KNOWLEDGE, ATTITUDE AND PRACTICE OF KANGAROO MOTHER CARE AMONG MOTHERS IN SCBU UBTH

TOPIC IS SUITABLE FOR:
1. Department of Nursing Science
2. Department of Midwifery
3. Department of Public Health
4. Department of Maternal and Child Health

TOPIC: KNOWLEDGE, ATTITUDE AND PRACTICE OF KANGAROO MOTHER CARE AMONG MOTHERS IN SCBU UBTH

TABLE OF CONTENT
Abstract
CHAPTER ONE: INTRODUCTION
1.1 Background of the Study 
1.2 Statement of the Problem 
1.3 Objective of the Study
1.4 Research Questions
1.5 Significance of the Study
1.6 Scope of the Study 
1.7 Definition of Terms  
CHAPTER TWO: REVIEW OF LITERATURE
2.1 Conceptual Review
2.2 Theoretical Framework 
2.3 Empirical Review 
2.4 Summary of Literature Review
CHAPTER THREE: METHODOLOGY    
3.1 Research Design    
3.2 Research Setting         
3.3 Target population                                  
3.4 Sample size 
3.5 Sampling technique    
3.6 Instruments for data collection     
3.7 Validity and Reliability of Instrument
3.8. Pilot Study    
3.9 Method of data collection 
3.10 Method of data analysis     
CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS
4.0 Introduction
4.1 Data Presentation
4.2 Demographic Analysis 
4.3 Analysis of the Level of Knowledge of Kangaroo Mother Care among Mothers in the Special Care Baby Unit of the University of Benin Teaching Hospital
4.4 Analysis of the Attitude of Mothers towards Kangaroo Mother Care in the Special Care Baby Unit of the University of Benin Teaching Hospital
CHAPTER FIVE: DISCUSSION OF FINDINGS
5.1 Discussion of Findings    
5.2 Implications of findings to nursing                            
5.3 Limitations of the study                            
5.4 Summary of the study                                      
5.5 Conclusion                                    
5.6 Recommendations                                 
5.7 Suggestions for further studies
References
Appendix

ABSTRACT
This study was carried out to examine the Knowledge, Attitude and Practice of Kangaroo Mother Care among mothers in the Special Care Baby Unit of the University of Benin Teaching Hospital (UBTH). The study was specifically carried out to determine the level of knowledge of Kangaroo Mother Care among mothers in SCBU UBTH, assess the attitude of mothers towards Kangaroo Mother Care in SCBU UBTH, examine the level of practice of Kangaroo Mother Care among mothers in SCBU UBTH, and identify factors influencing the practice of Kangaroo Mother Care among mothers in SCBU UBTH. The study employed the descriptive survey research design. Hence, the questionnaire was used for data collection, while the data collected were analyzed using frequency tables and percentage scores. A total population of 250 mothers in the Special Care Baby Unit of UBTH was used, while a sample size of 154 was determined using the Taro Yamane formula and a validated sample size of 139 respondents was analyzed using multi-stage sampling technique involving stratified and convenience sampling methods. The participants consisted of mothers with babies admitted in SCBU UBTH. From the responses obtained and analyzed, the findings revealed that 77.0% of respondents demonstrated adequate knowledge of Kangaroo Mother Care, 74.8% showed a positive attitude towards Kangaroo Mother Care, while 71.9% reported regular practice of Kangaroo Mother Care. The study further revealed that 74.8% of respondents agreed that health education and hospital support significantly influenced the practice of Kangaroo Mother Care. The study therefore recommends that nurses and health workers should intensify continuous health education on Kangaroo Mother Care, hospital management should provide enabling environments and adequate facilities to support practice, healthcare providers should ensure consistent guidance and supervision of mothers, and family support systems should be strengthened to improve sustained practice of Kangaroo Mother Care for better neonatal outcomes.
Keywords: Kangaroo Mother Care, Knowledge, Attitude, Practice, Mothers, SCBU, UBTH.

