Bilal, Selamawit MTadele, HenokAbebo, Teshome ATadesse, Birkneh TMuleta, MekonnenW/Gebriel, FitsumAlemayehu, AkalewoldHaji, YusufKassa, Dejene HAstatkie, AyalewAsefa, AntenehTeshome, MillionKawza, AknawWangoro, ShemelsBrune, ThomasSinghal, NaliniWorku, BogaleAziz, Khalid2021-01-102021-01-102021-01-07BMC Pregnancy and Childbirth. 2021 Jan 07;21(1):25http://hdl.handle.net/1880/112950https://doi.org/10.11575/PRISM/44313Abstract Background Globally, approximately 15 million babies are born preterm every year. Complications of prematurity are the leading cause of under-five mortality. There is overwhelming evidence from low, middle, and high-income countries supporting kangaroo mother care (KMC) as an effective strategy to prevent mortality in both preterm and low birth weight (LBW) babies. However, implementation and scale-up of KMC remains a challenge, especially in lowincome countries such as Ethiopia. This formative research study, part of a broader KMC implementation project in Southern Ethiopia, aimed to identify the barriers to KMC implementation and to devise a refined model to deliver KMC across the facility to community continuum. Methods A formative research study was conducted in Southern Ethiopia using a qualitative explorative approach that involved both health service providers and community members. Twenty-fourin-depth interviewsand 14 focus group discussions were carried out with 144study participants. The study applied a grounded theory approach to identify,examine, analyse and extract emerging themes, and subsequently develop a model for KMC implementation. Results Barriers to KMC practice included gaps in KMC knowledge, attitude and practices among parents of preterm and LBW babies;socioeconomic, cultural and structural factors; thecommunity’s beliefs and valueswith respect to preterm and LBW babies;health professionals’ acceptance of KMC as well as their motivation to implement practices; and shortage of supplies in health facilities. Conclusions Our study suggests a comprehensive approach with systematic interventions and support at maternal, family, community, facility and health care provider levels. We propose an implementation model that addresses this community to facility continuum.Journal Article2021-01-10enThe Author(s)https://doi.org/10.1186/s12884-020-03409-6