Summary

To date, community-based newborn care interventions have focused on pregnancy and post-partum care including essential newborn care and, to a limited extent, on resuscitation of asphyxiated babies and identification and management of newborn infections. However, greater focus is needed on the care of low birth weight (LBW) and preterm babies because they contribute to the vast majority of the neonatal deaths and are at much higher risk of developing asphyxia, infection and hypothermia. Kangaroo Mother Care (KMC) is a low-cost and low-technology intervention that has been proven as safe and effective as conventional care among LBW neonates in hospital settings. Although KMC has the potential to be practiced for LBW infants delivered at home, as of yet, there is no evidence that KMC can be effectively delivered at the community level to improve neonatal health outcomes. Our goal with the proposed study is to develop and pilot a KMC promotion intervention in Bangladesh that could achieve high rates of continuous KMC, particularly for LBW infants. The specific aims of this study are: 1) to assess the current thermal care practices for newborns and the acceptability of kangaroo mother care in Gopalgonj, Bangladesh; 2) to design and pilot a community KMC package and identify barriers and facilitating factors for implementation and uptake; 3) to document the level of adoption of community KMC among mothers participating in the pilot. This study will develop collaborations between the Department of International Health at JHSPH and the Department of Neonatology at JHMI and will build on a strong established relationship with the International Center for Diarrheal Disease Research, Bangladesh (ICDDR,B). The findings from this study will make important contributions to the literature on community delivery of KMC and will provide preliminary results that position the research team to pursue federal research funding for a cluster-randomized trial of community KMC.