The kangaroo mother care programme

Operational research and evaluation of the implementation and scale-up of kangaroo mother care and other maternal and newborn health interventions at different health-system levels

Kangaroo mother care (KMC) is a high-impact, cost-effective intervention in the care of preterm and low birthweight babies. These babies need special care to keep warm and to feed. Instead of being kept in an incubator or placed under a radiant warmer, stable babies are placed skin-to-skin on the mother’s or other caregiver’s chest in an upright position and tied securely.  If the baby cannot suck at the breast yet, the baby receives breastmilk with a tube or a cup. 

The KMC implementation research programme started in 1999. At that time, the method was relatively unknown globally and in South Africa. There was nothing available to assist clinicians and managers on how to implement this new intervention and for which services they should plan. In the first few years, a number of outreach strategies were developed and tested. The evidence that emerged included a stages-of-change model and a tool to assess progress with KMC implementation based on this model. Members of the Centre are involved in the training of healthcare providers and the scale-up and assessment of KMC practice and services. Many African countries have benefited from these activities, including Chad, Comoros, Côte d’Ivoire, Ghana, Kenya, Liberia, Mali, Malawi, Niger, Nigeria, Rwanda, Tanzania, The Gambia and Togo.

The stages-of-change model is transferable to other interventions and has been used in the scale-up of the Essential Steps in the Management of Obstetric Emergencies (ESMOE), for understanding and assessing the implementation of maternal and perinatal death audit systems and for implementing PMTCT and HIV-prevention programmes.

Investigators

• Anne- Marie Bergh, Researcher

• Elise Van Rooyen, Researcher/Collaborator

Sponsors

• Government departments

• South African Medical Research Council

Publications

Mohammadi M, Bergh A-M, Heidarzadeh M, Hosseini MB, Sattarzadeh N, Valizadeh L, Sarvaran B, Hakimi S. (2021). Implementation and effectiveness of continuous kangaroo mother care: a participatory action research protocol. International Breastfeeding Journal. 16:24. https://doi.org/10.1186/s13006-021-00367-3

Bergh, A-M. (2021). Effective health promotion and health education (chapter). In V Flenady (ed), Elements of professional care and support before, during and after pregnancy. In The Continuous Textbook of Women’s Medicine – Obstetrics Module, Volume 3. https://www.glowm.com/article/heading/vol-3--elements-of-professional-care-and-support-before-during-and-after-pregnancy--effective-health-promotion-and-health-education/id/414253#.YDJmcmhLjIU

Hailegebriel TD, Bergh AM, Zaka N, Roh JM, Gohar F, Rizwan S, Asfaw AG, Heidarzadeh M, Zeck W. Improving the implementation of kangaroo mother care. Bulletin of the World Health Organization. 2021 Jan 1;99(1):69. doi: 10.2471/BLT.20.252361

Charpak N, Angel NI, Banker D, Bergh A-M, Bertolotto AM, De Leon-Mendoza S, Godoy N, Lincetto O,  Lozano JM, Ludington-Hoe S, Mazia G, Mokhachane M, Montealegre AT, Ramirez E, Sirivansanti N, Solano JM, Day LT, Uy ME. (2020). Strategies discussed at the XIIth International Conference on Kangaroo Mother Care for implementation on a country-wide scale. Acta Paediatrica 109: 2278-2286. doi: 10.1111/apa.15214

Hailegebriel TD, Bergh A-M, Roh JM, Zaka N, Gohar F, Rizwan S, Asfaw AG, Heidarzadeh M, Zeck W. (Published online).  Improving the implementation of kangaroo mother care. Bulletin of the World Health Organization. Published online, 28 October 2020. http://www.who.int/bulletin/online_first/BLT.20.252361.pdf