Kangaroo Mother Care (KMC) was initially developed in Bogota 35 years ago when there was a shortage of incubators for preterm babies. When practiced in hospitals, it consists of continuous skin-to-skin contact, establishing breast feeding, early discharge, and close-follow-up. KMC is widely recognized to promote physiological stability, facilitate breastfeeding, keep a baby warm, reduce the risk of serious infections and reduce the mortality of hospitalized, stable premature infants by about 50 percent. This practice is also a wonderful way to promote bonding between infants and their parents, and may have lasting neurodevelopmental benefits.
In spite of these benefits, however, some key challenges have prevented KMC from being adopted widely across the globe. First, even where mothers receive training on KMC, socio-cultural, resourcing, and experiential barriers – such as a lack of support for the mother from the family and community – make practicing KMC difficult. Second, guidelines for KMC recommend initiation of the practice in the health facility, which means that the large portion of infants born outside of these health facilities may not have access to this practice. Even for mothers who deliver their babies in facilities, we have a long way to go to ensure that most premature babies have access to quality KMC services and support.
If universal KMC coverage was achieved, it is estimated that it could save the lives of more than 450,000 preterm newborns each year. However, despite global recognition of its inherent benefits and potential to improve newborn health, KMC is still struggling to catch on – with less than one percent coverage globally and no universally agreed upon indicator to measure uptake or impact.
It was for this reason that the Gates Foundation together with Save the Children / Saving Newborn Lives recently brought together more than 20 organizations representing governments, multinational organizations, non-governmental organizations, donors, civil society and academic institutions to garner support, enthusiasm, and build upon synergies to launch efforts to scale-up of KMC. Specifically, convening participants met to take stock of KMC globally, set a course for accelerating adoption and align as a community on a clear path forward.
We came together motivated to fundamentally shift our thinking and strategic approach to take KMC to scale, and in the process realized that we had much more in common than we originally thought. We all agreed that any efforts to promote a practice that is both feasible for mothers and effective for promoting its health benefits for their newborns must put the mother and her baby at the center.
We must better understand local social and cultural contexts, so that we can better work with mothers, families, communities, traditional leaders, health practitioners and governments to create an environment that empowers and supports the practices of KMC as a norm. We all agreed that going forward and reaching scale was critically dependent on our ability to effectively integrate KMC into reproductive, maternal, newborn and child health (RMNCH) and nutrition programs with a collaborative and coordinated global effort that includes governments, civil society, nonprofit organizations, communities, families and most importantly mothers.
Paramount to our success will be our ability to unify around clear goals, targets, and indicators. KMC is not a “poor person’s alternative” to good medical care, but represents a powerful evidence-based, standard-of-care for premature babies.
We are more convinced than ever that now is the time to act as a cohesive and inclusive group of stakeholders. We are rallying around what we have identified as the next steps necessary to reach our ambitious, yet attainable goal, of global coverage.
One of the clear next steps is a “Consensus Statement”, forthcoming from the group who attended the meeting. This will outline our agreements on the path forward and call for concerted and comprehensive action to accelerate and “bend the curve” of the spread of this powerful, life-saving intervention.
We remain optimistic that together, guided by shared principles, goals and a path forward we can create a world where mothers holding their babies skin-to-skin and exclusively breastfeeding is the social norm, fully supported by their families and communities, or any health professionals they may encounter.