Thanks for supporting our mission of saving newborn lives. Your support is crucial in delivering our intervention of building capacity in India’s public health care system to provide a simple, cheap and well-evidenced intervention called Kangaroo Care.
Summary
Ansh is now a year old!
Both pilots were wrapped up on March 31st. During our pilot, we delivered our programs to 480 low birth weight and premature babies.
These pilots were transitioned into full-fledged programs from April 1st onwards. This decision to continue them stems from preliminary data analysis (discussed below).
Ansh received a grant of $96K from Founders Pledge to sustain the programs and the organisation. Ansh is looking to replicate the programs in a third District Hospital with high mortality rates which would require an additional $37K. Based on the results and ease of the replication, Ansh is planning to scale up to another 17 districts of Rajasthan with similar or higher neonatal mortality and scale.
Our Impact: January and February
We registered and provided our intervention to 276 babies in January and February. All these babies are over a month old now, and have crossed the neonatal period. After making various adjustments, we estimate that our pilots not only averted deaths, but did so highly cost-effectively.
Just through our two current district hospitals, we expect to reach over 1,800 low birth and premature babies this year.
Our pilot sample size of 480 (up to 31st March), is higher than even the biggest study included in the Cochrane review, which treated 396 babies in Colombia.
Fundraising
We have received a grant of $96,000 from Founders Pledge to keep our current programs running for the rest of the year.
An additional $37,000 will allow us to set up in a new hospital (already identified) and save more lives.
How is our estimated cost-effectiveness so high without scale?
High Neonatal mortality High number of deliveries * High institutional delivery rate
Similar to r.i.c.e., our target group is low birth weight and premature babies. This group has a high neonatal mortality rate (NMR), especially in the contexts we work in. Secondly, not only do we work in districts with high neonatal mortality, but also in hospitals with a huge delivery load (one of them delivers 25+ babies a day, around 10,000 per year). Finally, Rajasthan as a state has an exceptionally high institutional delivery rate due to government provided incentives (Pali claims to have a 99% institutional delivery rate, we believe it’s lower but still quite high).
Our Potential Impact
Cochrane review states Kangaroo Care leads to a 33% reduction in mortality compared to conventional care (which usually looks like incubator and warmer care) which is quite high to start with (especially given the high mortality rates among low birth weight newborns). Even if we assume our mortality reduction was around 33%, or 27% after internal and external validity adjustments, we saved lives cost-effectively.
However, we believe our mortality reduction to be much higher than 27% for multiple reasons. Mainly, conventional care is not the alternative where we work. Most low birth weight and premature babies are sent home very soon after the delivery and do not receive any form of care or counselling. Additionally, there is also a lack of basic newborn care practices such as infection control, sufficient breastfeeding, and monitoring of newborns for other danger signs: all forms of care now provided by Ansh that contributed to lives saved.
On the Ground Updates
Ansh organised an Infection Prevention and Control workshop in Pali Hospital on 22nd March that was attended by 75 staff members of the hospital. The workshop was led by the district IPC trainer and supported by our staff. After the workshop, the hospital is now consistently employing the “3 Bucket Cleaning System” for Infection Control in all the rooms with newborns.
Dimagi, our digital data collection and health monitoring pro-bono partner, visited our Pali hospital and interacted with our nurses to look at how the data has been collected on their platform and how they can support us better as we transition from pilot to program stage.
Samantha Kassirer, a doctoral candidate from Northwestern University and a Global Priorities Research Fellow, also visited our hospitals and interacted with our mothers and nurses to better understand their needs and how we can improve our behaviour change strategies to increase KMC. Samantha plans to write an article detailing her findings and experience of visiting the hospitals and talking to the mothers from our programs.
We hope to release our pilot report in May, after all our babies from the pilot stage have turned one month old. Additionally, we're transitioning from monthly newsletters to ad-hoc updates. We deeply appreciate all the support.
