Population Council Research that makes a difference

Working with Columbia University, Bangladesh Rural Advancement Committee (BRAC), and Mitra and Associates, researchers with the Council’s FRONTIERS program tested the effectiveness and costs of community-based kangaroo mother care (CKMC) implemented by piggybacking CKMC instruction onto an existing community-based program. Kangaroo mother care (KMC) is a method for care of stable preterm or low-birth-weight infants who need thermal protection, adequate feeding, frequent observation, and protection from infection. This project measured the effect of CKMC on neonatal and infant survival as well as birth intervals associated with neonatal and infant survival.

Project staff adapted KMC for community-based implementation in a manner that does not require birth weight or clinical judgment, as measurement of birth weight is not routine in home deliveries in resource-poor countries. To deliver CKMC in a feasible, replicable manner, FRONTIERS researchers elected to train a single category of existing community-based workers who serve approximately one-third of Bangladesh.

This study is the first to demonstrate the impact of CKMC on newborn and infant survival and on subsequent pregnancy. The results demonstrate a strong, statistically significant, biologically and temporally plausible lower neonatal mortality. However, further experimental evaluation ensuring baseline similarity of study groups and complete, reliable assessment of birth weight is necessary to determine whether CKMC improves survival. CKMC training or taking CKMC to scale at this time is ill-advised before establishing its benefits and optimal methods of implementation.