A scalable health system model to achieve high coverage and quality of Kangaroo mother care in Uttar Pradesh, India

• DOI: 10.1111/apa.16534
• Publication Date: 2022-10-03T06:04:10Z
• Authors: Aarti Kumar; Madhuri Tiwari; Raghav Krishna; Pramod Kumar Singh; Arti Sahu; Vivek Singh; Aman Mishra; Pankaj Kumar; Alok Kumar; Gary L. Darmstadt; Vishwajeet Kumar
• Keywords: Infant, Newborn; Infant; Aftercare; India; Patient Discharge; 3. Good health; Kangaroo-Mother Care Method; 03 medical and health sciences; 0302 clinical medicine; Infant Mortality; Humans; Birth Weight; Female; Child

AbstractAimTo design a health system model for scaling‐up Kangaroo mother care (KMC) and assess its impact on the population‐level coverage and quality of KMC in Uttar Pradesh, India.MethodsWe co‐developed the model with mothers and health system stakeholders using human‐centred design over multiple cycles of implementation, learning and data‐driven refinement. Infants with birthweight <2000 g in the study district were prospectively followed to assess the ‘effective coverage’ of KMC. Effective coverage referred to the proportion of eligible infants receiving ≥8 h of daily skin‐to‐skin contact and exclusive breastfeeding.ResultsHigh delivery load facilities were equipped with a KMC Lounge to ensure comfort, respectful care of mothers and high‐quality KMC over prolonged periods. Systems to ensure weighing at birth, referral of infants with birthweight <2000 g to KMC facilities, initiation of KMC for all stable low birthweight infants, improving quality of care within KMC facilities and supporting families to continue KMC at home post discharge, were integrated into existing services. KMC was initiated in 93.3% of eligible infants with effective coverage of 52.7% and 64.8% at discharge and 7 days post discharge, respectively.ConclusionThe model addressed critical barriers to KMC implementation and adoption, contributing to its scale‐up across the state.