NATURAL INCUBATOR

Kangaroo mother care helps save babies’ lives

Method decrease mortality and morbidity in preterm and low birth weight infants

In Summary

• KMC has been accepted as a key component of care for preterm and low birth weight babies.

• It protects babies from infection, regulates temperature, breathing and brain activity, and encourages mother-baby bonding

A mother holds a baby in the KMC programme
A mother holds a baby in the KMC programme
Image: MAGDALINE SAYA

The Health ministry and partners has adopted Kangaroo Mother Care as another baby-friendly method to mitigate infant mortality.

KMC is a key component of care for preterm and low birth weight babies. Babies born even a few weeks old often need more medical care, and they are at greater risk of respiratory and feeding difficulties, as well as jaundice, reduced brain development and problems regulating temperature.

A premature birth is a birth that takes place more than three weeks before the baby's estimated due date — in other words, before the start of the 37th week of pregnancy. Short intervals between pregnancies, malaria, malnutrition, low weight and age of the mother are some of the risk factors that contribute to preterm births.

Kenya is ranked position 15 globally out of 188 counties with the highest number of preterm babies.

KMC involves providing continuous skin-to-skin contact between mother and a stable preterm/low birth weight baby, for a minimum of 20 hours a day.

It borrows from kangaroos, the Australian mammals that naturally give birth to underdeveloped young, then carries them in its pouch under the belly, nourishing them with milk and warmth.

KMC has been shown to decrease mortality and morbidity in preterm and low birth weight infants by providing protection from infection, regulating temperature, breathing and brain activity, and encouraging mother-baby bonding.

The World Health Organisation recommends KMC for the routine care of newborns weighing 2,000 grams or less at birth.

Ministry of Health statistics indicate that of the 1.5 million Kenyan live births annually, 188,000 babies are born too soon, below 37 weeks. Nearly 15,000 die.

Bungoma has been hailed as a trailblaser and pioneer in this life-saving initiative. KMC started in 2014 in Bungoma in five health facilities and progressed to nine.

Currently, 27 health facilities have adopted the technique. It has helped save more than 1,500 babies in 21 counties.

In Nairobi, it is offered at the Kenyatta National Hospital, Mbagathi District Hospital and Pumwani Hospital.

Joan Emoh, a senior health coordinator with Nairobi- based Save the Children, says though KMC involves more women than men, involving fathers in raising preterm babies makes a big difference in their growth.

"We are operating under limited resources but our aim is to ensure this system becomes embraced in all the 47 counties," Emoh said.

"This method has come in handy in saving time, cost and resources because as a country, we are faced with acute shortage of incubators in public health facilities."

This has led to the risky practice of babies sharing the medical equipment. As a result, babies born too soon spent limited time in incubators to make room for new arrivals.

Emoh said this is a low-cost but high-impact intervention that has significantly reduced mortality due to prematurity and low birth weight. She said children who go through this method may die, yes, but as a result of other factors.

The expert, however, called for attitude change because some people view it as a poor man's approach.

Emoh said before KMC was started, newborn mortality was too high. The mothers also got stressed when their babies were in the incubators and they would not produce enough milk.

“As a result, the facility used to purchase a lot of formula milk for the babies. Now, after introducing KMC, no baby has died while in the KMC position, and we buy very few formula milk. KMC has also worked in reducing incubator congestion in our newborn unit,” Emoh said.

 

RALLYING CRY TO MEN

Emoh called on men to support mothers providing KMC. Various hospitals using the life-saving method are encouraged to take men through a health education session on KMC benefits and how to practise it both at the facility and at home whenever they come to visit.

“We request them to support with other household duties and encourage them to accompany mothers to support group meetings where information and experiences are shared,” Emoh said.

The project aims to reach communities with communication on the importance of caring for preterm babies.

The project supports demand creation at community level, which includes male involvement in Maternal and Newborn Health issues.

Save the Children has so far conducted minor renovations of KMC rooms within four hospitals, provided basic equipment for care of the babies, trained 47 health care workers, and established follow-up mechanisms of babies discharged to continue with KMC at home.

Nairobi county, on the other hand, has been responsible for ensuring the KMC units are adequately staffed with sufficient medicine and commodities for care of the babies, as well and food and linen for the mothers while they are admitted.

Pumwani Maternity Hospital has been the champion and pioneer of this baby-friendly idea, by training other countries in the same.

The KMC programme at Pumwani includes a weekly support group session, in which mothers are instructed about how to go about the whole care process and encouraged to share their own stories.

These are KMC Champion Mothers, who have graduated the programme and now dedicate their time to coaching others through the process.

Those trained include neonatologists, paediatricians, midwives, nurses and Health ministry programme managers from Ethiopia, Kenya, Uganda, Zimbabwe, Liberia, Sierra Leone and Nigeria.

While most of those trained are from public hospitals, there are a few from private hospitals and universities.

Progress with KMC implementation varied between countries, with some like Liberia and Sierra Leone in the nascent stages and others like Ethiopia and Uganda already focusing on national or subnational scale.