnaires for caregivers and key informant interviews (KIIs) for healthcare providers. Quantitative data was analyzed using SPSS v26. Binary logistic regression used to determine influence of facility support on KMC neonates weight gain with α = 0.05. Qualitative data from 12 KIIs was thematically analyzed to provide deeper insights into the factors affecting KMC implementation. Results The average facility KMC implementation score was 10.78±2.59 out of 19 (56.71%±13.65%). Only 38.18% of neonates achieved the recommended daily weight gain (≥15g/kg). Average daily weight gain was 12.96g±4.85g. The average length of stay on KMC was 36.25±10.09 days, less than the average recommended 41.21±16.02 days for optimal weight gain. Facility-related predictors of achieving ≥15g/kg daily weight gain included the availability of breast pumps (AOR:2.81, P=0.009), milk banks (AOR:3.22, P=0.004), adequate food for mothers (AOR:5.32, P<0.001), seating for mothers (AOR:3.72, P=0.001), dedicated rooms for breast milk expression (AOR:4.77, P<0.001), presence of easily understandable KMC information (AOR:2.86, P=0.007), family-centered KMC support (AOR:2.41, P=0.032), and adequate staffing for KMC (AOR:3.44, P=0.002). The qualitative data showed that nurses played key roles in clinical care, education, research, advocacy, and community engagement for KMC. While formal training improved competency, gaps remained, emphasizing the need for continuous learning.. Conclusions Facility level support is crucial for maximizing benefits of KMC especially through provision of maternal nutrition, infrastructure support, guaranteeing maternal comfort, family-centered care and adequate staffing.