{"id":43372,"date":"2020-04-14T09:43:05","date_gmt":"2020-04-14T13:43:05","guid":{"rendered":"https:\/\/www.healthynewbornnetwork.org\/?post_type=resource&p=43372"},"modified":"2020-04-10T10:46:32","modified_gmt":"2020-04-10T14:46:32","slug":"improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial","status":"publish","type":"resource","link":"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/","title":{"rendered":"Improving Skin-to-Skin Practice for babies in Kangaroo Mother Care in Malawi through the use of a customized baby wrap: A randomized control trial"},"content":{"rendered":"
\n

Background<\/h2>\n

Complications of prematurity are a leading cause of newborn death in Malawi. Despite early adoption of Kangaroo mother care (KMC), coverage remains low and women have expressed challenges in using the traditional wrapper\u2013chitenje<\/em>. In 2016, a study was conducted to evaluate the acceptability and effectiveness of a customized KMC wrap in improving adherence to KMC practices among mothers.<\/p>\n<\/div>\n

\n

Methods<\/h2>\n

Mother-baby dyads (301) were randomized to receive either a customized CarePlus Wrap developed by L\u00e6rdal Global Health or a traditional\u00a0chitenje<\/em>. Enrolled mother-baby dyads were assessed in the KMC ward at 2\u20133 days after of admission, and then again at 7\u201315 days post-discharge. Topics covered included skin-to-skin practices, breastfeeding, perceptions of the wrap, and family\/community support.\u00a0Chi square<\/em>\u00a0tests were used to assess associations between wrap type and KMC practices. The study received ethics approval.<\/p>\n<\/div>\n

\n

Results<\/h2>\n

This study found that a customized KMC wrap is highly acceptable to women and improved skin-to-skin practices in facility-based KMC: 44% of mothers using a customized wrap reported 20 or more hours per day, compared to 33% of mothers using the traditional\u00a0chitenje<\/em>. Women using the customized wrap reported being comfortable in keeping the baby in skin-to-skin position more often than women using the chitenje (96% vs. 71%), and they were able to tie on the wrap themselves (86% vs. 10%). At the time of discharge from KMC, more women who used the customized wrap were satisfied with the wrap than those who used the traditional\u00a0chitenje<\/em>\u00a0(94% vs. 56%). The customized wrap did not appear to impact other newborn practices, such as breastfeeding.<\/p>\n<\/div>\n

