{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T18:29:01Z","timestamp":1786386541091,"version":"build-2736575974"},"reference-count":53,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Breastfeeding Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In 2020, \u223c13.4 million newborns were born preterm worldwide, with 65% occurring in sub-Saharan Africa and Southern Asia. In Ethiopia, fewer than 10% of eligible newborns received Kangaroo Mother Care (KMC) in 2021, despite WHO endorsement. This study evaluated effective early KMC (EeKMC) coverage and associated factors in northwest Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A facility-based cross-sectional study with a convergent parallel mixed-methods design was conducted from October 2024 to November 2025. Quantitative data were extracted from existing hospital records (secondary data) for 713 low-birth-weight neonates (&lt;2,000 g). EeKMC was defined as \u22658 hours of skin-to-skin contact combined with exclusive breastfeeding within 24 hours of birth. Qualitative data were collected through in-depth interviews (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 14) and observations to identify barriers and facilitators. Bivariate and multivariate logistic regression were used for quantitative analysis; thematic analysis was used for qualitative data.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of the 713 newborns, only 4.6% (33\/713; 95% confidence interval [CI]: 3.2\u20136.4%) received EeKMC, whereas 55.5% (396\/713) were exclusively breastfed within 24 hours. Newborns in incubators were less likely to receive EeKMC (adjusted odds ratio = 0.07; 95% CI: 0.015\u20130.34). Barriers included inadequate infrastructure, skill gaps, and cultural norms, while facilitators involved quality improvement initiatives and maternal willingness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>EeKMC coverage is critically low at 4.6%, with incubator use identified as a significant barrier. Qualitative findings revealed barriers, including inadequate infrastructure, skill gaps among health care workers, cultural norms, and maternal fears. The cross-sectional design limits causal interpretation of the identified associations. Comprehensive interventions addressing health care infrastructure, provider training, family engagement, and cultural acceptance are urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15568253261474782","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T07:45:11Z","timestamp":1786088711000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of Early Kangaroo Mother Care Coverage and Associated Factors Among Low-Birth-Weight Neonates in Selected Hospitals in Northwest Ethiopia: A Multicenter Convergent Parallel Mixed-Method Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2616-397X","authenticated-orcid":false,"given":"Tigabu Eskeziya","family":"Zerihun","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woretaw Sisay","family":"Zewdu","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Toxicology, Pharmacy Education and Clinical Service Directorate, Debre Tabor University, Debre Tabor, Ethiopia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abel Temeche","family":"Kassaw","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel Agegnew","family":"Wondm","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel Berihun","family":"Dagnew","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Getachew Yitayew","family":"Tarekegn","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilaye Arega","family":"Moges","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fasil Bayafers","family":"Tamene","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desalegn Addis","family":"Mussie","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Pharmacy Education and Clinical Services Directorate, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"e_1_3_6_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12982-025-01256-4"},{"key":"e_1_3_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(23)00878-4"},{"key":"e_1_3_6_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1213243"},{"key":"e_1_3_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102155"},{"key":"e_1_3_6_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-03271-6"},{"key":"e_1_3_6_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-020-02311-6"},{"key":"e_1_3_6_8_1","doi-asserted-by":"publisher","DOI":"10.47895\/amp.v55i9.3745"},{"key":"e_1_3_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2021-005905"},{"key":"e_1_3_6_10_1","unstructured":"9.Organization WH. 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