Premium
A scalable health system model to achieve high coverage and quality of Kangaroo mother care in Uttar Pradesh, India
Author(s) -
Kumar Aarti,
Tiwari Madhuri,
Krishna Raghav,
Singh Pramod Kumar,
Sahu Arti,
Singh Vivek,
Mishra Aman,
Kumar Pankaj,
Kumar Alok,
Darmstadt Gary L.,
Kumar Vishwajeet
Publication year - 2023
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.16534
Subject(s) - medicine , breastfeeding , population , uttar pradesh , referral , birth attendant , health care , environmental health , demography , nursing , pediatrics , health services , maternal health , socioeconomics , economic growth , sociology , economics
Aim To design a health system model for scaling‐up Kangaroo mother care (KMC) and assess its impact on the population‐level coverage and quality of KMC in Uttar Pradesh, India. Methods We co‐developed the model with mothers and health system stakeholders using human‐centred design over multiple cycles of implementation, learning and data‐driven refinement. Infants with birthweight <2000 g in the study district were prospectively followed to assess the ‘effective coverage’ of KMC. Effective coverage referred to the proportion of eligible infants receiving ≥8 h of daily skin‐to‐skin contact and exclusive breastfeeding. Results High delivery load facilities were equipped with a KMC Lounge to ensure comfort, respectful care of mothers and high‐quality KMC over prolonged periods. Systems to ensure weighing at birth, referral of infants with birthweight <2000 g to KMC facilities, initiation of KMC for all stable low birthweight infants, improving quality of care within KMC facilities and supporting families to continue KMC at home post discharge, were integrated into existing services. KMC was initiated in 93.3% of eligible infants with effective coverage of 52.7% and 64.8% at discharge and 7 days post discharge, respectively. Conclusion The model addressed critical barriers to KMC implementation and adoption, contributing to its scale‐up across the state.