\n

Conclusions<\/h2>\n

This study provides evidence that a customized KMC wrap is highly acceptable to mothers, and it can contribute to better skin-to-skin practices. Use of a customized wrap may be one mechanism to support mothers in practicing KMC and skin-to-skin contact in addition to other interventions.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Background Complications of prematurity are a leading cause of newborn death in Malawi. Despite early adoption of Kangaroo mother care (KMC), coverage remains low and women have expressed challenges in using the traditional wrapper\u2013chitenje. In 2016, a study was conducted to evaluate the acceptability and effectiveness of a customized KMC wrap in improving adherence to … Continued<\/a><\/p>\n","protected":false},"author":7211,"featured_media":43375,"comment_status":"open","ping_status":"closed","template":"","toolkit":[],"acf":[],"yoast_head":"\nHealthy Newborn Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Improving Skin-to-Skin Practice for babies in Kangaroo Mother Care in Malawi through the use of a customized baby wrap: A randomized control trial - Healthy Newborn Network\" \/>\n<meta property=\"og:description\" content=\"Background Complications of prematurity are a leading cause of newborn death in Malawi. Despite early adoption of Kangaroo mother care (KMC), coverage remains low and women have expressed challenges in using the traditional wrapper\u2013chitenje. In 2016, a study was conducted to evaluate the acceptability and effectiveness of a customized KMC wrap in improving adherence to … Continued\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/\" \/>\n<meta property=\"og:site_name\" content=\"Healthy Newborn Network\" \/>\n<meta property=\"article:modified_time\" content=\"2020-04-10T14:46:32+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/improving-skin-to-skin-practices-png.png\" \/>\n\t<meta property=\"og:image:width\" content=\"327\" \/>\n\t<meta property=\"og:image:height\" content=\"432\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/\",\"url\":\"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/\",\"name\":\"Improving Skin-to-Skin Practice for babies in Kangaroo Mother Care in Malawi through the use of a customized baby wrap: A randomized control trial - Healthy Newborn Network\",\"isPartOf\":{\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/improving-skin-to-skin-practices-png.png\",\"datePublished\":\"2020-04-14T13:43:05+00:00\",\"dateModified\":\"2020-04-10T14:46:32+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/#primaryimage\",\"url\":\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/improving-skin-to-skin-practices-png.png\",\"contentUrl\":\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/improving-skin-to-skin-practices-png.png\",\"width\":327,\"height\":432},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.healthynewbornnetwork.org\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Improving Skin-to-Skin Practice for babies in Kangaroo Mother Care in Malawi through the use of a customized baby wrap: A randomized control trial\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/#website\",\"url\":\"https:\/\/www.healthynewbornnetwork.org\/\",\"name\":\"Healthy Newborn Network\",\"description\":\"Addressing critical knowledge gaps in newborn health.\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.healthynewbornnetwork.org\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Healthy Newborn Network","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/","og_locale":"en_US","og_type":"article","og_title":"Improving Skin-to-Skin Practice for babies in Kangaroo Mother Care in Malawi through the use of a customized baby wrap: A randomized control trial - Healthy Newborn Network","og_description":"Background Complications of prematurity are a leading cause of newborn death in Malawi. Despite early adoption of Kangaroo mother care (KMC), coverage remains low and women have expressed challenges in using the traditional wrapper\u2013chitenje. In 2016, a study was conducted to evaluate the acceptability and effectiveness of a customized KMC wrap in improving adherence to … Continued","og_url":"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/","og_site_name":"Healthy Newborn Network","article_modified_time":"2020-04-10T14:46:32+00:00","og_image":[{"width":327,"height":432,"url":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/improving-skin-to-skin-practices-png.png","type":"image\/png"}],"twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/","url":"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/","name":"Improving Skin-to-Skin Practice for babies in Kangaroo Mother Care in Malawi through the use of a customized baby wrap: A randomized control trial - Healthy Newborn