Why is Kangaroo Mother Care not yet scaled in the UK? A systematic review and realist synthesis of a frugal innovation for newborn care

Objective Kangaroo Mother Care (KMC) is a frugal innovation improving newborn health at reduced cost compared with incubator use. KMC widely recommended; however, in the UK, poor evidence exists on KMC, and its implementation remains inconsistent. Design This Systematic Review Realist Synthesis explores barriers facilitators of UK. Data source OVID databases, Cumulative Index to Nursing Allied Health Literature (CINAHL), Scopus Google Scholar were searched. Eligibility criteria Studies UK based, maternity/neonatal units, for full-term/preterm children. First screening included studies (1) (KC) or skin-to-skin contact (SSC) (2) Baby Friendly Initiative, Small Wonders Change Program family-centred care if relation KMC/KC/SSC. Full texts reviewed regarding KMC/KC/SSC implementation. Results The paucity research did not permit realist review. However, expanded review available published KC SSC, used as proxy understand implementation, demonstrated that main are lack training, knowledge, confidence clear guidelines. Conclusion stands contrast already well-proven benefits stable babies low-income contexts highlights need further research, especially sick small population. Implementation of, into, KC/SSC inconsistent low quality. Improvements needed enhance staff training parental support, develop guidelines properly implement KC/SSC. It should be an opportunity emphasise focus potential cost-effective alternative reduce use