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Kangaroo Mother Care: A Low-Tech, High Impact Strategy for Saving Babies' Lives
URC's USAID ASSIST project recently hosted a webinar entitled, "Perspectives on the expansion of the Kangaroo Mother Care (KMC) method in Latin America: the past, present, and future," to present and discuss the expansion of the lifesaving method of Kangaroo Mother Care (KMC). KMC, in which a parent holds their newborn in contact with their own skin, is helping thousands of premature babies survive and thrive all over Latin America.
Moderated by Dr. Jorge Hermida, medical health expert and Latin American Regional Director of URC's USAID ASSIST Project, the webinar featured Dr. Nathalie Charpak, pediatrician at the San Ignacio University Hospital's Kangaroo Program and Founder, Researcher and Director of the Kangaroo Foundation in Bogotá, Colombia.
The KMC method was introduced in 1978 by Dr. Edgar Rey-Sanabria, pediatrician and professor at the National University in Bogotá. The method was developed as an alternative to incubators, which were scarce, for premature infants with no problems other than the need to grow. KMC is a low-cost, high-impact method that can improve an infant's chances of survival. KMC does not replace neonatal care in hospitals; rather, it provides a complementary means to improve outcomes.
The Kangaroo Foundation recommends the KMC method for all infants born preterm and weighing less than 2500 grams (5.5 pounds). Globally, 18 million babies are born every year preterm and at low birthweight; half of them are born in India alone. Of the four million babies who die in their first month annually, half die of complications from prematurity and low birthweight.
The Ministry of Health of Colombia adopted KMC as part of its 2013 official guide for health professionals entitled "Guide for Clinical Practice of the Premature Neonate."
During the webinar, Dr. Charpak cited several studies that clearly illustrate the positive effects of KMC. It has been shown to significantly reduce infant mortality among premature infants and aid in temperature regulation, physiological stability, apnea and reflux reduction, pain control, growth increase, and more. For example, comparing adolescents who were born very prematurely (less than 33 weeks) who received KMC versus those who did not, research has shown that KMC can have positive effects on brain development. Lactation is easier and lasts longer with KMC. Brain scans show that the sensory experiences that infants have with KMC create more connections and have clear positive effects on neural development. For more details on these and other studies, please see the presentation here. To see and hear the webinar in its entirety (in Spanish), please click here.
Despite the overwhelming scientific evidence of its effectiveness, KMC has not achieved sufficient expansion and implementation on a large scale in most countries of Latin America. Dr. Charpak suggests that there are several challenges that can have hindered the practice's spread.
First, the infant benefits the most when KMC is practiced 24 hours a day, seven days a week. People are often dismissive of such a commitment because they have other children to care for or they have jobs and other obligations. Dr. Charpak suggests that KMC can be shared by several members of the family – the father, the grandparents and even older siblings can help.
Follow-on visits can be challenging as well, often requiring parents and infants to travel long distances. In areas where transportation is costly or difficult to come by, or if parents must miss work, this is a significant deterrent.
KMC has been proven without a doubt to increase premature infants' chances of survival. We should continue to work toward expanding its practice throughout Latin America and addressing the barriers that are preventing this expansion.
Please see Salud Materno Infantil (Maternal Infant Health) for more information on this vital work.
URC and KMC
As a component of its work to address neonatal mortality, the USAID Health Care Improvement Project (HCI), managed by URC, has been working with five Latin American countries to implement national KMC programs: Guatemala, El Salvador, Honduras, Nicaragua and Ecuador. In these countries, HCI supports the work of each Ministry of Health.
In an effort to encourage the wider adoption of KMC programs, HCI has worked closely with hospital technical teams and Ministries to carefully design and evaluate the implementation plan at each step to ensure the sustainability of the program. Each Ministry selects a priority hospital to pilot the program, and a team from that hospital is identified to attend training at the Kangaroo Foundation in Bogotá. After the initial training, the program is rolled out with additional training for other hospital staff, building support, developing educational materials, setting up a dedicated physical program space, procuring basic supplies, organizing in-hospital activities and follow-up visits and setting up an information system to monitor basic indicators. Later in the process, hospitals typically create an ambulatory component that provides continued support for KMC patients after they leave the hospital. Once the program is successfully established in the pilot hospital, it is scaled up to hospitals in other regions.
Nicaragua was the first country to open a KMC program under HCI. After seeing successful results, physicians now frequently refer patients to the program. In El Salvador, the program has expanded beyond its initial hospital to several regional programs. In Guatemala, a regional hospital using KCM saw a 50 percent reduction in incubator use. The KMC program in Honduras is strong and growing. Finally, the Ecuadorian Ministry of Health recently adopted an essential obstetrics and newborn care model as part of its national policy for improving care, of which KMC is a part.
June 09, 2014