Circle of care model for strengthening newborn care through Kangaroo Mother Care integration in primary health systems in rural India

Vollständiger Abstract

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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.