By Eliane Dominique Yao Sigan, Communications Officer, Jhpiego with contributions from Corey White, Communications Consultant

Lady KZ was seven months along in her pregnancy when she knew something wasn’t right. The 20-year-old and her husband live in Bettié, a town in the southeast corner of Côte d’Ivoire. They walked to their local hospital when she experienced severe pelvic pain. There, she met her midwife, Kouakou.

Kouakou informed Lady KZ that her labor had begun and requested she stay for observation. Lady KZ returned home, however, because she did not accept that she was in labor and she did not want to give birth early.  Later that same day, her husband alerted Kouakou that she had given birth to a very small baby at home.

Kouakou immediately brought Lady KZ and her preterm baby boy, who weighed only three pounds (1.4 kilograms), back to the hospital for care. The midwife knew just what to do. Only three days earlier, Kouakou was one of 96 health care providers to participate in a three-hour training session supported by MOMENTUM Country and Global Leadership on implementing Kangaroo Mother Care.

Kangaroo Mother Care is a method of care for preterm infants that involves infants being carried, usually by the mother, with skin-to-skin contact. It also includes exclusive breastfeeding. It is a longstanding practice that is considered one of the simplest, most effective ways to prevent death among small and sick newborns.

Recent evidence from the New England Journal of Medicine (2021) clarified that initiating Kangaroo Mother Care for small and sick newborns immediately after birth has the best results, compared to waiting until the baby is stable.

Although Lady KZ was too physically and psychologically exhausted after giving birth and returning to the hospital to offer Kangaroo Mother Care to her new baby, the boy’s grandmother volunteered to provide immediate skin-to-skin contact.

Kouakou learned from her training that Kangaroo Mother Care increases the survival of babies born weighing less than four pounds (2.5 kilograms) thanks to the warmth transmitted by the mother or caregiver using their body temperature. The method is recommended by the World Health Organization and requires minimal financial or material resources to implement. In addition to the weight criteria, the training covered:

• How best to position and feed the baby
• The importance of exclusive breastfeeding
• How to create a primary health care plan and the supportive caregiver environment needed to strengthen the new mother and her baby.

Lady KZ and her baby boy stayed in the hospital for 48 hours for follow-up. She started exclusive breastfeeding, and Kouakou established a care schedule to visit them both every two days at home to follow up on the Kangaroo Mother Care practice.

Every two weeks, Lady KZ brought her baby to the hospital to track his progress. His weight increased to five pounds at five months old, and he continues to thrive.

The MOMENTUM training on implementing Kangaroo Mother Care informs and empowers health care providers, like Kouakou, to implement evidence-based interventions. It is an important step in advancing the national policy for maternal and child health as Côte d’Ivoire scales up the implementation of Kangaroo Mother Care.

Hands-on clinical mentoring and coaching for health care workers is offered by MOMENTUM in 48 of Côte d’Ivoire’s 86 health districts at district-level facilities. The project has trained 96 health care workers from primary healthcare facilities in four training sessions since 2021. These trainings strengthen the skills of frontline health workers like midwives as they support others in practicing Kangaroo Mother Care. It’s part of the project’s work in Côte d’Ivoire to help ensure the delivery of equitable, respectful primary health care for vulnerable groups and young, first-time mothers like Lady KZ.

This implementation guide offers policymakers and managers of maternal and newborn health programs steps for developing, implementing and expanding facility-based Kangaroo Mother Care services in developing countries.