Presenter: Nathalie Charpak, Kangaroo Foundation
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Background: KMC is an evidence-based technology useful for ameliorating LBW effects on infant mortality and morbidity. It brings physiologically sound, human and emotionally appropriate intervention to complement neonatal care. Most network members have identified the urgent need for locally generated and conducted sound research, and these type of experiences should be supplemented with a research capacity-building effort aimed not only at generating knowledge but to disseminate it locally.
Methodology: It consists of an ongoing: 1) dissemination of KMC by training health-care teams not only in the KMC delivery but in the recording and monitoring of key-quality indicators, 2) coaching teams while implementing and adapting their programs, 3) design and implementation of a quality program to support a continuous performance evaluation, 4) identification and analysis of difficulties encountered for the implementation of KMC.
Results: From the 32 teams trained in Bogota, 80% of KMC implementation has been successful, despite the wide variety of specific needs and difficulties encountered by each program in each setting: 17 excellent results, 7 good, 8 fair. Nine KMC programs already began a KMC training diffusion program in their countries. The 3 components of KMC: kangaroo position, early discharge with follow-up and breastfeeding have been adapted to settings and to the health status of the LBW infant, including all the spectrum of inpatient care: NICU to the rooming-in with the mother. The KMC follow-up is the most difficult aspect to implement, despite its significant impact on hospital costs and risks. Major difficulties for many newly established programs are insufficient access to the network, scientific literature and local research capability.
Conclusion: Our experience shows the feasibility of developing a complex effective and efficient heath care intervention in a developing country, and direct transfer to developing countries through training, coaching, support and development of non-governmental networks.