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.
This month’s highlights include
We have launched our first pilot: Our first pilot in Pali was launched this week!
Our second pilot launch: Our second pilot launch will happen on the 4th of January. Dr Sashi Vani, known as the mother of Kangaroo Care in India, will be travelling to Baran to train our nurses.
We are fundraising: We are raising $300,000 for Year 2.
Your thoughts and feedback are invaluable to us. We're eager to hear your thoughts on our work and this newsletter. Please feel free to reach out—we genuinely appreciate your input.
Warmest Regards
Updates from Pilot Programs
Pali Pilot: Launched
The training for the Pali pilot took place on the 22nd and 23rd of December for our Monitoring and Evaluation Coordinator, Program Coordinator and 9 nurses. After a couple of days of orientation in the Pali district hospital, our team started identifying babies who were born too soon. In less than 5 days, our team identified and registered 12 babies. For context, the GiveWell-funded Kangaroo Care charity, r.i.c.e, takes in around 11.5 babies per week.
Successes
In less than a week:
We know there is a dire need for our program, especially in public district hospitals.
We have been able to identify champions within the facility, including a head paediatrician and a lactation counsellor. These champions are paramount to the success of the program and we will need to identify similar champions in other facilities for scale up.
We can and have been able to do KMC for babies in intensive care units (SNCUs and NICUs), potentially increasing the impact we can have and the lives we can save. This was a separate program that we were highly uncertain of and was driven by the strong recent WHO evidence.
Time and resource investment in M&E has been highly beneficial: Due to our strong M&E systems and a dedicated member for observations, we are able to make quick program changes and iterations.
Learning, Failures and Realisations
Establishing standardised protocols is difficult. Our initial plan was to train the existing delivery staff in the facility to refer the babies to one particular PNC ward from where we could operate. However, that might require more liaisoning and stakeholder engagement than initially anticipated. Currently, our nurses make rounds in all the PNC wards (3 in total) and intensive care units (2 NICUs and 1 SNCU) to identify babies.
As anticipated, the biggest challenge we face currently is behaviour change and providing high-quality care (at least 8 hours of skin-to-skin a day and exclusive breastfeeding). We plan to largely focus on these two aspects from here on, given the established success on other fronts.
Another challenge is persuading mothers to stay in the hospitals and persuading the hospital to allow us to keep mothers in the hospital.
The case of Rohan*
The first baby identified by our program staff was a 1-day-old infant, weighing less than 1500 grams (a healthy baby weighs more than 2500g). When our program staff identified the baby, the family already had the discharge papers in their hands, seemed scared and unsure but still getting ready to leave. We were able to persuade the hospital to let us keep the baby in the hospital. The next morning, during the monitoring of danger signs (another component of our program that our nurses have been trained in), one of our nurses found out that the baby had severe hypothermia. She was able to call the doctor on duty, and the baby was swiftly admitted to the intensive care unit. Without Ansh, the baby would have been taken care of by the family at home, and it was highly likely that the family would have never realized that the baby had severe hypothermia leading to further health complications. The family was counselled and trained in Kangaroo care and was given a KC Sling and TempWatch for monitoring at discharge.
*name changed to protect the identity
Baran Pilot: Launching on 4th January
Our second pilot is launching next week, with training happening on the 4th and 5th of January. Dr Sashi Vani, popularly known as the Mother of Kangaroo Care in India, will be leading the training herself.
Major differences in Baran Pilot
Our Baran pilot is done in partnership with a national organisation with more influence and access to resources. This means that we already have been able to identify champions in the hospitals, have more control over establishing protocols, and have been given access to half of one PNC ward to be just used for KMC.
We have been able to refurbish the bathrooms of the chosen PNC ward, which were badly clogged and were in major violation of Infection Prevention and Control protocols.
Both pilots offer invaluable lessons for scale-up: we are aware that we will not be able to identify partners with influence and resources in every district we want to work in. However, reduced challenges during the Baran pilot might help us achieve high-quality care sooner and establish a replicable proof of concept.
On the other hand, our Pali pilot is much more scalable, as the pilot was launched with a small local organisation with no contacts or influence in the district hospital.
Fundraising
We are fundraising $300,000. This includes the costs of running the pilots beyond the 3 month period for one additional year, being able to replicate the model in one additional hospital, M&E costs and salaries. Please reach out if you would like to learn more and donate.
Thankful
Reaching this milestone of launching our pilot within 8 months of being incubated has only been possible with the support of:
Our wonderful, committed volunteers:
Sam Harvey, a medical doctor from New Zealand, for his contributions in designing our M&E strategy for the Dimagi software.
Hassini Kellampalli, a highly talented high school student for her research in behaviour change for Kangaroo Care.
Cecile Pomarede for help on various fronts.
Alex Khoury from Harvard Kennedy School Government Performance Lab, for his contributions to the design and research of the iKMC program in intensive care units.
Samantha Kassirer, behaviour change scientist from Northwestern University, for her contributions and expert advice on our behaviour change strategy.
We would also like to thank our non-profit partners, Sahaj Sansthan (Pali) and Action Against Hunger (Baran) for making it happen, Dimagi for offering pro-bono support in building our health monitoring and data collection software, and Kangaroo Mother Care India Foundation for offering pro-bono training to our healthcare workers and staff.
Finally, we would like to thank our advisors and expert team of doctors and paediatricians for supporting us and providing invaluable advice at times of uncertainty.
Working at making Ansh happen has been an incredibly gratifying experience. Despite the inherent challenges of being directly involved in the field and so close to our small beneficiaries, it has proven to be exceptionally rewarding: from getting a message from our program coordinator on how an unstable baby was stabilised through KMC within hours, to checking the data and worry about another baby with a fever.
As we conclude the year, I am profoundly thankful for the opportunity to run a charity that holds significant potential for cost-effectiveness and impact and at the same time, have the privilege of being intimately close to our vulnerable babies.
Wishing you all a joyous New Year ahead,
Supriya