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Community-Based Kangaroo Mother Care to Prevent Neonatal and Infant Mortality (2001-2007)

 

The CKMC Study was designed as an experimental test to assess the effectiveness of Kangaroo Mother Care Method as a community-based intervention to reduce neonatal and infant mortality. KMC Method, that was Kangaroo Mother Care Method, was a method to stabilize the newborn, keeping it in 24-hour skin-to-skin contact. Thus, the method involves placing the newborn, immediately after birth, without cloth, except for diapers and cap, in an upright position between the mother’s breasts for skin-to-skin contact.  

 

The study was implemented with a randomized cluster design.  Four upazilas have been selected, one in Sylhet Division and three in Dhaka Division. The study covered 42 clusters; a cluster being a union. Fifty percent of the clusters were KMC intervention clusters and 50% were control clusters, stratified by union population size and distance to the upazila hospital.

 

A household surveillance system monitors pregnancies, vital events, reported morbidity, nutritional status, breastfeeding, skin-to-skin contact and sleeping pattern for 27 months.  All women expected to deliver within the first 15 months of the project and consenting to participate in the study had enrolled as study subjects. Birth weight was measured within 72 hours of birth.

 

The Community-based Kangaroo Mother Care Study was conducted in the following steps:

 

  • the pilot test of the community-based adaptation of KMC was carried out from June to August 2002 
  • the baseline survey of Community-based Kangaroo Mother Care started in February 2004 and completed in September 2004 covering 26,000 households
  • the quarterly households’ survey had been carried out since November 2004 to identify pregnancies/births in the study area covering around 25,000 households and was completed in January 2006
  • the neonatal follow up survey commenced in December 2004 and was completed in February 2006. Around 4,000 neonatal data were collected during this period
  • the quarterly infant follow-up survey commenced in February 2005 and was completed in April 2007

 

The CKMC study was a very large and complex in nature and the first of its kind in Bangladesh, and for the first time all data were collected by using portable handheld computers. 

The study was commissioned by the Population Council, USA and funded by the William and Flora Hewlett Foundation, the John D. and Catherine T. Mac Arthur Foundation, Save the Children Saving Newborn Lives, and the USAID. 

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