Network","isPartOf":{"@id":"https:\/\/www.healthynewbornnetwork.org\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/#primaryimage"},"image":{"@id":"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/#primaryimage"},"thumbnailUrl":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/improving-skin-to-skin-practices-png.png","datePublished":"2020-04-14T13:43:05+00:00","dateModified":"2020-04-10T14:46:32+00:00","breadcrumb":{"@id":"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/#primaryimage","url":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/improving-skin-to-skin-practices-png.png","contentUrl":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/improving-skin-to-skin-practices-png.png","width":327,"height":432},{"@type":"BreadcrumbList","@id":"https:\/\/www.healthynewbornnetwork.org\/resource\/improving-skin-to-skin-practice-for-babies-in-kangaroo-mother-care-in-malawi-through-the-use-of-a-customized-baby-wrap-a-randomized-control-trial\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.healthynewbornnetwork.org\/"},{"@type":"ListItem","position":2,"name":"Improving Skin-to-Skin Practice for babies in Kangaroo Mother Care in Malawi through the use of a customized baby wrap: A randomized control trial"}]},{"@type":"WebSite","@id":"https:\/\/www.healthynewbornnetwork.org\/#website","url":"https:\/\/www.healthynewbornnetwork.org\/","name":"Healthy Newborn Network","description":"Addressing critical knowledge gaps in newborn health.","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.healthynewbornnetwork.org\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"}]}},"featured_image":"<img width=\"327\" height=\"432\" src=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/improving-skin-to-skin-practices-png.png\" class=\"attachment-medium_large size-medium_large\" alt=\"\" decoding=\"async\" srcset=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/improving-skin-to-skin-practices-png.png 327w, https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/improving-skin-to-skin-practices-png-227x300.png 227w\" sizes=\"(max-width: 327px) 100vw, 327px\" \/>","author_name":"HNN Team","author_image":"<img src=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/themes\/hnn\/dist\/images\/member-default.jpg\" alt=\"\" class=\"avatar avatar-32 photo\" height=\"32\" width=\"32\"\/>","acf_custom_fields":{"publication_date":"20200319","authors":false,"additional_authors":"Kondwani Chavula ,Tanya Guenther,Bina Valsangkar, Victoria Lwesha, Gedesi Banda, Marte B\u00f8e Wensaas, Richard Luhanga, Lydia Chimtembo, Mary V. Kinney, Queen Dube","type":"articles","language":["en"],"external_links":[{"link":""}],"files":[{"file":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/improving-skin-to-skin-practices.pdf"}],"partners":[],"other_organizations":"","issues":[{"ID":128,"post_author":"7211","post_date":"2015-10-21 15:19:45","post_date_gmt":"2015-10-21 15:19:45","post_content":"<p>[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]Transforming care for the 30 million newborns who require medical care, and who are currently being left behind, is a smart investment in the health and development of future generations. Kangaroo Mother Care (KMC) is one of the leading proven interventions that can radically improve inpatient care for small and sick newborns, leading to shorter hospitalizations and improved health outcomes.<\/p>\n<p>KMC refers to the practice of providing early, continuous, prolonged skin-to-skin contact between mother and baby, exclusive breastmilk feeding, and follow-up care with high-risk newborns. It has shown to decrease mortality and morbidity in preterm and low birthweight infants by providing protection from infection; regulating temperature, breathing, and brain activity; and encouraging mother-baby bonding. In many cases, newborns who receive KMC are able to be discharged early from the hospital and KMC can be continued at home. When delivered as a complete package, it is highly effective at reducing newborn mortality \u2013 up to 40% according to recent data.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">14.7<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690899267181{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\">percent of infants with low birthweight globally (2020)<\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">27<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666024070330{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\">percent of infants who were not weighed at birth globally (2014-2020)<\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-blue\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">40<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1466618727036{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\">percentage reduction in mortality of low birthweight infants (<2000g) who receive KMC compared to conventional neonatal care*<\/h3>\n<p>[\/vc_column_text][vc_column_text css=\".vc_custom_1545998791435{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h6 style=\"text-align: center;\"><a href=\"https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD002771.pub4\/full\"><span style=\"font-weight: 400; color: #808080;\">*\u00a0Conde\u2010Agudelo and Diaz\u2010Rossello. 