Aim: To measure progress with the implementation of kangaroo mother care (KMC) for low birth-weight (LBW) infants at a health systems level.
Design: Action research design, with district and regional hospitals as the unit of analysis.
Setting: Four regions in Ghana, identified by the Ghana Health Service and UNICEF.
Participants: Health workers and officials, health care facilities and districts in the four regions.
Intervention: A one-year implementation programme with three phases: (1) introduction to KMC, skills development in KMC practice and the management of implementation; (2) advanced skills development for regional steering committee members; and (3) an assessment of progress at the end of the intervention.
Main outcome measures: Description of practices, services and facilities for KMC and the identification of strengths and challenges.
Results: Twenty-six of 38 hospitals (68%) demonstrated sufficient progress with KMC implementation. Half of the hospitals had designated a special ward for KMC. 66% of hospitals used a special record for infants receiving KMC. Two of the main challenges were lack of support for mothers who had to remain with their LBW infants in hospital and no follow-up review services for LBW infants in 39% of hospitals.
Conclusions: It was possible to roll out KMC in Ghana, but further support for the regions is needed to maintain the momentum. Lessons learned from this project could inform further scale-up of KMC and other projects in Ghana.
Keywords: Ghana; evaluation; implementation; kangaroo mother care; premature infant.