Table 5 Major problems and root causes for kangaroo mother care and breastfeeding (based on the presentation from health workers during bottleneck analysis workshop

1. Kangaroo Mother Care service not initiated in the hospital

1. No separate space to initiate KMC; KMC corner

2. Unavailability of materials, logistics to initiate KMC (KMC cloth)

3. Inadequate human resource

4. Lack of initiation by service providers

5. Low level of motivation

2. Inadequate knowledge about the importance and technique of KMC

1. Untrained service provider

3. Lack of separate space for breastfeeding to ensure privacy

1. No adequate space due to old infrastructure.

4. Early initiation of breastfeeding not sufficient

1. No counseling to mothers by health workers due to workload

2. Health workers do not realize the importance of early initiation of breastfeeding.

3. Practice bottle feeding/ formula feeding

4. Mothers not able to breastfeed within 1 h