Researchers from Aga Khan University have published the findings of a Pakistan-based evaluation of a neglected care-giving method for newborns, Kangaroo Mother Care (KMC), which involves regular, skin-to-skin contact between mother and child.
KMC is a common practice around the world but is rarely used in Pakistan due to cultural barriers even though it has been found to reliably improve newborn health.
Neonatal morbidity and mortality is high in rural areas of Pakistan owing to the lack of access to healthcare services, unsafe newborn care practices and community beliefs against early breastfeeding and bathing. Each day over 600 newborns die in Pakistan due to complications related to birth asphyxia, prematurity and sepsis, according to United Nations Children’s Fund (UNICEF).
The study, Effect of Kangaroo Mother Care on neonatal health outcomes in rural Pakistan, A Randomized Controlled Trial, saw the research team from AKU compare the effectiveness of three sets of interventions.
The research sought to understand the efficacy of a low-cost intervention in underprivileged communities and the extent to which it could improve birth outcomes for premature babies in the initial months of their lives.
The study found that the intervention package diminished the risk of neonatal infections and reported a favourable impact on weight gain. While ENC and chlorhexidine were effective in improving neonatal outcomes, the effect was considerably enhanced with the KMC component added to it. Moreover, the results of this study are in line with a recent systematic review of interventions to improve neonatal health and survival which suggests that packaged interventions ─ such as KMC ─ in a health system have beneficial effects on neonatal morbidity and mortality.
The nine-month trial was carried in Dadu district, Sindh in 2014-15. Trainers from AKU and the Ministry of Health educated the study team in early neonatal care to identify neonatal infections and other complications in subjects during the course of the research.
“The acceptability of KMC in Pakistan’s community context is evidence that it should be scaled up to reach to underprivileged communities that can help reduce the burden of neonatal mortality in Pakistan,” said Dr Muhammad Atif Habib, an assistant professor at department of paediatrics and child health at AKU and a co-researcher on the study.
The study’s objectives correspond with the University’s commitment to help achieve targets under the Sustainable Development Goals which aims to reduce neonatal mortality to as low as 12 per 1,000 live births by 2030.
Co-authors of the research from AKU include Zulfiqar A. Bhutta, Sajid Bashir Soofi, Shabina Ariff, Mushtaq Mirani, Fariha Shaheen and Amjad Hussain of the department of paediatrics and child health. Two researchers from The University of Sydney specialising in in obstetrics, gynaecology and public health were also part of the study.
*The essential neonatal care package consisted of birth practices relating to cleanliness, thermal protection, delayed bathing, early and exclusive breast feeding, initiation of breathing, eye care and immunisation.