Supporting kangaroo mother care in Ethiopia

Keeping mothers and babies together after birth improves survival rates for babies born early or small

Agere Molla and her husband Solomon Minayehu provide skin-to-skin care to their premature twins at Felege Hiwot Hospital in Bahir Dar, Ethiopia. © WHO / Hilina Abebe.

Around the world, 15 million babies are born preterm (before 37 weeks) and 21 million are born low birthweight (under 2.5kg) each year. These infants face significant health risks. Prematurity-related complications are the leading causes of death of newborns and children under 5.

A sign indicating the way to the kangaroo mother care unit at Felege Hiwot Hospital. © WHO / Hilina Abebe

Kangaroo mother care is the practice of providing continuous, skin-to-skin contact for the baby for as long as possible during day and night, usually with the mother, as well as exclusive breastfeeding. Fathers and other caregivers can also provide skin-to-skin care.

It is the recommended, effective method of care for low birth weight babies, and is better than keeping a baby in an incubator, where they are separated from their parents or caregivers and lack precious close contact and bonding time.

Nurse Yewognesh Gebre-Meskel assists Elisabeth Ali to provide skin-to-skin contact to her baby at the kangaroo mother care unit at Felege Hiwot Hospital. © WHO / Hilina Abebe

Kangaroo mother care is one of the most cost-effective ways to increase premature or low birthweight babies’ chances of survival, especially in low-income countries.

Among infants born preterm or low birthweight, kangaroo mother care has been shown to reduce infant deaths by as much as 40%, hypothermia by more than 70%, and severe infections by 65%, and provides more opportunities to breastfeed.

Solomon Minayehu provides skin-to-skin care to one of his preterm twins at Felege Hiwot Hospital. © WHO / Hilina Abebe

Kangaroo mother care was introduced in Ethiopia in 1996 at the Black Lion Hospital in Addis Ababa. Since then, with assistance from the World Health Organization (WHO) and other partners, support for the practice has been expanded to other health facilities, including Felege Hiwot Hospital in Bahir Dar.

Elisabeth Ali provides skin-to-skin care to her low birthweight baby at Felege Hiwot Hospital. © WHO / Hilina Abebe

Work continues to overcome barriers to acceptance of kangaroo mother care in Ethiopia. WHO recently led a multi-country kangaroo mother care implementation research study to determine effective models of delivery. In Ethiopia, in the four regions where the study was conducted the use of kangaroo mother care increased from less than 5% to more than 60%. The study concluded that there are a number of factors that help inform national efforts to improve the implementation of kangaroo mother care. These include government leadership, an understanding by health workers that kangaroo mother care is the standard of care, and acceptance of the practice from women and families. Changes in infrastructure, policy, and health worker skills and practice are also key.

Meseret Alemayehu records patient information at Felege Hiwot Hospital. Meseret has been working as a nurse at the hospital’s kangaroo mother care unit for two years. © WHO / Hilina Abebe

However, COVID-19 threatens to derail recent progress. The COVID-19 pandemic is affecting the quality of care provided to babies in all regions of the world and threatening implementation of life-saving interventions like breastfeeding and kangaroo mother care.

A new analysis showed that there is an increased risk of death among preterm or low birthweight babies if kangaroo mother care is not practiced, with this risk 65-fold higher than the risk of death due to COVID-19 infection.

WHO therefore advises that wherever possible, mothers and babies should not be separated during the pandemic, and that kangaroo mother care should continue to be supported for babies born early or small.

Read more:

New research on the risks of separating newborns from mothers during the COVID-19 pandemic

New research on the benefits of starting kangaroo mother care immediately after birth

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