{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T16:54:54Z","timestamp":1780678494569,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T00:00:00Z","timestamp":1614297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Kangaroo mother care (KMC) can be challenging in multiple births and more so in resource\u2010limited settings. This study aims at increasing the mean duration of KMC with early initiation in twin preterm neonates born at a tertiary care hospital using a quality improvement (QI) initiative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Barriers for poor KMC practice in twin preterm neonates born at the tertiary care hospital were analysed and baseline data were collected over a period of 4\u00a0months using a predesigned proforma. A QI team was formed and suggested solutions were prioritised through focus group discussions in the form of Plan\u2010Do\u2010Study\u2010Act (P\u2010D\u2010S\u2010A) cycles. Each cycle was of one\u2010month duration and three cycles were implemented, followed by the sustenance phase studied at 1\u2010month post\u2010implementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were a total of 238 twin deliveries in the study period, of which 169 twin pairs were included in the study. At the end of implementation, the average day of initiation of KMC improved from 8th to 3rd day of life and the duration of KMC increased significantly from an average of 2.70\u00a0h\/infant\/day to 7.88\u2009h\/infant\/day.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This QI project focused on the improvement of KMC practice in twin preterm neonates in a tertiary care hospital where results were achieved with maximal utilisation of available hospital resources and low\u2010cost interventions. This study design is generalizable to other hospitals in resource\u2010limited settings where family participatory care can be strengthened to overcome the challenges of KMC in multiple births.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.15406","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T12:14:19Z","timestamp":1614341659000},"page":"1082-1088","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Quality improvement initiative to improve the duration of kangaroo mother care for twin preterm neonates born at a tertiary care hospital in resource\u2010limited settings"],"prefix":"10.1111","volume":"57","author":[{"given":"Pihu","family":"Arora","sequence":"first","affiliation":[{"name":"Department of Paediatrics Vani Vilas Hospital, Bangalore Medical College and Research Institute  Bengaluru India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0196-3824","authenticated-orcid":false,"given":"Anitha","family":"Kommalur","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Vani Vilas Hospital, Bangalore Medical College and Research Institute  Bengaluru India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahana","family":"Devadas","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Vani Vilas Hospital, Bangalore Medical College and Research Institute  Bengaluru India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mallesh","family":"Kariyappa","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Vani Vilas Hospital, Bangalore Medical College and Research Institute  Bengaluru India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suman P N","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Neonatology St. John's Medical college  Bengaluru India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"World Health Organization.Kangaroo Mother Care: A Practical Guide. Department of Reproductive Health and Research World Health Organization;2003Available from:http:\/\/www.who.int\/maternal_child_adolescent\/documents\/9241590351\/en\/[accessed 22 June 2020]."},{"key":"e_1_2_7_3_1","unstructured":"Kangaroo Mother Care and Optimal Feeding of Low Birth Weight Infants. Operational Guidelines. National Heath Mission Government of India;2014. Available from:http:\/\/nhm.gov.in\/images\/pdf\/programmes\/child\u2010healthy\/guidelines\/Family_Participatory_Care_for_Improving_Newborn_Health\u2010Operational_guideline.pdf[accessed 22 June 2020]."},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002771.pub4"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-2063"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13312-019-1635-y"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.15.157818"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0125643"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.17511\/ijpr.2018.i02.08"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-018-5197-z"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jnn.2019.11.008"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14269"},{"key":"e_1_2_7_13_1","first-page":"1070","article-title":"Fertility treatments and multiple births in the United States","volume":"370","author":"Kulkarni AD","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.03.040"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.15537\/smj.2017.6.17699"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13312-018-1372-7"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13445"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-14-293"},{"key":"e_1_2_7_19_1","unstructured":"Family Participatory Care for improving newborn health.Operational Guidelines for Planning and Implementation.2017. Available from:http:\/\/nhm.gov.in\/images\/pdf\/programmes\/child-health\/guidelines\/Family_Participatory_Care_For_Improving_Newborn_Health-Operational_guideline.pdf[accessed on 22 June 2020]."},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13312-021-2194-6"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4017-1"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6909.2006.00024.x"},{"key":"e_1_2_7_23_1","first-page":"6","article-title":"Effectiveness of kangaroo mother care in the management of twin low birth\u2010weight neonates: A non\u2010randomized, open, controlled trial","volume":"9","author":"Gonuguntla Y","year":"2018","journal-title":"Iran. J. 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