{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:15:57Z","timestamp":1787015757674,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Timely and prolonged skin\u2010to\u2010skin contact (SSC) immediately after birth is recommended in the Ugandan Clinical Guideline, the 2023 International Research and Practice Guideline on SSC and by the WHO\/UNICEF Baby\u2010Friendly Hospital Initiative. Skin\u2010to\u2010skin contact is safe, low\u2010resource, evidence\u2010based and contributes to short\u2010 and long\u2010term health outcomes. However, practice is inconsistent. A rapid\u2010change intervention, PRECESS (Practice, Reflection, Education and training, Combined with Ethnography for Sustainable Success), encouraged adaptation of the SSC Guideline protocol in a regional referral hospital in Uganda. Fifteen key informants, including leadership and staff members, were interviewed before and after the practice change about perceived barriers and solutions for implementing SSC. The semi\u2010structured pre\u2010 and post\u2010intervention interviews were recorded, transcribed and analyzed for meaningful units and themes. Three themes emerged: (1) Commitment to consistent, evidence\u2010based care within constraints; (2) Addressing knowledge and skill regarding the optimal practice of SSC; and (3) Willingness to \u201ctake\u2010up\u201d the practice change for the benefit of mothers and babies. Our findings support the experiential method of practice change PRECESS to implement immediate, continuous, uninterrupted SSC for at least the first hour after birth. Despite the challenges and barriers identified in key informant interviews, significant progress was made in increasing the duration of SSC for both vaginal and cesarean births. The identified themes provide insight for future implementation of skin\u2010to\u2010skin contact.<\/jats:p>","DOI":"10.1111\/mcn.70047","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T04:30:15Z","timestamp":1747369815000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["\u201cI Am Going to Take It Up\u201d: Implementing Skin\u2010to\u2010Skin Contact in Uganda"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5361-1185","authenticated-orcid":false,"given":"Karin","family":"Cadwell","sequence":"first","affiliation":[{"name":"Healthy Children Project, Inc Harwich Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6277-048X","authenticated-orcid":false,"given":"Anna","family":"Blair","sequence":"additional","affiliation":[{"name":"Healthy Children Project, Inc Harwich Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3789-635X","authenticated-orcid":false,"given":"Kajsa","family":"Brimdyr","sequence":"additional","affiliation":[{"name":"Healthy Children Project, Inc Harwich Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7138-6209","authenticated-orcid":false,"given":"Kristin","family":"Svensson","sequence":"additional","affiliation":[{"name":"Karolinska Institutet Solna Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9592-8330","authenticated-orcid":false,"given":"Melissa","family":"Reyes","sequence":"additional","affiliation":[{"name":"Healthy Children Project, Inc Harwich Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5048-685X","authenticated-orcid":false,"given":"Mike","family":"Kagawa","sequence":"additional","affiliation":[{"name":"College of Health Sciences Makerere University Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4969-6362","authenticated-orcid":false,"given":"Louise Racine","family":"Bastarache","sequence":"additional","affiliation":[{"name":"Harvard Medical Faculty Physicians Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4945-130X","authenticated-orcid":false,"given":"Scovia Nalugo","family":"Mbalinda","sequence":"additional","affiliation":[{"name":"College of Health Sciences Makerere University Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMC.0000000000000521"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aorn.2017.04.003"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12571"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13042"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-83761-1"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.16842"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1891\/1058-1243.21.3.149"},{"key":"e_1_2_10_9_1","first-page":"320","volume-title":"Acta Paediatrica (Oslo, Norway: 1992)","author":"Bystrova K.","year":"2003"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2018.0048"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13597"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1741540"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2019.0202"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2011.0040"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.10.021002"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0254781"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.11124\/JBISRIR-2017-003535"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMC.0000000000000646"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0172623"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.3233\/NPM-210703"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.13227"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-1143"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.16371"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-03638-3"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2009.01597.x"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.15452\/cejnm.2020.11.0021"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2018.09.009"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1080\/08035250216102"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/08035250410023115"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003519.pub4"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.16575"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.12968\/ajmw.2018.0037"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czaa122"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-041829"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.12968\/ajmw.2019.0019"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.5430\/jnep.v6n5p100"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.14754"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2010.01983.x"},{"key":"e_1_2_10_39_1","volume-title":"Competency verification toolkit: Ensuring competency of direct care providers to implement the Baby\u2010friendly Hospital Initiative (Licence: CC BY\u2010NC\u2010SA 3.0 IGO)","author":"World Health Organization (WHO) and the United Nations Children's Fund (UNICEF)","year":"2020"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.15120"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2014.08.014"}],"container-title":["Maternal &amp; Child Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.70047","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T13:39:37Z","timestamp":1758634777000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/mcn.70047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,16]]},"references-count":40,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1111\/mcn.70047"],"URL":"https:\/\/doi.org\/10.1111\/mcn.70047","archive":["Portico"],"relation":{},"ISSN":["1740-8695","1740-8709"],"issn-type":[{"value":"1740-8695","type":"print"},{"value":"1740-8709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,16]]},"assertion":[{"value":"2024-07-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70047"}}