Peer-reviewed article
Circle of care model for strengthening newborn care through Kangaroo Mother Care integration in primary health systems in rural India.
Thakral Y, Gulechha A, Mohan SB, Mohan P ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study evaluated a facility-community model for Kangaroo Mother Care (KMC) in rural India, where facility staff initiated the practice with low birth weight infants and outreach teams supported families to continue it at home. Over three years, KMC facility coverage increased from 60% to 88%, with over half of mothers continuing the practice at home and 99% infant survival. The coordinated approach strengthened communication between health workers, built staff capability, and improved exclusive breastfeeding rates to 98%.
Key points
- Facility KMC coverage rose from 60% to 88% over the 3-year period
- 52% of mother-infant dyads continued KMC at home after facility discharge
- Exclusive breastfeeding reached 98%, with average daily skin-to-skin contact of 9 hours
- Infant survival was 99% among the cohort
- The circle of care model strengthened continuity, trust, and workforce capability between facility and community teams
Limitations
The study lacks a comparison group to establish whether outcomes resulted from the circle of care model or other factors in the PHC setting. The document does not provide data on cost-effectiveness or long-term follow-up beyond the initial period.
Abstract
Background Kangaroo Mother Care (KMC) reduces morbidity and mortality among preterm and low birth weight infants, yet continuity between facility initiation and home practice remains weak in rural settings. This study examined a facility-community circle of care model in a primary care setting in southern Rajasthan, India. Methods In a primary health centre (PHC) managed as a public-private partnership in rural south Rajasthan, India, we trained and supported the PHC facility-based team to initiate KMC for all low birth weight babies at birth, and the outreach team to continue KMC at household levels. Both teams educated and supported mothers and family members to provide and sustain KMC for the babies.We reviewed the programme and supervisory data of a 3-year period (2021-2024) following the KMC introduction to estimate key indicators of its coverage and effectiveness. We also conducted semi-structured interviews with the team members to understand and document the process of introduction. Results Among 1188 live births, 34% were low birth weight. Facility KMC coverage rose from 60% to 88%, and 52% of dyads continued KMC at home. Exclusive breastfeeding reached 98%, mean skin-to-skin contact averaged 9 hours daily and infant survival was 99%. The circle of care strengthened continuity, trust and workforce capability. Conclusion Embedding KMC within a coordinated, mentorship-supported circle of care provides a scalable systems approach to enhancing newborn outcomes and primary care in rural and tribal settings.