Bulletin of the World Health Organization | 2021
Improving the implementation of kangaroo mother care.
Abstract
In recent years, studies have found evidence that kangaroo mother care is a cost-effective, high-impact intervention that reduces mortality and morbidity in preterm infants.1 A cornerstone of kangaroo mother care is skin-to-skin care of the infant in an upright position on a caregiver’s chest. Other components of this care are support for exclusive and early breastfeeding and timely discharge from the hospital with appropriate follow-up.2 The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) recommend facility-based kangaroo mother care as a routine method of care for clinically stable newborns weighing 2000 g or less at birth.1,3 UNICEF supports countries that have a high burden of neonatal deaths through a health-systems strengthening approach that focuses on quality, scalability and sustainability of kangaroo mother care. During the past decade, UNICEF has been partnering with WHO, Save the Children, Every Preemie–SCALE, the Bill & Melinda Gates Foundation, Johnson & Johnson, the University of Pretoria, the Colombian Kangaroo Foundation and others to achieve its priority of strengthening newborn care through policy, advocacy and technical assistance through the 2014 Every Newborn Action Plan. This action plan focuses on specific kangaroo mother care coverage targets, that is, at least 50% of these small newborns should receive such care by 2020 and 75% by 2025.1 However, health systems are still experiencing multiple-level challenges to implementation of kangaroo mother care at scale and to commitment and health-facility readiness.4,5 In 2017, a rapid assessment of kangaroo mother care implementation was conducted to assess progress in the 25 lowand middle-income countries in Africa, Asia and the Middle East that had received support from UNICEF (Box 1). We followed up this assessment by consulting the 2018 and 2019 Every Newborn progress reports2,6 and information available in the Every Newborn database to track further developments in the implementation and scale-up of such care.