CHAPTER ONE
INTRODUCTION (Preview)
1.1 Background of the Study
Maternal and child health is a core element of Public Health systems everywhere, and more focus is being placed on improving outcomes of early life and neonatal survival. The neonatal period is identified as a critical period in the development of humans, which needs special care and timely interventions to improve survival and long term wellbeing. Early neonatal care practices are known to play a major role in trends of morbidity and mortality in low- and middle-income contexts, as reported by Torres et al, (2021). Likewise, Davidson et al, (2025) highlighted that structured newborn care strategies have a positive influence on physiological stability in the newborn, during the first days of life. Often in health care systems, efforts are focused on improving support systems and infant care in the hospital, especially in special care baby units. Moreover, Mohammed et al, (2023) and Olu-Abiodun et al, (2022) showed that integrated maternal-infant care approaches help in adaptation to extra-uterine life and bonding of mother and infant. Such interventions are now becoming part of the treatment strategies of various health care facilities all over the world, and Adamu A & Isezuo K O (2024) stated maternal engagement in supporting neonatal resilience in the clinical setting.
Kangaroo Mother Care (KMC) is a standard package of care for babies born too early and/or too small, and consists of continuous, close contact between the mother and baby, exclusive breastfeeding, if possible, and early hospital discharge with appropriate follow-up care. Bhattarai & Thapaliya (2025) states that KMC is an evidence-based intervention that focuses on regulating body temperature and preventing neonatal complications related to preterm babies. It makes sure that the baby is upright on the mother's chest, allowing for physiological stability and improved neurodevelopmental outcomes. According to Aziz P M, (2024) skin-to-skin contact helps to initiate breastfeeding and can promote attachment between the mother and infant. Moreover, Adedia et al (2025) and Ogbeye et al (2025) found that KMC helps in decreasing hospital admission and enhancing neonates' weight gain. This technique has special relevance in low-resource areas where there may be limited incubator resources and thus low-cost and effective alternative to manage neonatal care.
The knowledge, attitude, and practice (KAP) approach is a common model that is often used to understand the perceptions of people and how they act on health-related interventions including neonatal care interventions like KMC. Knowledge indicates how aware and how much mothers understand the principles and benefits of KMC and attitude is the feeling, belief and predisposition of mothers to keep-up with the practice. Practice refers to the use of KMC in caring situations. The study by Lawal et al, (2023) highlights the importance of maternal knowledge in the acceptance of newborn care interventions in clinical settings. Osaji et al, (2023) added that positive attitude of mothers towards the neonate improves adherence to recommended neonatal care. In the same way, Mohammed et al (2023) found that women's practices were influenced by health education and counselling provided in the prenatal and postnatal care. Davidson et al, (2025) highlighted that amplifying the KAP dimensions positively influence neonatal adaptation and the quality of newborn care in settings where structured newborn interventions are implemented in the hospital setting.
The Special Care Baby Unit (SCBU) of the University of Benin Teaching Hospital (UBTH) is a tertiary neonatal care unit where specialized care of vulnerable newborns is a frequent occurrence. In this clinical setting, Kangaroo Mother Care is gradually integrated in the care of newborns facing challenges of thermal stability and developmental care, while also being integrated into mother education. Olu-Abiodun et al, (2022) found that Tertiary healthcare institutions are important centres for the promotion of evidence-based practices for newborn care through structured maternal engagement. Adamu A & Isezuo K O, (2024) noted that maternal involvement in the neonatal unit in the hospital setting supports post-admission continuity of care. Also, Lawal et al, (2023) and Ogbeye et al, (2025) reported that exposures in institutional facilities have an impact on maternal knowledge and practice of KMC. Studying mothers' knowledge, attitude and practice of KMC gives a structured way to view the internalization and implementation of the neonatal care interventions in the tertiary healthcare setting of UBTH.

