An estimated 15 million babies are born too early every year i.e. more than 1 in 10 babies. The global prevalence of low birth weight (LBW) is 15.5%, which amounts to about 20 million LBW infants born each year, 96.5% of them in developing countries
Two-thirds of the world’s neonatal deaths occur in just 10 countries, mostly in Asia. Pakistan is number three among these countries. Pakistan ranked 4th with highest rate of prematurity. UNICEF reported 16 preterm births per 100 live births in 2010
Premature and LBW babies are the major contributor of high neonatal mortality rate in Pakistan too. Approximately, 46% of newborn babies die due to prematurity in Pakistan. Majority of them die due to hypothermia. Only 1 in 10 infants’ birth weight has been recorded and out of them, 26% were reported to have low birth weight
To reduce the number of newborn deaths in province of Sindh, PPHI Sindh has been implementing Kangaroo Mother Care (KMC) in its 150 maternal and child health centers. KMC, an alternative to the incubator care, is a breakthrough and low-cost initiative recommended by WHO (WHO Guidelines 2015) to reduce mortality and morbidity among premature and Low Birth Weight (LBW) babies. It started in 1979 in Bogota, Columbia by Dr. Edgar Ray and Dr. Hector Martinez in response to shortage of incubator
PPHI Sindh took the lead to introduce KMC for the first time at Basic Health Unit (BHU) level in Pakistan. These centers are operated under limited resources and without any neonatal intensive care facility. Fully equipped KMC units are established with all the essential supplies. Healthcare providers were trained and new guidelines for newborn care and discharge were introduced. Mothers are advised to come for follow-up and the ones that do not show up were traced through phone calls
- For Preterm
Admission criteria: <37 weeks of gestation
Follow up frequency: Twice a week - For LBW
Admission criteria: <2.5 kgs
Follow up frequency: Once a week - Note:
All Preterm and LBW babies are admitted and kept for at least 24 hours at facility. After being discharged, KMC continues at home till baby attains normal weight or gestational age. For this purpose, mothers are trained in providing skin to skin care and exclusive breast feeding. They are also provided with binders to hold babies. During follow ups baby’s wellbeing and growth are checked. Further counselling is provided for KMC.
- 1
World Health Organization: Maternal, newborn, child and adolescent health: care of the preterm and/or low-birth-weight newborn Available from:
http://www.who.int/maternal_child_adolescent/topics/newborn/care_of_preterm/en/ - 2 Black, R.E., Morris, S.S. & Bryce, J. (2003) Where and why are 10 million children dying every year? The Lancet, 361: 2226–34
- 3
World Health Organization: Preterm Birth: Fact sheet. November 2016; Available from:
http://www.who.int/mediacentre/factsheets/fs363/en/ - 4
Pakistan demographic and health survey 2012-2013. Available from:
https://dhsprogram.com/pubs/pdf/fr290/fr290.pdf - 5 District Health Information System
- 6 Summary of Additional Services, PPHI Sindh
- 7 UNICEF (2010). Maternal, newborn and child health disparities in Pakistan