Pakistan: A journey from gloom to hopefulness: “Parveen and Sadam are happy and feel good about Kangaroo Mother Care (KMC)”
A journey from gloom to hopefulness: “Parveen and Sadam are happy and feel good about KMC”
Globally, around 20 million babies are born with low birth weight (LBW) (weight less than 2500 grams at birth) each year, and nearly 97% of these are born in low-and middle-income countries (LMICs) (1). These babies are at high risk of death and may have impaired growth and development (2). Currently, Pakistan’s neonatal mortality rate is 42 deaths per 1000 live births, which is one of the highest in the world (3). Essential neonatal care is unaffordable and inaccessible in most parts of the country. Simple cost-effective measures and evidence-based interventions such as Kangaroo Mother Care (KMC) could prevent a large number of the deaths and adverse neonatal outcomes (1).
In response to this, Dr. Shabina Ariff and her team from Aga Khan University is conducting an implementation trial to improve uptake of KMC at community level. Dr. Shabina is an expert clinician scientist and has led multiple national and international research projects aimed to improve maternal and neonatal health in Pakistan. She has been advocating for community and facility KMC. Presently she is conducting a trial on community at the rural district Dadu, South of Pakistan. The population of the district is marginalized, where majority of births take place at home, and accessibility to basic neonatal care is a major issue. We are implementing this low-cost intervention and exploring its impact on newborn survival and breast-feeding practices.
The story is a reflection of how KMC served as a miracle for couple Parveen and Sadam, who live in a small village of Fateh Pur, in District Dadu. It is a remote area with no facility providing advanced newborn care.
Figure 1: 26-year-old Parveen providing KMC to her low birthweight, preterm baby
Our KMC research team met 26-year-old Parveen in April 2019, when she was seven months pregnant. She had no living children, since one of her infants was a 30 weeks preterm neonatal death, and she had two stillbirths. Stricken with grief and hopelessness on the loss of her three pregnancies, her worries exacerbated as she dwelled on the idea of never being able to bear children. Her husband Sadam is an unskilled labourer who barely manages household expenses. Medical expenses and accessing health facilities added financial constraints to their lives. The coupled grief of losing three children and being unable to seek medical consultation left the couple distressed and dejected.
When our team met Parveen, she was anxious and stressed for her unborn baby. The KMC mobilization team introduced her to KMC and educated her on its benefits in saving newborn lives. She was also counselled on the importance of antenatal visits, birthing in a healthcare facility by a skilled birth attendant, danger signs to look out for during her pregnancy and after the baby is born, attending post-natal care visits to follow-up on the baby’s health.
On 20th May 2019, Parveen gave birth to a low birthweight, baby-girl weighing about 1.68 kg. Initially, Parveen was scared to perform KMC on her little one. The KMC mobilization team gave her a demonstration of KMC with a local wrap and successfully encouraged her to initiate the practice within the first hour of life. She loved every minute she performed KMC, and the baby received approximately 12 to 14 hours of KMC each day. The whole family saw a glimpse of hope and came together to ensure the baby’s survival. Parveen’s mother-in-law and brother-in-law supported her in providing skin-to-skin contact to the baby
After seeing her baby growth and survival, Parveen was ecstatic and the family experienced profound happiness.
“Each day I saw progress in my baby, it gave me confidence”- Parveen
Figure 2: Picture of baby taken at her first birthday, she weighed 8.3 kg.
Parveen shared her success story with pregnant women and other women of reproductive age in her village to encourage the practice of KMC. She further became a KMC mother champion and helped provide other mothers in her community on the practice of KMC.
“I am very happy and I can say KMC is an excellent method for a small baby;
it saved my baby’s life. I will advocate KMC for all small babies in my community”- Parveen
- Mazumder S, Taneja S, Dube B, Bhatia K, Ghosh R, Shekhar M, et al. Effect of community-initiated kangaroo mother care on survival of infants with low birthweight: a randomised controlled trial. The Lancet. 2019;394(10210):1724-36.
- Organization WH. Global Nutrition Targets 2025: Low birth weight policy brief. World Health Organization; 2014.
- National Institute of Population Studies (NIPS) [Pakistan] and ICF. 2019. Pakistan Demographic and Health Survey 2017-18. Islamabad, Pakistan, and Rockville, Maryland, USA: NIPS and ICF.