While his family was cherishing the news about the birth of his child, there remained an underlying concern. Durgappa’s child weighed just over one and a half kilos. The child was at a high risk of several health complications.
Durgappa, a daily wage labourer who hails from Koppal District was working in Bengaluru when the news reached him. Medical professionals attending to the child spoke to the family about the need to give the baby extra care.
Conventionally, a child that weighs anything below 2,500 grams at the time of birth is kept in an incubator under the observation of doctors and nurses to ensure that its vital parameters remain normal.
Durgappa’s family, however, was given an alternate option. One of the members of the family had to the keep the new-born abreast, give him skin-to-skin contact for several hours until he grew stable enough to sustain on its own. This, they were told, would cost them nothing but would reap benefits over time.
This was how he was introduced to the concept of ‘Kangaroo Mother Care’ (KMC). There was another challenge involved in his case. With his wife having undergone a C Section, she did not have the energy to carry the child all throughout the day.
“Doctors called me and told me that I could offer KMC in place of my wife. All I had to do is to hold my son all day long, giving skin contact. Initially, my family was skeptical on whether it would help. I consented,” he says.
It meant taking time off from his job and heading to his hometown. “I would do anything for him. The staff at the hospital where my wife had delivered explained the procedure to me. I held him for several weeks that way for about 10 hours every day. Today, my child is healthy,” he recollects.
Today, Durganna has been promoting KMC in Koppal, reaching out to parents with underweight and pre-term children.
Known to be among the backward Districts in Karnataka when it comes to healthcare, Koppal reports high number of infant mortalities. According to figures with the Karnataka Health Promotion Trust (KHPT) who have taken up the KMC initiative on a pilot basis in Koppal, this district sees 28,000 deliveries a year. About 20 per cent children weigh below 2,500 grams (which is the ideal weight) and of this, five to six per cent weigh below 2,000 grams.
A case for World Health Organisation
Recently, Renuka Hadapad, a mother from Koppal made it to the news after their triplets survived with the help of Kangaroo Mother care. What more? This is now a case study for the World Health Organisation. The WHO intends to scale this up to a global model. Even as the government of India had issued a set of guidelines to be followed for KMC in 2003, there was no effort made towards implementation.
The Concept
Dr Swaroop N, Deputy director, quality improvement and quality life, KHPT explains that the concept dated back to 1979 and originated in Columbia.
“The WHO wanted to showcase a model that can be implemented across the globe. Seven sites have been chosen for the pilot project. Of this, there are four in Ethiopia and three in India (Karnataka, Haryana and Uttar Pradesh). We chose Koppal as it is known to have higher infant mortality rates,” he says. The project was started in 2016 here and about 700 new-borns have benefited from the same. This is being done by the government of Karnataka in association with the St Johns National Academy of Health Sciences.
What is Kangaroo Mother Care?
When a newborn is underweight, additional care ought to be given for it to cope with the environment. It is done in places which have no access to incubators and to families that cannot afford other modes of care. It involves keeping the child in close skin-to-skin contact for several hours. However, for this, all the other vital parameters of the child ought to be normal.
Pratibha Rai B, manager, Community interventions, KHPT explains that the advantages are plenty. “It protects a child from hypothermia, enables better breastfeeding, promotes weight gain, reduced readmission to hospitals, exposure to healthy bacteria from the mother, minimises chances of hypoxia, improves sleep and also enhances the mother-child bonding,” she adds. In cases where the mother is unable to provide KMC, any other member in the family can offer to do the same.
The procedure could last for as three hours in short KMC, five to eight in extended, and nine to 12 hours in long KMC and can be prolonged to 12 hours. When it was initiated in Karnataka, staff could achieve three hours and at present, families are counselled to offer KMC for over eight hours, according to KHPT.