2016<\/span><\/a><\/h6>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_column_text]<\/p>\n<h6 style=\"text-align: center;\"><em>All data on this page represents the most recent data available, unless otherwise noted. Please visit our <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a>\u00a0page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452735746534{padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column][vc_row_inner equal_height=\"yes\"][vc_column_inner width=\"1\/2\"][vc_column_text]<\/p>\n<h4>KMC implementation<\/h4>\n<p><img class=\"wp-image-1622 size-full alignnone\" src=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/small-kmcimplementation.jpg\" alt=\"\" width=\"570\" height=\"230\" \/><\/p>\n<p>The World Health Organization (WHO) <a href=\"https:\/\/cdn.who.int\/media\/docs\/default-source\/mca-documents\/nbh\/standards-for-improving-the-quality-of-care-for-small-and-sick-newborns-in-health-facilities-2020.pdf?sfvrsn=f2da583c_1\">recommends KMC<\/a> for the routine care of newborns weighing 2000 grams or less at birth, regardless of availability of incubator care. <a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2026486\">Recent studies<\/a> are showing a significant decrease (25%) in morbidity and mortality for newborns who begin KMC immediately after birth, especially in newborns weighing between 1 kg and 1.79 kg. KMC can and should be started as soon as possible following birth, and can occur while stabilizing care is provided to the mother and newborn (eg, newborn receiving continuous positive airway pressure (CPAP) for respiratory distress). Additionally, <a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/effect-of-community-initiated-kangaroo-mother-care-on-postpartum-depressive-symptoms-and-stress-among-mothers-of-low-birth-weight-infants-a-randomized-clinical-trial\/\">recent studies<\/a> have shown that KMC can be effectively implemented at home for newborns who are born outside of a facility, although all small newborns should receive post-natal care and follow-up with health care providers.<\/p>\n<p>There is a global push advocating for skin-to-skin contact between mother and newborn for one hour immediately following birth for all newborns, regardless of size at birth. While skin-to-skin contact is a key component of KMC, skin-to-skin alone is not sufficient for small newborns. All small newborns should receive complete KMC care, depending on facility and national protocols.<\/p>\n<p>KMC is considered a part of family-centered, respectful newborn and maternal care. It can be implemented during the full continuum of care, and is especially effective transitioning from the facility to the household. Providers should be trained to educate mothers and fathers in home-based continued KMC, and encourage its use at the home following discharge. Additionally, early and immediate KMC can also support positive early development, beyond the physical health benefits and morbidity prevention.[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/2\"][vc_column_text]<\/p>\n<h4>Accelerating KMC uptake<\/h4>\n<p><img class=\"wp-image-1621 size-full alignnone\" src=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/small-acceleratingthisintervention.jpg\" alt=\"\" width=\"570\" height=\"230\" \/><\/p>\n<p>Despite the many benefits of KMC, country-level adoption and implementation have been limited, and only a small proportion of newborns who could benefit from KMC receive it. Barriers to KMC implementation at the facility level include inadequate facilities and supplies for KMC, insufficient staffing in facilities, lack of training and prioritization of KMC by facility staff, and inadequate policy and professional commitment to KMC. At the family and community level, barriers include cultural norms that make practice of skin-to-skin care difficult, lack of family and financial support for mothers to practice KMC, limited understanding of KMC, and stressors related to extended hospitalization.<\/p>\n<p>The COVID-19 pandemic was and continues to be a barrier for implementation of KMC in most settings. Infection prevention measures during the pandemic led to more newborns being separated from their mothers immediately following birth, even low birthweight and preterm newborns who would benefit from KMC. It is critical that infection prevention policies and government agencies do not recommend separation of mother and newborn, so that all vulnerable newborns receive KMC, even during COVID-19 outbreaks and infections.[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_cta h2=\"Small and Sick Newborn Community of Practice\" txt_align=\"center\" color=\"sandy-brown\"]KMC features prominently as one of the core elements of care for the small or sick newborn.\u00a0 A new community of practice, the Small and Sick Newborn CoP (SSNB CoP) is an interactive platform that enables practitioners and experts to exchange ideas, share lessons learned, disseminate and discuss implementation research results and evidence regarding KMC and the other essential interventions comprising quality care of small for sick newborns.\u00a0<a href=\"https:\/\/ibpnetwork.org\/topics\/14356\">Click here<\/a>\u00a0to register for SSNC CoP and access webinars, networking, resources, events and much more.