Experiences with Community Kangaroo Mother Care in Very Low-Income Settings

Community-based Kangaroo Mother Care (CKMC) was designed to be initiated immediately after birth in very low-income settings where most births occur at home, access to clinical care is limited and newborn mortality rates are high. The objectives of CKMC are to prevent hypothermia, some respiratory conditions, diarrhea and improve newborn nutrition. In these settings, babies are seldom weighed at birth and newborn clinical assessment is rarely available, therefore CKMC is promoted for all babies. While KMC was successfully adapted for immediate postnatal community-based application in the Bangladesh pilot study, subsequent weak training has produced token skin-to-skin care with little health, nutrition or survival potential. If rigorous evaluation proves the CKMC guidelines affordably produce adequate skin-to-skin care, their costs and effectiveness to improve health and survival should be assessed in randomized controlled trials that adhere to the guidelines. Regardless of its health and survival potential, some babies will require other care.