In June, the USAID ASSIST-supported Salud Materno Infantil (Maternal and Infant Health) Kangaroo Mother Care (KMC) Community of Practice hosted its second virtual discussion forum in Spanish on "Experiences in startup and early consolidation of Kangaroo Mother Care (KMC) activities in hospitals in Latin America: favorable aspects, constraints and lessons learned.” As a pediatrician and director of the USAID ASSIST Project in Nicaragua, I was honored to moderate the forum.
During the nine days of this forum, from June 16th through the 25th, participants from Bolivia, Colombia, Ecuador, El Salvador, Guatemala, Mexico, Nicaragua, Paraguay and the Dominican Republic shared valuable experiences and insights about the successes and challenges to implementing KMC programs in their respective countries, and shared innovative ways in which challenges were overcome.
Themes discussed during the virtual forum included the importance of having a well-trained team that is committed to KMC and ensuring that there is buy-in and support from hospital management. Involving all personnel at the hospital with more emphasis on the staff working in maternal and newborn health was revealed as a best practice, as was the importance of promoting the scientific evidence about the benefits of KMC for newborns among medical staff so as to overcome pushback from staff who don’t fully understand its importance and feasibility.
The conversation also addressed the limitations to expanding KMC in Latin America, including lack of adequate financial and human resources and infrastructure. Forum participants mentioned creative ideas to increase support from the Ministry of Health, civil society, and NGOs, international organizations and medical societies. Among the most pertinent lessons learned included the importance of working with hospital management to implement guidelines, track indicators, and to ensure that relevant information, including the benefits of KMC, is shared with mothers, families, and the community and that parents are supported to perform KMC.
We also shared results from cost effectiveness studies of KMC in Nicaragua and Ecuador, which show that KMC actually saves money for hospitals that implement it. As hospitals realize KMC improves health outcomes for premature newborns and is cost effective, they will be more open and excited to implement KMC.
Thiago de Oliveira, pictured with his daughter, Agate Victoria, who was born at 6 months’ gestation, Rocha Faria State Hospital in Campo Grande, Brazil. Photo credit: Edna Galvão. View full article.
A summary of the steps to introduce KMC to a health facility was also shared and discussed. Discussions also include guidelines, indicators and URC’s experience with respect to the application of KMC for premature and underweight babies in four countries in Latin America.
Discussions also included the importance of couples’ counseling as a much more effective method to achieving enrollment and retention in the KMC program than targeting pregnant women alone. Husbands often hold decision-making power within families in Latin America, and from a gender perspective, it’s important to educate fathers about the importance of KMC, so that they are aware of its benefits and support their wives to use the KMC method. Promoting fathers’ participation in KMC, at the discretion of the mother, can relieve mothers from some of the pressure of being the sole partner to carry out the skin-to-skin contact and can strengthen the bond between father and child, which can set the tone for the rest of the child’s life.
This was my first experience moderating a virtual forum, and it afforded me the opportunity to interact with health care professionals from all across Latin America. Some had general questions, others asked for help to resolve a specific problem, while some participants simply wanted to share the KMC context in their country. In reflecting on the forum, it is clear that we all face similar issues and challenges across Latin America. We can help and support each other and learn from our failures and successes.
The virtual forums and webinars hosted by our USAID ASSIST KMC community of practice team are critical because they offer a user-friendly platform for health professionals working in KMC to connect with one another at no cost, to share learning, best practices, and what doesn’t work about implementing and expanding KMC in Latin America. Forum participants echoed this sentiment, acknowledging the utility of the forum as a place to experiences between countries, strengthening their links and allowing each one to learn from others, in effect collectively strengthening all of our KMC work.
For more information about the KMC Community of Practice, visit the USAID ASSIST-supported Salud Materno Infantil (maternal and infant health) Spanish language website or join our upcoming webinar, “Scientific Evidence and Recent Developments that support the benefits of the KMC method” which will be held on July 22nd. For more information about Kangaroo Mother Care and its implementation, visit the Healthy Newborn Network’s KMC Information Page.