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28 Dec 2016 00:39

Dear Kangaroo Family   We want to thank you for being part of the last International Conference on Kangaroo Mother Care. It was a pleasure to share great moments with all of you during those 4 days !   C [ ... ]


Consensus On Kangaroo Mother Care Acceleration

On Oct 21–22, 2013, stakeholders in newborn health, convened in Istanbul, Turkey, to discuss how to accelerate the implementation of kangaroo mother care (KMC) globally. Focused attention on newborn deaths, which now account for 44% of under-5 mortality. Is required to accelerate progress towards Millennium Development Goal (to reduce child mortality by two-thirds) and beyond. KMC has been proven to reduce newborn mortality, but only a very small proportion of newborns who could benefit from KMC receive it. The Istanbul convening was assembled to accelerate the uptake of this life-saving intervention.


We affirm accelerating adoption of KMC, recognizing that:

• Prematurity is a major cause of newborn death and disability globally. Each year, preterm complications account for over 1 million deaths, or 35% of all neonatal mortality.

• We have an evidence-based solution for reducing preterm mortality and morbidity: KMC, which can avert up to 450.000 preterm deaths each year if near-universal coverage is achieved.

• Investment in KMC has beneficial effects beyond survival, including healthy growth and development. KMC comprises a set of care practices for low birth weight newborns—including continuous skin-to-skin contact, establishing breastfeeding, and close follow-up after discharge from a health facility. Additionally, skin-to-skin contact and exclusive breast feeding are beneficial for all newborns and mothers, and can further accelerate reduction of newborn deaths.

Global implementation of quality KMC for preterm newborns has not kept pace with the robust, long-standing evidence for the following reasons:

• KMC is incorrectly perceived as a practice for preterm newborns in low-income countries, as a “next-best” alternative to incubator care.

• Many health-care providers (at all levels) do not know or do not believe in the benefits of KMC, and lack the skills for effective implementation.

• Cultural and social norms related to mother and newborn practices make uptake of KMC challenging.

• Human resources for health required for KMC have been lacking, and the role of mothers and communities has been overlooked.

• KMC has not been included in many country-level government newborn agendas and policies. Based on the available evidence we reached consensus, , that KMC should be adopted and accelerated as the standard of care and an essential intervention for preterm newborns. We defined success as augmented and sustained global and national level action to achieve 50% coverage of KMC among preterm newborns by the year 2020 as part of an integrated RMNCH package, and propose the following call for action to achieve this goal:

IRevise WHO KMC guidelines and country-level government health agendas and policies to define KMC as standard of care for all preterm newborns.

IIIncorporate high-quality KMC in national RMNCH and nutrition policies, plans, and programs.

IIIEngage health professional associations in high-income countries to adopt KMC as standard of care, to mitigate beliefs that KMC is only for low-income countries.

IV Address local and context-specific, cultural barriers in the design of KMC guidelines, protocols, and education.

VRally communities and families to support mothers in the practice of KMC and address misconceptions and stigma associated with preterm birth, early bonding, skin-to-skin practices, and breastfeeding.

VI Improve practitioner uptake of KMC by working with professional associations, ministries of health, and traditional leaders, who can work with local providers to overcome barriers related to workforce, skills, and cultural norms.

VII Develop a unified advocacy narrative that culturally and medically normalizes KMC, with messages that can be adapted in different contexts.

VIIIMeasure our progress against our definition of success, using robust metrics and indicators.

IXConduct research, to better understand optimal timing, duration, and conditions for KMC, its impact on development and survival segmented by gestational age, how to tackle barriers to KMC practice, change provider behaviors, and cost analyses of establishing KMC services.

The KMC Acceleration Convening in Istanbul was a key opportunity to build consensus for accelerated implementation of KMC. In conjunction with the upcoming Every Newborn Action Plan, the KMC acceleration plan outlined above can bend the curve on newborn mortality and give vulnerable newborns around the world a better chance of survival and health.

*Cyril Engmann, Stephen Wall, Gary Darmstadt, Bina Valsangkar, Mariam Claeson, on behalf of the participants of the Istanbul KMC Acceleration Meeting.

Maternal, Newborn and Child Health, Bill & Melinda Gates Foundation, Seattle, WA 98102, USA (CE, GD, MC); and Save the Children Saving Newborn Lives, Washington D.C., USA (SW, BV).

This email address is being protected from spambots. You need JavaScript enabled to view it.

We declare that we have no conflicts of interest.

