In Istanbul, Turkey, a city where East meets West, and emblematic of our challenge to meld state-of-the-art science with age-old parental instincts to provide newborn children with food, warmth and love, a group came together on October 21-23, 2013, to “bend the curve” on newborn survival through acceleration of adoption of Kangaroo Mother Care (KMC). Perhaps the blending of cultures all around us in that ancient city provided a clue to what must take place in the realm of KMC acceleration. Over the last 35 years, evidence has amassed that KMC promotes maternal-infant bonding and physiological stability in the newborn, facilitates breastfeeding, provides warmth, reduces risk of serious infections and mortality of premature infants by about 50 percent.
If universal KMC coverage was achieved, it is estimated that it could save 450,000 preterm newborns each year. If universal KMC coverage was achieved, it is estimated that it could save on the order of 450,000 preterm newborns each year. Yet current global coverage of KMC is less than one percent. This travesty led the Maternal, Newborn and Child Health team at the Bill and Melinda Gates Foundation, together with Save the Children / Saving Newborn Lives to convene more than 20 organizations representing governments, multinational organizations, non-governmental organizations, donors, civil society and academic institutions to address the fundamental question of what barriers we need to overcome, and what it will take collectively to drive the acceleration of coverage with this critical practice.
At the meeting, we all agreed that any efforts to promote a practice that is both feasible for mothers and effective for newborns must put the mother and her baby at the center. We must better understand local social and cultural contexts, so that we can better work with mothers, families, communities, traditional leaders, health practitioners and governments to create an environment that links care in the hospital with behaviors in the community and empowers and supports the practice of KMC as a norm.
As policies and programs shift, it will be critical to keep mothers and newborns, and the context in which they eat, sleep and live at the center of all we do.We all agreed that going forward and reaching scale was critically dependent on our ability to effectively integrate KMC into reproductive, maternal, newborn and child health and nutrition programs with a collaborative and coordinated global effort that includes governments, civil society, nonprofit organizations, communities, families and most importantly mothers. Paramount to our success will be our ability to unify around clear goals, targets, and indicators. KMC is not a “poor person’s alternative” to good medical care, but represents a powerful evidence-based, standard-of-care for premature babies.
We came together at this crossroad and emerged with broad consensus, captured in a Consensus Statement that is newly published in The Lancet as a first concrete step to act on our resolve to be held accountable for taking these principles forward rapidly to improve care for mothers and their newborns across the globe through acceleration of uptake of KMC. A multi-stakeholder group is now actively shaping these principles into a global strategy to bend the curve on KMC adoption as part of the Every Newborn Action Plan that will be launched in May 2014 in conjunction with the World Health Assembly. As plans roll out and policy and program shifts are negotiated, and questions of “how” emerge, it will be critical to move beyond the walls and halls of our institutions and keep mothers and newborns, and the context in which they eat, sleep and live at the center of all we do. For KMC, it was most fitting that in the city which bridges East and West, we similarly embarked on a journey to bridge evidence to action.