Community Kangaroo Mother Care: implementation and potential for neonatal survival and health in very low-income settings

Abstract

Objective: Immediate Kangaroo Mother Care (KMC), an intervention following childbirth whereby the newborn is placed skin-to-skin (STS) on mother's chest to promote thermal regulation, breastfeeding and maternalnewborn bonding, is being taught in very low-income countries to improve newborn health and survival. Existing data are reviewed to document the association between community-based KMC (CKMC) implementation and its potential benefits.Study Design: New analyses of the sole randomized controlled study of CKMC in Bangladesh and others' experiences with immediate KMC are presented.Result: Newborns held STS less than 7 h per day in the first 2 days of life do not experience substantially better health or survival than babies without being held STS. Conclusion:Most women who were taught CKMC hold their newborns STS, but do so in a token manner unlikely to improve health or survival. Serious challenges exist to provide effective training and postpartum support to achieve adequate STS practices. These challenges must be overcome before scaling up.

Home-based neonatal care by community health workers for preventing mortality in neonates in low- and middle-income countries: a systematic review

“…19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103 Among these, 77 references were excluded 19, 20, 21, 22, 23, 24, 25, 26, 27, <...>…”

Availability and Quality of Emergency Obstetric and Newborn Care in Bangladesh

“…43 Previously articulated strategies to overcome these challenges include training health workers, 44 and extending KMC to the community level, 45,46 as well as effective training and postpartum support to achieve correct and adequate skin-to-skin contact practices in the community setting. 46 Corticosteroids have been shown to help accelerate lung maturation and reduce the incidence of respiratory complications, 47,48 but fear of side effects 48,49 could have contributed to the lack of provision. Administration of injectable antibiotics for neonatal sepsis (gentamicin and ampicillin), unlike KMC, is more common at private health facilities than government health facilities.…”

Implementing Kangaroo mother care in a resource‐limited setting in rural Bangladesh

“…Unstable neonates received more daily hours of skin‐to‐skin contact than stable neonates. Our study found greater duration of skin‐to‐skin contact among unstable infants than other studies . This study included extensive KMC training for all study staff as well as an inbuilt process of quality assurance, support for group efforts and dedication to KMC implementation.…”