Beyond Awareness: Cultural and knowledge barriers to kangaroo mother care uptake in Lagos, Nigeria

Abstract

Background: Kangaroo Mother Care (KMC) is a World Health Organization recommended intervention proven to reduce mortality in preterm and low-birth-weight infants. Despite its efficacy, utilization remains low in many resource-limited settings. This study aimed to assess the knowledge, attitudes, and practices regarding Kangaroo Mother Care (KMC) among mothers in Lagos, Nigeria, and to identify the primary barriers to its adoption. Methods: This community-based, descriptive cross-sectional survey was conducted with 334 mothers of infants aged 0-12 months using a multistage sampling method. Primary outcomes included the proportion of mothers with awareness, good knowledge, positive attitudes, and practice of KMC. Barriers to KMC uptake were also assessed.Results: Awareness of KMC was high (93.4%). However, only 35.6% possessed good knowledge, and a significant majority (82.7%) were unaware of its specific benefits. Attitudes were predominantly negative (92.2%), and practice was low (14.7%). The principal barriers identified were a cultural preference for traditional baby carrying methods (58.1%) and the perception that KMC is foreign to local culture (21.9%). Mothers expressed a preference for receiving KMC information through simple messages in their local language and direct discussions with health workers. Conclusions: A profound disconnect exists between high awareness and poor knowledge, attitude, and practice of KMC in this setting. The major impediments are socio-cultural, centered on a preference for traditional practices. Effective scale-up requires culturally sensitive community engagement, empowerment of healthcare workers to provide counselling, and the development of localized educational materials to bridge the knowledge-attitude-practice gap.