Premature babies all over Africa and in developing countries around the world have a greater chance of survival today thanks to the work of University of Pretoria (UP) researchers. Drs Anne-Marie Bergh, Elise van Rooyen and colleagues have been tirelessly promoting the benefits of Kangaroo Mother Care for almost 20 years, training nurses and doctors in this low-tech solution that is saving premature and low birth-weight infants.
“Globally, 35% of neonatal deaths are due to conditions related to prematurity - problems with temperature control, breathing, and the cardiovascular system,” says Bergh, who oversees education aspects of public health projects for the SA MRC Unit for Maternal and Infant Healthcare Strategies at UP. “In our study, the introduction of Kangaroo Mother Care in South Africa was associated with a 30% reduction in neonatal mortality. It is now recommended by the World Health Organisation as a key intervention around the world.”
Kangaroo Mother Care (KMC) was originally developed in Colombia in 1979 as a solution to overcrowding in a neonatal unit in Bogotá, but was only taken up in other countries in the 90s after more than a decade of research. In essence, mothers and other caregivers are taught to carry their babies skin-to-skin, between the breasts, for 20 or more hours per day. This helps the baby maintain a regular temperature, enhances breastfeeding and dramatically improves a baby’s chance of survival.
In the absence of sophisticated care for small and sick newborns, KMC is a life-saving strategy for keeping the baby warm and reducing the chance of infection. Skin-to-skin care is also used worldwide to help premature babies bond with their parents. But that’s not all: Bergh says studies are starting to show the positive effects of KMC on long-term brain development.
Bergh and Van Rooyen first started working to implement KMC in South Africa in 1999. They started at Kalafong hospital in Pretoria where Van Rooyen heads the KMC unit, and over the next 10 years developed multimedia training materials, techniques and methods for sustainable implementation, as well as tools to evaluate the success of their efforts.
“When we started working with KMC, it was a new thing,” says Bergh. “Nobody knew how to implement it.”
Now, Bergh and Van Rooyen are world experts in getting KMC to work, regardless of the context. Since 2007, when they evaluated a project implementing KMC in Malawi, they have worked with African countries like Ghana, The Gambia, Mali and Rwanda (to name a few), as well as Asian countries like Indonesia, India and Bangladesh. This work, often in partnership with development agencies and ministries of health, either involves helping countries assess the needs of the country, implement a KMC programme, or review the success of such an implementation.
Bergh says that KMC is gaining ground globally as an important life-saving intervention in newborn care.
“Since 2014, the Every Newborn Action Plan has put its focus more strongly on initiatives to save premature and low birth-weight babies,” she says. “Each country has its own specialised plan, but KMC is in there as a key intervention - it’s been identified as high impact, life-saving, and cost-effective.”
In SA, KMC is in place in hospitals all over the country, and it forms part of the newborn care taught to new doctors and nurses. Bergh says that it might not always be implemented in the same way - the methods are designed to be adaptable to different situations, skill levels and institutions - but the outcome is the same: newborn lives are saved.
Left: The Kalafong thari is used to carry babies cared for using Kangaroo Mother Care babies all over the world. Right: Babies are carried skin-to-skin with their mothers or carers, to improve temperature control. Image credit Elise van Rooyen.