The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #64781

Nancy L Sloan, DrPh¹, Iftekhar Quasem, MD², Anita Chowdhury, MA², Salahuddin Ahmed, MD³, Beverly Winikoff, MD, MPH¹, and A. M. R. Chowdhury, PhD⁴. (1) International Programs Division, Population Council, One Dag Hammarskjold Plaza, New York, NY 10017, 2123390601, nsloan@popcouncil.org, (2) Research and Evaluation Division, Bangladesh Rural Advancement Committee, BRAC Centre, 75, Mohakali, Dhaka-1212, Bangladesh, (3) Mitra and Associates, 2/17 Iqbal Road, Mohammadpur, Dhaka-1207, Bangladesh, (4) Division of Population and Family Health, Columbia University School of Public Health, 60 Haven Avenue, New York, NY 10032

Kangaroo mother care (KMC) method, whereby hospital-born, stabilized low birth weight newborns are placed in an upright position in twenty-four hour skin-to-skin contact on the mother’s breast, has been shown to significantly reduce the incidence of life-threatening morbidity. Yet it has never before been formally adapted for community-based implementation, where it could prove to be the best means of non-institutional stabilization and significantly reduce neonatal and infant mortality.

In Bangladesh, we formally adapted KMC for community-based implementation. A select team of multi-national, multi-disciplinary experts discussed ways to create a community-based KMC (CKMC) method. We attempted to mimic the ‘spirit’ of KMC, promoting constant skin-to-skin contact, exclusive, on-demand breastfeeding, sleeping upright with the baby, using a damp or dry cloth to clean the baby instead of immersing the baby in water, and recommending the mother immediately seek health care if the baby experiences danger signs. The same easily transferable teaching technique as the hospital-based method, relying on person-to-person communication and demonstration, was used, and the ‘main messages’ pamphlet given to mothers in our earlier Ecuador study was adapted for the mostly illiterate women in the Bangladesh study area. The strategy integrates CKMC into an existing government program, whereby community-based workers teach CKMC to expectant mothers.

With local data collection experts, we pilot tested CKMC and found it was quickly and popularly adopted. We now plan to conduct a large, randomized controlled cluster trial to test the effects of CKMC on reducing neonatal mortality.

Learning Objectives:

• Participants will be able to describe the process by which hospital-based KMC was successfully adapted for community-based implementation.

Keywords: Child Health, International Public Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.