title: Rolling out of kangaroo mother care in secondary level facilities in Bihar-Some experiences.
abstract: Preterm birth is one of the leading causes of under-five child deaths worldwide and in India. Kangaroo mother care (KMC) is a powerful and easy-to-use method to promote health and well-being and reduce morbidity and mortality in preterm/low birth weight (LBW) babies.
  
  
  
  As the part of the roll-out of India Newborn Action Plan interventions, we implemented KMC in select facilities with an objective to assess the responsiveness of public health system to roll out KMC.
  
  
  
  KMC intervention was implemented in two select high priority districts, Gaya and Purnea in Bihar over the duration of 8 months from August 2015 to March 2016. The implementation of intervention was phased out into; situation analysis, implementation of intervention, and interim assessment. KMC model, as envisaged keeping in mind the building blocks of health system, was established in 6 identified health-care facilities. A pretested simple checklist was used to assess the awareness, knowledge, skills, and practice of KMC during baseline situational analysis and interim assessment phases for comparison.
  
  
  
  The intervention clearly seemed to improve the awareness among auxiliary nurse midwives/nurses about KMC. Improvements were also observed in the availability of infrastructure required for KMC and support logistics like facility for manual expression of breast milk, cups/suitable devices such as paladi cups for feeding small babies and digital weighing scale. Although the recording of information regarding LBW babies and KMC practice improved, still there is scope for much improvement.
  
  
  
  There is a commitment at the national level to promote KMC in every facility. The present experience shows the possibility of rolling out KMC in secondary level facilities with support from government functionaries.
authors.affiliation: Additional Professor, Indian Institute of Public Health-Delhi, Public Health Foundation of India, India.
authors.forename: Sutapa B
authors.initials: SB
authors.lastname: Neogi
authors.affiliation: Project Associate, Indian Institute of Public Health-Delhi, Public Health Foundation of India, India.
authors.forename: Monika
authors.initials: M
authors.lastname: Chauhan
authors.affiliation: Associate Professor, Indian Institute of Public Health-Delhi, Public Health Foundation of India, India.
authors.forename: Jyoti
authors.initials: J
authors.lastname: Sharma
authors.affiliation: Associate Professor, Indian Institute of Public Health-Delhi, Public Health Foundation of India, India.
authors.forename: Preeti
authors.initials: P
authors.lastname: Negandhi
authors.affiliation: Health Specialist, UNICEF, Bihar, India.
authors.forename: Ghanshyam
authors.initials: G
authors.lastname: Sethy
authors.forename: Syed Hubbe
authors.initials: SH
authors.lastname: Ali
mesh_terms: D005260:Female; D006268:Health Facilities; D006801:Humans; D007194:India; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D060127:Kangaroo-Mother Care Method; D015397:Program Evaluation