Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2019 Nov 21;9(11):e025879.
doi: 10.1136/bmjopen-2018-025879.

Kangaroo Mother Care implementation research to develop models for accelerating scale-up in India and Ethiopia: study protocol for an adequacy evaluation

Araya Abrha Medhanyie  1 , Hibret Alemu  2 , Anteneh Asefa  3 , Selemawit Asfaw Beyene  1 , Fisseha Ashebir Gebregizabher  4 , Khalid Aziz  5 , Nita Bhandari  6 , Habtamu Beyene  7 , Thomas Brune  8 , Grace Chan  9   10 , John N Cranmer  11 , G Darmstadt  12 , Dereje Duguma  13 , Addisalem Fikre  14 , Bizuayehu Gashaw Andualem  15 , Abebe Gebremariam Gobezayehu  16 , Damen Haile Mariam  14 , Tedros Hailu Abay  17 , H L Mohan  18 , Arun Jadaun  6 , K Jayanna  19   20 , F N U Kajal  21 , Arin Kar  22 , Raghav Krishna  23 , Aarti Kumar  23 , Vishwajeet Kumar  23 , Tarun Kumar Madhur  6 , Mulusew Lijalem Belew  24 , Rajini M  25 , Jose Martines  26 , Sarmila Mazumder  6 , Hajira Amin  16 , Prem K Mony  27 , Mekonnen Muleta  28 , Cynthia Pileggi-Castro  29 , Suman Pn Rao  30 , Abiy Seifu Estifanos  14 , Lynn M Sibley  31 , Nalini Singhal  32 , Henok Tadele  33 , Abraham Tariku  34 , Ephrem Tekle Lemango  35 , Birkneh Tilahun Tadesse  33 , Ravi Upadhyay  6 , Bogale Worku  14   36 , Marta Yemane Hadush  17 , Rajiv Bahl  37 ; KMC Scale-Up Study Group
Collaborators, Affiliations
Comparative Study

Kangaroo Mother Care implementation research to develop models for accelerating scale-up in India and Ethiopia: study protocol for an adequacy evaluation

Araya Abrha Medhanyie et al. BMJ Open. .

Abstract

Introduction: Kangaroo Mother Care (KMC) is the practice of early, continuous and prolonged skin-to-skin contact between the mother and the baby with exclusive breastfeeding. Despite clear evidence of impact in improving survival and health outcomes among low birth weight infants, KMC coverage has remained low and implementation has been limited. Consequently, only a small fraction of newborns that could benefit from KMC receive it.

Methods and analysis: This implementation research project aims to develop and evaluate district-level models for scaling up KMC in India and Ethiopia that can achieve high population coverage. The project includes formative research to identify barriers and contextual factors that affect implementation and utilisation of KMC and design scalable models to deliver KMC across the facility-community continuum. This will be followed by implementation and evaluation of these models in routine care settings, in an iterative fashion, with the aim of reaching a successful model for wider district, state and national-level scale-up. Implementation actions would happen at three levels: 'pre-KMC facility'-to maximise the number of newborns getting to a facility that provides KMC; 'KMC facility'-for initiation and maintenance of KMC; and 'post-KMC facility'-for continuation of KMC at home. Stable infants with birth weight<2000 g and born in the catchment population of the study KMC facilities would form the eligible population. The primary outcome will be coverage of KMC in the preceding 24 hours and will be measured at discharge from the KMC facility and 7 days after hospital discharge.

Ethics and dissemination: Ethics approval was obtained in all the project sites, and centrally by the Research Ethics Review Committee at the WHO. Results of the project will be submitted to a peer-reviewed journal for publication, in addition to national and global level dissemination.

Study status: WHO approved protocol: V.4-12 May 2016-Protocol ID: ERC 2716. Study implementation beginning: April 2017. Study end: expected March 2019.

Trial registration number: Community Empowerment Laboratory, Uttar Pradesh, India (ISRCTN12286667); St John's National Academy of Health Sciences, Bangalore, India and Karnataka Health Promotion Trust, Bangalore, India (CTRI/2017/07/008988); Society for Applied Studies, Delhi (NCT03098069); Oromia, Ethiopia (NCT03419416); Amhara, SNNPR and Tigray, Ethiopia (NCT03506698).

Keywords: kangaroo-mother care method; low birth weight; newborn; research protocol.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Core framework for Kangaroo Mother Care implementation.
Figure 2
Figure 2
Logic model for Kangaroo Mother Care scale-up.
Figure 3
Figure 3
Optimisation of implementation model.
Figure 4
Figure 4
Research timeline.
See this image and copyright information in PMC

References

    1. Blencowe H, Cousens S, Oestergaard MZ, et al. . National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 2012;379:2162–72. 10.1016/S0140-6736(12)60820-4 - DOI - PubMed
    1. Blencowe H, Cousens S, Chou D, et al. . Born too soon: the global epidemiology of 15 million preterm births. Reprod Health 2013;10(Suppl 1):S2 10.1186/1742-4755-10-S1-S2 - DOI - PMC - PubMed
    1. Lawn JE, Davidge R, Paul VK, et al. . Born too soon: care for the preterm baby. Reprod Health 2013;10(Suppl 1):S5 10.1186/1742-4755-10-S1-S5 - DOI - PMC - PubMed
    1. World Health Organization, Department of Reproductive Health and Research . Kangaroo Mother Care: a practical guide, 2003. Available: http://apps.who.int/iris/bitstream/10665/42587/1/9241590351.pdf
    1. Conde-Agudelo A, Díaz-Rossello JL, Cochrane Neonatal Group . Kangaroo Mother Care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev 2016;34 10.1002/14651858.CD002771.pub4 - DOI - PMC - PubMed

Publication types

Associated data