1.2 Statement of the Problem
Despite its important contribution in neonatal morbidity and mortality, maternal and newborn health remains a topic of global attention. In this context, early neonatal interventions and maternal involvement in the care delivered has been well known to be critical parts of good healthcare systems. Kangaroo Mother Care (KMC), an evidence-based neonatal care approach has been integrated into numerous maternal and child health programmes because of its impacts on newborn's stabilization and better survival outcomes. As per Torres et al, (2021) and Bhattarai & Thapaliya, (2025) structured neonatal care practices like KMC are now considered as standard interventions practiced in both high-resource and low-resource health care settings. In the same vein, Olu-Abiodun et al (2022) and Mohammed et al (2023) pointed out that maternal involvement in caring for the newborns enhances the wellbeing of infants and facilitate continuity of care in hospitals. This changing focus on mothers in neonatal care gives a context in which to consider neonatal care in specialist neonatal services.
Atlhough the need for Kangaroo Mother Care is known there is still variability in understanding and practice of KMC among mothers of neonates admitted in the hospital, especially in SBC. Ideally mothers who bring their baby to a Special Care Baby Unit should have a good knowledge, a positive attitude and routinely perform KMC during their stay at the Unit. Despite this, evidence indicates that there is still a gap between the recommended standards and mothers' participation in the KMC practices. According to Lawal et al, (2023) and Osaji et al, (2023) maternal knowledge and attitude play significant role on adoption and maintenance of neonatal care intervention. However, in many clinical settings, there is a lack of awareness and different perceptions of KMC which results in suboptimal practice, thereby reducing the full benefits of KMC for neonatal outcomes. This gap between theory and practice calls attention to the need for continuous professional development in neonatal nursing and for mothers.
There is very little known about mothers' knowledge, attitude and practice on Kangaroo Mother Care in the Special Care Baby Unit, University of Benin Teaching Hospital (UBTH). Although healthcare providers can offer advice on neonatal care practices, there is still limited understanding of how much mothers know and accept, and how well they are able to put into practice KMC in the healthcare environment. Adedia et al, (2025); Mohammed et al, (2023) pointed out the need for localized assessment of the KAP of mothers to design targeted interventions that will improve the outcomes of neonatal care. UBTH SCBU does not provide any context-specific information that would help to understand the determinants of maternal engagement in KMC. This study thus aims to fill this gap by evaluating knowledge, attitudes and practices of Kangaroo Mother Care (KMC) among mothers in SCBU UBTH in order to inform better education of mothers and care for the neonates.
1.3 Objectives of the Study
The main purpose of this study is to assess knowledge, attitude and practice of kangaroo mother care among mothers in SCBU UBTH. The specific objectives of the study seek:
1.Determine the level of knowledge of Kangaroo Mother Care among mothers in the Special Care Baby Unit of the University of Benin Teaching Hospital.
2.Assess the attitude of mothers towards Kangaroo Mother Care in the Special Care Baby Unit of the University of Benin Teaching Hospital.
3.Examine the level of practice of Kangaroo Mother Care among mothers in the Special Care Baby Unit of the University of Benin Teaching Hospital.
4.Identify the factors influencing the practice of Kangaroo Mother Care among mothers in the Special Care Baby Unit of the University of Benin Teaching Hospital
OTHER PARTS OF CHAPTER ONE INCLUDE:
1.4 Research Questions
1.5 Significance of the Study
1.6. Scope of the Study 
1.7 Operational Definition of Terms 