1 UNICEF, WHO, The World Bank, UN. Levels and trends in child mortality, report 2013. Estimates developed by the UN Inter-agency Group for Child Mortality Estimation. New York: United Nations Children’s Fund, 2013.

2 March of Dimes, Partnership for Maternal, Newborn and Child Health, Save the Children, WHO; CP How son, MV Kinney, JE Lawn, eds. Born too soon: the global action report on preterm birth. Geneva: World Health Organization, 2012.



1 The following people attended the Istanbul meeting where the 'Consensus on kangaroo mother care acceleration' was drafted and support the statement in their personal capacity.

2 We call for investments in developing newborn care infrastructure, including facilities for mothers and babies where KMC is implemented, and for developing skilled health workforce to support mothers and families in providing quality KMC to their babies.


Abdulla Baqui
Johns Hopkins University School of Public Health


Agustin Conde-Agudelo
World Health Organization, Collaborating Centre in Human Reproduction


Amy Jerret
Bill & Melinda Gates Foundation

Anju Puri1
Senior Advisor - Newborn & Child Health
Maternal and Child Health Integrated Program (MCHIP)/USAID Grantee
New Delhi,India.

Anne-Marie Bergh
MRC Unit for Maternal and Infant Health Care Strategies

Bina Valsangkar, MD, MPH
Newborn Technical Advisor. Saving Newborn Lives
Save the Children
Washington, DC


Brendan Wackenreuter
Save the Children


Brian Mulligan
Bill & Melinda Gates Foundation


Cheryl A. Moyer, PhD, MPH
Managing Director, Global REACH
University of Michigan Medical School


Chief Mc Jullior Carstens Kwataine
Safe Motherhood Initiative


Cyrill Engmann
Bill & Melinda Gate Foundation


Elizabeth Jane Soepardi
Indonesia Ministry of Health


Evelyn Zimba
Save the Children


Fannie Kachale
Malawi Ministry of Health

Gabriel Seidman
Boston Consulting Group

Gary Darmstadt

Bill & Melinda Gates Foundation

Goldy Mazia, MD, MPH 1; 2
Coordinator- LAC Neonatal Alliance and Maternal and Child Health Integrated Program (MCHIP)

 Grace Chan
Save the Children

 Hadi Pratomo
Universitas Indonesia

 Jose Martinez
World Health Organization

 Joseph de Graft Johnson

 Kate Kerber
Save the Children

Kerstin Hedberg Nyqvist, RN, PhD. 1; 2
Associate Professor,
Department of Women's and Children's Health, Uppsala University
Uppsala, Sweden

Kim Eva Dickson1
Senior Adviser (Maternal and Newborn Health)
Health Section

Lily Kak 1; 2

Linda Vesel, PhD, MPH

Maternal and Newborn Health Program
UNICEF, New York

Lori McDougall

The Partnership for Maternal, Newborn & Child Health

Lydia Schmeltzer

Bill & Melinda Gates Foundation

Mariam Claeson 1
Bill & Melinda Gates Foundation

Mohammod Shahidullah

Bangabandhu Sheikh Mujib Medical University

Nancy Sloan

Independent Consultant

Nathalie Charpak 1; 2

Manager, Founder

Kangaroo Foundation

Nita Bhandari

Society for Applied Stuides

Peter Waiswa 1
Chair Newborn Working Group, INDEPTH network, and Lecturer, Dept of Health Policy, Planning and Management
Makerere University School of Public Health

Praveen Mishra

Nepal Ministry of Helath

Priscilla Wobil

Komfo Anokye Teaching Hospital

Queen Dube 1;2
 Save The Children

Rajiv Bahil 1
World Health Organization

Sarah Cairns-Smith

Boston Consultin Group

Sarmila Mazumder

Society for Applied Studies

Shalini Unnikrishnan

Boston Consulting Group

Socorro De Leon-Mendoza, M.D.
Kangaroo Mother Care Foundation Phil., Inc.

Stephen Hodgins

Save the Children

Steve Wall

Save the Children

Sunita Taneja

Society for Applied Studies

Vinod K. Paul   MD, PhD, FAMS 2
Head, Department of Pediatrics &
WHO Collaborating Centre for Training & Research in Newborn Care, ALL INDIA INSTITUTE OF MEDICAL SCIENCES,
New Delhi, India

Vishwajeet Kumar

Community Empowerment Lab

 Zelee Hill
University College London

 Severin von Xylander 1
WHO, Department for Maternal, Newborn, Child and Adolescent Health Department (MCA)