New guidelines to improve neonatal care for premature babies in Bangladesh

icddr,b research and expertise have contributed to new national guidelines for kangaroo mother care for premature newborn babies in government healthcare facilities in Bangladesh

The Government of Bangladesh has developed a national guideline to introduce facility-based kangaroo mother care, a neonatal healthcare technique that reduces the mortality rate of premature newborn babies, in government healthcare facilities in Bangladesh. icddr,b experts contributed to the development of the guidelines by participating in a national-level advisory group, drawing on the institution’s experience of running a kangaroo mother care project in a hospital in Matlab for several years. icddr,b scientists also conducted a health systems bottleneck  analysis to identify existing gaps and challenges in public health systems of Bangladesh.

In addition, the icddr,b team is leading an operations research project in three first-level facilities in Kushtia district to systematically document the operational challenges and determine overcoming strategies to provide a Kangaroo Mother Care Service in resource poor settings.  

The decision to adopt kangaroo mother care was based on decades of international research proving that kangaroo mother care can reduce the mortality and morbidity rate of premature and underweight babies in low-income settings.

A range of partners contributed to the development of the guidelines, which seek to overcome the practical challenges to scale-up associated with the intervention, including LAMB, icddr,b and Save the Children’s Saving Newborn Lives project. The operational analysis and guidelines should be completed by the end of 2016.

Shumona holds her baby girl aged three-days close to keep her warm in the Neonatal unit, icddr,b Matlab Hospital. She has been receiving treatment and advice from the hospital since conception. Photo: Shahzad Noorani/icddr,b/2016

Premature birth is a big risk factor for child mortality, with preterm birth complications causing nearly 1 million deaths of children under five worldwide in 2013. This is because premature babies are usually underweight and have compromised immune systems, and as a result they are more susceptible to disease and infection. Unfortunately, the mechanical equipment required to care for premature babies, like incubators, are not always available in resource-poor settings like rural healthcare facilities in Bangladesh.

Kangaroo mother care is a low-cost and technically simple alternative that has the potential to prevent these deaths. The intervention involves placing a newborn premature baby on his or her mother’s or caregiver’s chest, ensuring skin to skin contact, and it can reduce the risk of deadly infections like pneumonia through the regulation of body heat. However, despite being developed and tested in Colombia more than 35 years ago, the method has proven hard to implement and scale-up in low-income countries worldwide due to the individual time investment and support required from the mother and her family.

“By conducting the health systems and operational analysis, we hope to identify the human resources and logistical gaps and challenges that the Government of Bangladesh will need to address in order to implement and scale-up kangaroo mother care,” says Dr Ahmed Ehsanur Rahman, a Senior Research Investigator in icddr,b’s maternal and child health division.

If the Government is successful in rolling out the guidelines, Bangladesh will be one of the few countries in the world to have adopted facility-based kangaroo mother care as part of the government healthcare system.