Accelerated scale‐up of Kangaroo Mother Care: Evidence and experience from an implementation‐research initiative in south India.

Aim: Though Kangaroo Mother Care (KMC) has demonstrated benefits for low birth weight newborns, coverage continues to be low in India. As part of a World Health Organization (WHO) multi‐country study, we explored intervention models to accelerate KMC coverage in a high priority district of Karnataka, India. Methods: We used implementation‐research methods, formative assessments and quality improvement approaches to design and scale‐up interventions. Evaluation was done using prospective cohort study design; data were collected from facility records, and client interviews during KMC initiation, at discharge and at home after discharge. Results: KMC was initiated at health facilities for 87.6% of LBW babies under 2000 g. At discharge, 85.0% received KMC; 67.9% continued to receive KMC at home on the 7th day post‐discharge. The interventions included training, mentoring and constant advocacy at many levels: public health facilities, private sector and the community. Innovations like a KMC case sheet, counselling, peer support group triggered KMC in the facilities; a KMC‐link card, a microplanning and communication tool for CHWs helped to sustain practice at homes. Conclusion: The study provides a novel approach to designing and scaling up interventions and suggests lessons that are applicable to KMC as well as to broader reproductive, maternal, neonatal and child health programmes. [ABSTRACT FROM AUTHOR]