Accelerated scale-up of Kangaroo Mother Care: Evidence and experience from an implementation-research initiative in south India

Acta Paediatr. 2023 Aug:112 Suppl 473:15-26. doi: 10.1111/apa.16236. Epub 2022 Feb 10.


Aim: Though Kangaroo Mother Care (KMC) has demonstrated benefits for low birth weight newborns, coverage continues to be low in India. As part of a World Health Organization (WHO) multi-country study, we explored intervention models to accelerate KMC coverage in a high priority district of Karnataka, India.

Methods: We used implementation-research methods, formative assessments and quality improvement approaches to design and scale-up interventions. Evaluation was done using prospective cohort study design; data were collected from facility records, and client interviews during KMC initiation, at discharge and at home after discharge.

Results: KMC was initiated at health facilities for 87.6% of LBW babies under 2000 g. At discharge, 85.0% received KMC; 67.9% continued to receive KMC at home on the 7th day post-discharge. The interventions included training, mentoring and constant advocacy at many levels: public health facilities, private sector and the community. Innovations like a KMC case sheet, counselling, peer support group triggered KMC in the facilities; a KMC-link card, a microplanning and communication tool for CHWs helped to sustain practice at homes.

Conclusion: The study provides a novel approach to designing and scaling up interventions and suggests lessons that are applicable to KMC as well as to broader reproductive, maternal, neonatal and child health programmes.

Keywords: India; Kangaroo Mother Care; implementation research; neonatal mortality; scale-up.

MeSH terms

  • Aftercare
  • Child
  • Humans
  • India
  • Kangaroo-Mother Care Method*
  • Patient Discharge
  • Prospective Studies