Kangaroo Mother Care - MCHIP

Identify a “champion” who can advocate and support the cause.
Engage existing national advocacy groups, such as White Ribbon Alliances, to put care and
survival of LBW/preterm infants on their agenda. These national groups could organize national
campaigns, including walks and special days dedicated to LBW/preterm infants.
6.2 HEALTH-FACILITY-LEVEL SENSITIZATION AND MOBILIZATION
KMC is often well-received by health workers when the evidence is presented to them. However,
many health professionals in developing countries currently do not have an in-depth knowledge
of the effectiveness and benefits of KMC. Most of those who have been introduced to KMC—
through national or international conferences, peer review articles, discussions with colleagues
or visits to KMC sites—may have difficulty implementing the intervention in their own health
institutions for a variety of reasons. A study conducted by Charpak and Ruiz-Pelaez (2006)
identified some of the major factors that limit the introduction and expansion of KMC
services in developing countries:
KMC is considered sub-standard care compared with incubator care.
The provision of KMC services creates extra work for health staff.
SSC is unacceptable to some health professionals.
Health institution policies do not permit relatives, in particular males (fathers), to stay in the
ward for long periods of time.
There is a lack of support from health institution management.
Program managers must identify potential obstacles to implementation of KMC from health
professionals and address these concerns. The idea of KMC as sub-standard care for
LBW/preterm babies can be addressed through multiple channels: onsite KMC orientations;
presentations at professional association meetings; and incorporation of KMC evidence with
nursing, medical and other health pre-service training.
In most countries, there may be a pediatrician or medical doctor who has introduced this type of
care in his/her health institution and is ready (with minimal support) to serve as a KMC
champion. If such a person is found, engaging this KMC advocate/practitioner in the national
stakeholders’ meeting to share his/her experience will help address the practical concerns of
health professionals. In countries where they are no such champions or early adopters of KMC,
a visit to a neighboring country can assist in addressing concerns health professional may have.
Identifying major concerns before arranging a site visit is important to ensure that the visit is
tailored to these specific concerns.
One of the above obstacles cited by Charpak and Ruiz-Pelaez (2006) is a lack of support from
health institution management. This critical barrier must be addressed if KMC services are to
take hold in the facility. Therefore, programs must make the effort to orient facility managers to
the effectiveness and benefits of KMC services, including a reduction in overcrowded wards,
lowered cost due to early discharge and improved survival rate for LBW/preterm babies.
Discussions on institutional policies that need to be revised to permit successful KMC
implementation in the facility (and the possible rearrangement of various wards) should happen
before training staff on KMC.
Kangaroo Mother Care Implementation Guide 27