Facilitators and barriers to KMC practice: an umbrella review protocol

Introduction: Kangaroo Mother Care (KMC) is a special care technique for preterm and low birth weight newborns that has been extended to full-term newborns. KMC was originally understood as skin-to-skin contact. For some years now, its practice has been extended: in addition to the skin-to-skin contact, it includes exclusive breastfeeding, and follow-up of newborns. There are several reviews on the facilitators and barriers of each of these aspects separately, but none integrate the three aspects together. Objective: The purpose of this umbrella review is to summarize the evidence about the facilitators and barriers to KMC practice for premature babies. Inclusion criteria: The umbrella review will include scoping reviews and systematic reviews of quantitative and qualitative studies examining facilitators and barriers of skin-to-skin contact, breastfeeding, and follow-up of premature babies. Methods: Databases to be searched will include MEDLINE, CINAHL, Embase, Scopus, PsycINFO, JBI Evidence Synthesis, and Cochrane Database of Systematic Reviews. Two independent reviewers will screen titles, abstracts, and full-text articles, and perform data extraction and quality assessment of included studies. The extracted data will include specific details about the study characteristics (e.g. setting/context, participants, and phenomena of interest). Findings from the included reviews, as they relate to the umbrella review question, will be presented in tabular format, and accompanied with a supplemental narrative synthesis. If possible, evidence will be compared according to study design, type of facilitator or barrier, level of facilitator or barrier (parent, health professionals, health institutions, health policy).