Published in PLOS One on 2026-05-11, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original study title: Evaluating healthcare professionals’ readiness for community-based kangaroo mother care in resource-limited setting
Original authors: Hagos T. Atalay, Victoria J. Kain, Amanda G. Carter
Source: PLOS One • DOI 10.1371/journal.pone.0349104
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Neonatal mortality remains a major public health challenge in low-resource settings. Community-Based Kangaroo Mother Care (cKMC) improves survival outcomes for preterm and low-birthweight infants. However, its implementation is hindered by healthcare professionals’ readiness and the lack of validated tools to assess and support cKMC. This study primarily aimed to assess the readiness of healthcare professionals for the implementation of cKMC. In addition, this study developed and performed preliminary validation of an instrument to measure healthcare professionals’ capability, perception, knowledge, and engagement with cKMC.
A cross-sectional study was conducted among 593 healthcare professionals in northern Ethiopia. A 30-item instrument was developed through literature review, expert consultation, and cognitive interviews. Preliminary psychometric evaluation included content validity, internal consistency reliability, and construct validity testing. Sampling adequacy was confirmed using the Kaiser–Meyer–Olkin measure of 0.82 and Bartlett’s test of sphericity (P < 0.001). Descriptive analyses, Kruskal–Wallis tests, and generalised linear models were applied to examine subscales of readiness and their predictors.
The survey instrument assessing healthcare professionals’ capability, perception, knowledge, and engagement regarding cKMC demonstrated strong psychometric performance (CVI = 0.97; Cronbach’s α = 0.85). An evaluation of construct validity through factor analysis generated four factors: capability, perception, knowledge, and engagement. Total and subscale scores correlated significantly. Only 13.2% of participants had read the national the cKMC guideline, and 73.7% had not received formal training; 55.6% reported inadequate workplace support. In multivariable analyses, prior cKMC experience predicted higher perception scores (p = .029); age predicted knowledge (p < .001); and both age and work experience were associated with higher engagement (p < .001).
The instrument demonstrated satisfactory preliminary reliability and construct validity, providing a context-appropriate measure of healthcare professionals’ readiness to implement cKMC. Although perceptions were positive, substantial gaps in knowledge, familiarity with guidelines, and practical capabilities highlight the need for structured training and institutional support to enhance community-based neonatal care.
Introduction
Neonatal mortality continues to pose a significant global health challenge, particularly in low-resource settings where access to quality maternal and newborn care is limited [1,2]. In Ethiopia, the neonatal mortality rate of 33 per 1,000 live births remains markedly higher than the 2–3 per 1,000 reported in high-income countries [3–6]. The leading contributors to neonatal deaths are preterm birth and low birthweight [7].
Kangaroo Mother Care (KMC) is an approach for caring of premature and low birthweight neonates that involves continuous skin-to-skin contact for at least 8 hours a day, coupled with exclusive breastfeeding [8]. This method has emerged as a cost-effective, evidence-based intervention to improve outcomes of premature and low birthweight neonates, endorsed by the World Health Organisation (WHO) [8,9]. Adopting the core principles of KMC in the community or at home is referred to as community-based kangaroo mother care (cKMC) [8], which has the potential to reduce neonatal mortality by 30% [10,11], decrease hypothermia and neonatal infections, and improve rates of exclusive breastfeeding [12], and a reduction in postpartum depression among mothers [13].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Hagos T. Atalay, Victoria J. Kain, Amanda G. Carter. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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- Evidence brief: Survival status and predictors of mortality among preterm neonates admitted to the neonatal intensive care unit at public hospitals of Harari region and Dire Dawa administration, eastern Ethiopia: Retrospective cohort study 2025