[\/vc_cta][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=\"Key resources\"][\/vc_column][\/vc_row][vc_row][vc_column width=\"2\/3\"][vc_column_text]<strong>Guidance<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/global-position-paper-on-kangaroo-mother-care\/\" target=\"_blank\" rel=\"noopener\">Global Position Paper on Kangaroo Mother Care: A transformative innovation in healthcare (2023)<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/kangaroo-mother-care-implementation-strategy-for-scale-up-adaptable-to-different-country-contexts\/\" target=\"_blank\" rel=\"noopener\">Kangaroo Mother Care: Implementation strategy for scale-up adaptable to different country contexts (2023)\u00a0<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/who-recommendations-for-care-of-the-preterm-or-low-birth-weight-infant\/\">WHO recommendations for care of the preterm or low-birth-weight infant (2022)<\/a><\/li>\n<li><a href=\"https:\/\/cdn.who.int\/media\/docs\/default-source\/mca-documents\/nbh\/standards-for-improving-the-quality-of-care-for-small-and-sick-newborns-in-health-facilities-2020.pdf?sfvrsn=f2da583c_1\">Standards for improving the quality of care for small and sick newborns in health facilities (2020)<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/survive-and-thrive-transforming-care-for-every-small-and-sick-newborn\/\">Survive and Thrive: Transforming care for every small and sick newborn (2018)<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/joint-statement-international-recommendations-interventions-improve-preterm-birth-outcomes\/\">Joint Statement: International WHO Recommendations on Interventions to Improve Preterm Birth Outcomes (2017)<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/kmcjointstatement\/\">Kangaroo Mother Care Joint Statement (2016)<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/kangaroo-mother-care-challenge-brief\/\">Kangaroo Mother Care challenge brief (2016)<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/kangaroo-mother-care-implementation-guide\/\">Kangaroo Mother Care Implementation Guide (2012)<\/a><\/li>\n<\/ul>\n<p><strong>Research<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/effect-on-neonatal-sepsis-following-immediate-kangaroo-mother-care-in-a-newborn-intensive-care-unit\/\">Effect on neonatal sepsis following immediate kangaroo mother care in a newborn intensive care unit: a post-hoc analysis of a multicentre, open-label, randomised controlled trial (2023)<\/a><\/li>\n<li><a href=\"https:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/s12884-021-03646-3\">Barriers and facilitators of facility-based kangaroo mother care in sub-Saharan Africa: a systematic review (2021)<\/a><\/li>\n<li><a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2026486\">Immediate \u201cKangaroo Mother Care\u201d and Survival of Infants with Low Birth Weight (2021)<\/a><\/li>\n<li><a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(19)32223-8\/fulltext\">Effect of community-initiated kangaroo mother care on survival of infants with low birthweight: a randomised controlled trial (2019)<\/a><\/li>\n<li><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4750435\/\">Kangaroo mother care: a systematic review of barriers and enablers (2015)<\/a><\/li>\n<\/ul>\n<p><strong>Country Specific Resources<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/scaling-up-kangaroo-mother-care-in-ethiopia-and-india-a-multi-site-implementation-research-study\/\">Scaling up Kangaroo Mother Care in Ethiopia and India: a multi-site implementation research study (2021)<\/a><\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/mother-newborn-care-unit-mncu-experience-in-india-a-paradigm-shift-in-care-of-small-and-sick-newborns\/\">Mother\u2011Newborn Care Unit (MNCU) Experience in India: A Paradigm Shift in Care of Small and Sick Newborns (2022)<\/a><\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][vc_column width=\"1\/3\"][vc_single_image image=\"20053\" img_size=\"medium\" onclick=\"custom_link\" link=\"https:\/\/www.healthynewbornnetwork.org\/kangaroo-mother-care-toolkit\/\"][vc_btn title=\"Kangaroo mother care toolkit\" color=\"1\" link=\"url:https%3A%2F%2Fwww.healthynewbornnetwork.org%2Fkangaroo-mother-care-toolkit%2F|||\"][\/vc_column][\/vc_row]<\/p>\n","post_title":"Kangaroo Mother Care","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"kangaroo-mother-care","to_ping":"","pinged":"","post_modified":"2023-08-01 10:14:43","post_modified_gmt":"2023-08-01 14:14:43","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=128","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"regions":[{"ID":251,"post_author":"7211","post_date":"2015-11-22 21:37:22","post_date_gmt":"2015-11-22 21:37:22","post_content":"","post_title":"Asia","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"asia","to_ping":"","pinged":"","post_modified":"2016-02-11 21:51:07","post_modified_gmt":"2016-02-11 21:51:07","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=region&p=251","menu_order":0,"post_type":"region","post_mime_type":"","comment_count":"0","filter":"raw"}],"countries":[{"ID":196,"post_author":"7211","post_date":"2015-10-21 22:00:20","post_date_gmt":"2015-10-21 22:00:20","post_content":"[vc_row][vc_column css=\".vc_custom_1453305596740{padding-top: 30px !important;padding-bottom: 30px !important;}\"][vc_text_separator title=\"Leading causes of neonatal deaths in Malawi (2020)\" el_class=\"transform:upperclass\"][vc_row_inner][vc_column_inner][vc_round_chart