Creation of a globally informed and locally relevant KMC implementation model for population‐impact in Amhara, Ethiopia

Abstract

Aim: As part of a multi-country implementation trial, we tested a regionally specific model of kangaroo mother care (KMC). Effective KMC was defined as ≥8 h of newborn-caregiver skin-to-skin contact daily plus exclusive breast feeding. The study was designed to achieve ≥80+% effective KMC coverage at the population level. Methods:The Amhara KMC model was designed using global evidence, formative research in the region and input from government officials, clinicians, newborn families and global scientists. We optimised the initial model using continuous quality improvement with process feedback, outcome measurement and collaborative redesign. Outcomes from the evaluation period are reported.Results: At discharge, the final model resulted in a median of 16 h per day of skin-toskin contact with 63% effective KMC coverage. Fifty-three percent sustained effective KMC to 7 days post-discharge.Conclusions: It is possible to achieve high coverage (63%), high-quality KMC at public hospitals without prior KMC services using government-owned, multisectoral collaborative design. Targeted co-design, real-time data and customisation of KMC interventions with input from impacted stakeholders was critical in achieving high coverage and sustained quality.

Developing context‐specific models to achieve high coverage and quality of KMC in India and Ethiopia: Learnings from implementation research

“…Several factors supported these positive results and each paper in this supplement highlights site‐specific factors 5–11 . Government guidelines were supportive in all sites.…”

“…This supplement brings together eight papers published by Acta Paediatrica 5–12 . They present learnings from a multi‐site implementation research 13 on how to accelerate the scale‐up of KMC in support of these goals.…”

“…4 ThissupplementbringstogethereightpaperspublishedbyActa Paediatrica. [5][6][7][8][9][10][11][12] They present learnings from a multi-site implementationresearch 13 ThisisanopenaccessarticledistributedunderthetermsoftheCreativeCommonsAttributionIGOLicense,whichpermitsunrestricteduse,distributionand reproductioninanymedium,providedtheoriginalworkisproperlycited. ©2023WorldHealthOrganization;licensedbyFoundationActaPaediatrica.PublishedbyJohnWiley&SonsLtd.…”

Designing Electronic Data Capture Systems for Sustainability in Low-Resource Settings: Viewpoint With Lessons Learned From Ethiopia and Myanmar

“…Emory-Ethiopia is the lead partner for the Amhara region in this national SLL consortium. These SLL activities build upon the same consortium’s scale-up research on KMC conducted in the same regions [ 12 , 16 ].…”

“…We describe 2 exemplar cases in Ethiopia and Western Myanmar/Eastern India to illustrate how robust EDC systems may be designed to support population health surveillance, specifically during humanitarian crises (ie, civil unrest and the COVID-19 pandemic). The research activities related to these cases have been described in other publications [ 11 , 12 ]. In this viewpoint, we describe case descriptions using a sociotechnical conceptual model to determine barriers and facilitators of successful development and use of EDC.…”