CHAPTER TWO
REVIEW OF LITERATURE (Preview)
This chapter critically examines relevant literature that would assist in explaining the research problem and, furthermore, recognizes the contributions of scholars who have previously conducted studies related to the subject. The chapter intends to deepen the understanding of the study and identify gaps in existing literature. This chapter, therefore, focuses on the concept of Kangaroo Mother Care, knowledge of Kangaroo Mother Care among mothers, attitudes towards Kangaroo Mother Care, practices of Kangaroo Mother Care, benefits and challenges of Kangaroo Mother Care, and factors influencing its adoption among mothers in the Special Care Baby Unit (SCBU) of the University of Benin Teaching Hospital (UBTH). The chapter covers the following subheadings:
2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review
2.4 Summary of Literature Review

CHAPTER THREE
METHODOLOGY (Preview)
Research Design: The study adopted a descriptive research design.
Population of the Study: The population of the study comprises all mothers whose babies were admitted into the Special Care Baby Unit (SCBU) of the University of Benin Teaching Hospital (UBTH), Benin City, Edo State.
Sample Size Determination: The study adopted the Taro Yamane formula to determine a sample size of 154 participants.
Sampling Technique: The study employed a multi-stage sampling technique, involving stratified and convenience sampling, to select the individual respondents.
Research Instrument: The study utilized a structured questionnaire titled “Knowledge, Attitude and Practice of Kangaroo Mother Care among Mothers in the Special Care Baby Unit of the University of Benin Teaching Hospital” as the instrument for data collection.
Methods of Data Analysis: The collected data were analyzed using frequencies and percentages to summarize and present the demographic characteristics of the respondents and their responses. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) and presented in tables, charts, and graphs.

CHAPTER FOUR; DATA PRESENTATION AND ANALYSIS
MAJOR FINDINGS (Preview)
The analysis results were presented in tables. Based on the results obtained from the analysis, the following findings are made:

i. The study found that the level of knowledge of Kangaroo Mother Care among mothers in SCBU UBTH is high, as evidenced by 77.0% of respondents who understood the meaning of Kangaroo Mother Care, 77.7% who knew that skin-to-skin contact is a key component, and 77.0% who were aware that it helps regulate babies’ body temperature. Furthermore, 56.8% disagreed that Kangaroo Mother Care is practiced only by health workers, while 64.1% disagreed that it is not useful for premature or low-birth-weight babies, indicating a good level of knowledge among the mothers.

ii. The study found that mothers generally had a positive attitude towards Kangaroo Mother Care, as evidenced by 74.8% who agreed that it is beneficial for newborn survival and recovery and 74.8% who expressed willingness to practice it when recommended by health workers. Furthermore, 51.1% disagreed that Kangaroo Mother Care is uncomfortable and should be avoided, while 56.8% disagreed that it is less important than incubator care, indicating a generally favourable attitude towards Kangaroo Mother Care.

iii. The study found that the level of practice of Kangaroo Mother Care among mothers in SCBU UBTH is generally high, as evidenced by 71.9% of respondents who regularly practiced it for their babies, 74.8% who practiced skin-to-skin contact for the recommended duration, and 73.4% who ensured proper positioning of their babies during Kangaroo Mother Care. Furthermore, 57.6% disagreed that there was no need to continue Kangaroo Mother Care after hospital advice, indicating a positive level of practice among the mothers.

iv. The study found that health education, availability of time and comfort, and hospital facilities were important factors influencing the practice of Kangaroo Mother Care among mothers in SCBU UBTH. This was evidenced by 74.8% of respondents who agreed that adequate health education from nurses encouraged their practice, 74.8% who indicated that availability of time and comfort influenced their ability to practice it, and 75.5% who agreed that the availability of hospital facilities encouraged consistent practice. Furthermore, 53.3% disagreed that lack of knowledge made Kangaroo Mother Care unnecessary, while 59.0% disagreed that family support did not affect their decision to practice it.

CHAPTER FIVE: DISCUSSION OF FINDINGS
This chapter covers the following outline:
5.1 Discussion of Findings
5.2 Implication of the Findings 
5.3 Limitations of the Study 
5.4 Summary 
5.5 Conclusion
5.6 Recommendations
5.7 Suggestions for Further Studies

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