type=\"doughnut\" stroke_width=\"1\" stroke_color=\"custom\" values=\"%5B%7B%22title%22%3A%221%25%20Diarrhoea%22%2C%22value%22%3A%221%25%22%2C%22color%22%3A%22vista-blue%22%7D%2C%7B%22title%22%3A%220%25%20Tetanus%22%2C%22value%22%3A%220%25%22%2C%22color%22%3A%22mulled-wine%22%2C%22custom_color%22%3A%22%23f79468%22%7D%2C%7B%22title%22%3A%228%25%20Pneumonia%22%2C%22value%22%3A%228%25%22%2C%22color%22%3A%22peacoc%22%7D%2C%7B%22title%22%3A%2242%25%20Preterm%20birth%20complications%22%2C%22value%22%3A%2242%25%22%2C%22color%22%3A%22blue%22%7D%2C%7B%22title%22%3A%2224%25%20Intrapartum%20related%20events%22%2C%22value%22%3A%2224%25%22%2C%22color%22%3A%22turquoise%22%7D%2C%7B%22title%22%3A%225%25%20Sepsis%20and%20other%20infectious%20conditions%20of%20the%20newborn%22%2C%22value%22%3A%225%25%22%2C%22color%22%3A%22pink%22%7D%2C%7B%22title%22%3A%228%25%20Congenital%20abnormalities%5Ct%22%2C%22value%22%3A%228%25%22%2C%22color%22%3A%22violet%22%7D%2C%7B%22title%22%3A%2211%25%20Other%20conditions%22%2C%22value%22%3A%2211%25%22%2C%22color%22%3A%22chino%22%7D%5D\" custom_stroke_color=\"#f6f6f4\" css=\".vc_custom_1686242563305{padding-right: 30px !important;padding-left: 30px !important;background-position: center !important;background-repeat: no-repeat !important;background-size: contain !important;}\"][\/vc_column_inner][\/vc_row_inner][vc_column_text]\r\n<h6 style=\"text-align: left;\">Source: Estimates for causes of death 2000-2020 generated by the WHO and Maternal and Child Epidemiology Estimation Group (MCEE) 2023 and downloaded from <a href=\"http:\/\/data.unicef.org\/\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=http:\/\/data.unicef.org&source=gmail&ust=1551964625737000&usg=AFQjCNFsFTtu9FzS8H64YC88NPOzQVbPwQ\">http:\/\/data.unicef.org<\/a><\/h6>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" gap=\"5\" css=\".vc_custom_1453306441839{background-image: url(\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/country-stat-bkgr.jpg?id=389) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}\"][vc_column css=\".vc_custom_1453306493120{margin-top: 30px !important;margin-bottom: 30px !important;}\"][vc_text_separator title=\"key indicators\" el_class=\"transform:uppercase text-white\"][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686242385649{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">19.3<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Newborn mortality rate (deaths per 1,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686242429914{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">3.3<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Annual reduction in newborn mortality rate 2000-2021 (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686242502209{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">47<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Proportion of under-5 child deaths that are newborn (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686242453991{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">16.1<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Stillbirth rate (deaths per 1,000 births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686242537563{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">96.4\r\n<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Skilled birth attendance (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1517061672962{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">76<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Early initiation of breastfeeding (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1698696506197{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">14.5<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Preterm birth rate (births <37 weeks per 100 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686242518072{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">381<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Maternal mortality ratio (deaths per 100,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_column_text css=\".vc_custom_1456600985441{margin-top: 20px !important;}\"]\r\n<h5 style=\"text-align: center;\"><span style=\"color: #ffffff;\">Visit our<\/span> <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn numbers<\/a> <span style=\"color: #ffffff;\">page to explore the most recent data further<\/span><\/h5>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"Malawi","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"malawi","to_ping":"","pinged":"","post_modified":"2023-10-30 16:07:02","post_modified_gmt":"2023-10-30 20:07:02","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=country&p=196","menu_order":0,"post_type":"country","post_mime_type":"","comment_count":"0","filter":"raw"}],"views":"1275"},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource\/43372"}],"collection":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource"}],"about":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/types\/resource"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/users\/7211"}],"replies":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/comments?post=43372"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource\/43372\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/43375"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=43372"}],"wp:term":[{"taxonomy":"toolkit","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/toolkit?post=43372"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}