India accounts for the largest number of neonatal deaths globally, and causes related to preterm birth and low-birth weigh represent about 35% of neonatal mortality. Kangaroo Mother Care (KMC) is a critical, low-cost intervention to reduce adverse outcomes in low birth or preterm infants. The government of India tested the feasibility and acceptance of KMC in select locations prior to a national rollout per the India Newborn Action Plan. This poster was presented by Natasha Kanagat at the Fifth Global Symposium on Health Systems Research in Liverpool in October.

1. COMMUNITY PERSPECTIVES ON
KANGAROO MOTHER CARE (KMC)
IN INDIA
BACKGROUND MEASUREMENT APPROACH
LESSONS LEARNED
Authors: Natasha Kanagat, John Snow, Inc. (JSI); Amrita Misra, John Snow India Private Limited; Penny Dawson, JSI; Sudhir
Maknikar, John Snow India Private Limited
38 Key Informant Interviews with
»» mothers
»» KMC coverage for eligible infants rose
from 16% at baseline to 42% at midline.
90% of infants received breastmilk, most
from their mother’s breast.
»» All mothers reported initiating KMC
in hospitals and administering KMC at
home.
»» All mothers correctly described the key
components and benefits of KMC.
»» On average, mothers reported providing
KMC 2-3 times a day for 1.5 hours each
time.
»» Mothers highlighted that their mothers-in-
law and, in some cases, husbands or other
family members supported them by freeing
them from household tasks and giving
them exclusive time and privacy to provide
KMC. Some husbands and mothers-
in-law also reported providing KMC
themselves.
»» Mothers described a close relationship with
ASHAs (community based health workers)
who visited them regularly, reinforced the
importance of KMC and often accompanied
them to the hospital for delivery.
»» India accounts for the largest number of neonatal
deaths globally, and causes related to preterm
birth and low-birth weight represent about 35% of
neonatal mortality.¹ Between 20-30% newborns have
low birth weight (<2500gms) due to prematurity
of intrauterine growth retardation.Almost 50% low
birth weight newborns may need intensive care in a
sick newborn care unit.
»» KMC² is a critical, low-cost intervention to
reduce adverse outcomes in low birth or
preterm infants. Key features include skin-to-
skin contact between the mother and the baby and
nutrition through maternal milk (ideally).The close
contact enables monitoring of the newborn. KMC
is initiated in the hospital and can be continued at
home.
»» The Government of India is testing the feasibility and
acceptability of KMC in select locations prior to a
national rollout per the India Newborn Action Plan,
2014.
Examining quantitative program data on
»» breastfeeding
»» number of follow up visits after discharge
»» KMC coverage
»» Most mothers went for one follow-up visit
instead of the recommended four. Reasons
for not completing the recommended
number of follow up visits included distance
to the facility, transport challenges and
disrespectful treatment by facility based
nurses. Some mothers reported traveling to
their home villages while a few were told to
not return for follow up visits by facility staff.
We conducted a midline assessment, which included:
1. PHFI, AIIMS, and SC- State of India’s Newborns (SOIN) 2014- a report. (Eds) Zodpey S and Paul VK. Public Health Foundation of India, All India Institute of Medical Sciences and Save the
Children. New Delhi, India; https://www.newbornwhocc.org/SOIN_PRINTED%2014-9-2014.pdf; accessed 3.1.2018
2. JSI, as a consortium partner on the USAID funded Project Vriddhi, introduced KMC in one district each in Jharkhand and Uttarakhand. Project Vriddhi was led by IPE Global.
0%
35%
24%
14%
41%
37%
67%
SEP 2016 OCT 2016 NOV 2016 DEC 2016 JAN 2017 FEB 2017 MAR 2017
0%
69%
40% 38%
89%
94%
SEP 2016 OCT 2016 NOV 2016 DEC 2016 JAN 2017 FEB 2017
TREND OF KMC COVERAGE AT DEMONSTRATION
SITE- HARIDWAR, UTTARAKHAND
TREND OF KMC COVERAGE AT DEMONSTRATION
SITE- GUMLA, JHARKHAND
10 Focus Group Discussions with
»» health care providers at facility and
community levels
Photo Credit: Natasha Kanagat/ JSI