Lakshmipur, a district in the southern part of Bangladesh, has been hit by the COVID-19 pandemic like every other place in the country this year. Seeking regular health services from healthcare centers decreased rapidly, in fear of contracting this deadly virus. However, in recent months the situation started to improve gradually. In the Lakshmipur District Hospital, which is a major public healthcare center in this area, the pediatric consultant and nurses continue to provide necessary services and guidance to mothers so that every baby born alive can be saved from preventable death.
Baby Sayef was born prematurely weighing only 1,500 grams. After six days of KMC, the baby’s weight increased to 1,600 grams. Doctors further advised to continue KMC at home, with weekly follow-ups at the hospital’s KMC unit until the baby reached a goal weight of 2,500 grams. After four KMC follow-up visits, Sayef reached a healthy 2,000 grams and survived. Photo credit: Save the Children.
The fear of contracting COVID-19 remains high, so people prefer to stay at home. However, it is evident that babies born prematurely at home would not survive unless taken to healthcare professionals. The District Hospital’s management also acted on addressing this challenge together with the development partners and projects that work towards reducing maternal and newborn death rates in the country, strengthening the government’s healthcare structure while improving quality of services.
Kangaroo Mother Care—or KMC in short—is a proven low-cost and easily adaptable method worldwide to save premature babies born before 37 weeks and/or babies that are underweight and sick. USAID’s MaMoni Maternal and Newborn Care Strengthening Project (MaMoni MNCSP), a consortium led by Save the Children in Bangladesh, has been working closely with the Bangladesh government’s health sector to introduce, establish, and efficiently manage this KMC method in its project areas.
MaMoni coordinates with all tiers of service providers, from specialized doctors to nurses in a healthcare center, to orient them on identifying cases and managing premature and sick newborns through KMC. The project also provides orientation on the KMC package to field staff, and formal training to the KMC nurse in-charge. Even during meetings with hospital management and staff, MaMoni staff regularly advocate to ensure an enabling environment in the KMC room that would encourage parents to obtain their services. As a result, dedicated doctors and nurses now coordinate well with the Special Care Newborn Units (SCANU), child wards, labor wards, and emergency rooms to screen babies as per KMC criteria to identify cases. They then provide parental counselling on admission and receiving KMC services to save their babies from this life-threating condition, and most of the time, they are successful.
The best thing about KMC is that parents do not need to remain in the hospital for the whole recovery time. During admission into KMC service, the KMC nurses primarily equip and guide the mother to hold the baby in the right position, provide skin-to-skin contact, transfer body warmth, and breastfeed exclusively. When the mother needs rest, sometimes a close family member such as the father or grandmother of the baby takes over and provides KMC. Once the newborn starts to show signs of progress, the family is released from the hospital with specific guidance to continue the KMC method at home. In Bangladesh, even though this method has been introduced for several years now, it still has not gained much popularity. Different government entities and projects are working together to promote this method more widely, as well as prepare healthcare centers and professionals to popularize this method within their work areas.
To ensure KMC continues even after their release from the hospital, service providers rigorously follow up with mothers. During mobile phone calls, providers assure mothers of a safe environment and patient management system compliant with infection prevention control management, in case they need to visit the hospital. They are further encouraged to visit the hospital with their newborns to check the progress, and receive additional medical treatment and counseling from a pediatric consultant. Mothers receive one follow-up call per month (for the first four months), and it has been found that usually the third and fourth follow-up calls are not always needed, as the child recovers by then.
Lakshmipur is one of the MaMoni MNCSP project areas. Therefore, in Lakshmipur District Hospital, this process continued throughout the pandemic situation over the last couple of months. In total, the use of KMC saved 39 babies during the period June to August. This number might seem low, but these babies managed to survive death in just one hospital, especially during a pandemic. Optimistically, if a similar approach could save babies in other facilities in Bangladesh’s 64 districts, imagine how many more newborn deaths could be prevented!
USAID’s MaMoni Maternal and Newborn Care Strengthening Project (MaMoni MNCSP) supports the government of Bangladesh to achieve its goal of reducing the maternal and newborn death rate in ten districts, where ensuring a safe journey to motherhood, availability of quality services and resources are of high concern. Some of the various interventions in MaMoni project areas include improving facility readiness and development of health workers skills through training and counselling.