Introduction: Kangaroo Mother Care (KMC) is a simple method of caring Low Birth Weight (LBW) babies with a birth weight below 2500 grams. The grandmothers play a key role in child rearing in the Indian society. Aim: To estimate the level of knowledge about the KMC in the grandmothers and to compare it with that of the mothers. Materials and Methods: The cross-sectional study was conducted in the neonatal follow-up clinic of a tertiary care hospital with a convenience sampling of all the mother (Group 1) and grandmother (Group 2) dyads. The mothers and grandmothers were interviewed separately using a pre-validated questionnaire with 15 open ended questions to assess the knowledge about the KMC. Mann-Whitney U test and Fischer’s- exact test were used for statistical analysis. Results: There were 390 mother- grandmother dyads in the study group. The mean age of the mothers and grandmothers were 24.69±1.54 years and 53.89±1.80 years, respectively. For all the 15 questions the grandmothers had a significantly lower score when compared to the mothers (p<0.001). The grandmothers (mean score: 8.48±2.00) had a significantly lower overall knowledge scores than the mothers (mean score: 23.10±1.55). On comparison of the mean knowledge scores of the mothers with their age, educational status and socio- economic class, it was found to be independent of these factors (p-value=0.209, 0.691 and 0.731, respectively). Conclusion: This study had demonstrated that the grandmothers have a significantly lower knowledge about KMC. There is an urgent need to empower them with the knowledge about KMC for the successful continuation KMC in the home.

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Background: For effective policy making, it is important to understand out of pocket costs incurred in neonatal admissions in public hospitals. This cross sectional study was conducted with an objective to estimate out of pocket expenses expended on neonates and attenders during neonatal hospitalizations in a tertiary care referral hospital. Material and Methods: The data were collected using a pretested and semi structured questionnaire in 298 neonates during July’2022. Expenditures were reported as median values with interquartile range (IQR) and compared using the Kruskal Wallis test. Result: On analyzing the results, there were no direct medical costs. The median cost spent on food per day, transport during the stay, non medical expenses per day, and total expenses per day were Rs. 300 (IQR 200, 500), Rs. 1000 (500, 1500), Rs. 500 (333, 896), and Rs. 1080 (800, 1533), respectively. Higher expenses were associated with preterm, low birth weight, neonatal seizures, and longer stay (P values <0.001, 0.028, <0.001, and <0.001, respectively). About 9.39% and 1% of the families were found to be catastrophic health expenditures at 10% and 25% threshold levels, respectively. Conclusion: To conclude, all the direct medical costs were borne by the caregiver. However, some non medical and indirect costs are associated with neonatal hospitalizations in public hospitals and cash benefit schemes can offset them.