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’re co-developing a digital health platform: We’re working with our Digital Health partner, Dimagi, to develop the first iteration to be used in our program for data collection and health monitoring.
Healthcare Innovations: We are showcasing the innovations we are using in our pilot for high-quality care and infection control in this newsletter.
Sharing our experience at the Second Regional Conference of
Asia-Oceania Network of KMC: Supriya will be sharing our journey so far and our vision for scale with attendees. If you are attending come say Hi to Chetan and Supriya at the conference!
We’ve partnered with the KMC India Foundation to train our healthcare workers.
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
Building a data collection and job aid tool
We’re pleased to announce that we have partnered with Dimagi to build and deploy a data collection and job aid tool on their CommCare platform. Dimagi is a for-profit social enterprise that delivers open-source software technology suitable for low-resource settings and underserved communities.
This will help our nurses monitor the newborn's health in our program and have the data organised and digitalised, which would otherwise be in paper forms and files. The nurses will also be able to access videos and other material that they need to refresh on what they learned in their training. These videos will be further used as an aid to counsel mothers about KMC, breastfeeding and monitoring babies for danger signs.
Furthermore, this will help the program management get access to real-time data needed to learn and improve the program design. In addition to nurses monitoring the health of the babies, our M&E Coordinators would be collecting both quantitative and qualitative data about the program on this application.
Innovations for high-quality care
As part of our commitment to providing high-quality care to newborns in public hospitals, we will be providing families of newborns with simple, well-designed and well-researched products from Bempu:
1) TempWatch:
Once a newborn is discharged, even with extensive counselling and telephonic follow-ups by our program, there is a high chance of the newborn still getting hypothermic and going undetected for hours.
Exposure to cold temperatures, even for a few minutes, can harm a baby. We would be providing all newborns in our program with TempWatch, an accurate screening tool to detect and alert for neonatal hypothermia with 99% sensitivity and 95% specificity. TempWatch is a well-researched innovation that supports mothers' behavioral change and improves babies' clinical outcomes.
How it works
The TempWatch emits a blue light when the baby is sufficiently warm.
The watch will beep and emit an orange light when the temperature is below 36.5 C.
The watch beeps for one minute for the first minute. Then, the watch beeps every five minutes till the baby is sufficiently warm.
Mothers should call the hospital 2 hours after the watch starts beeping orange and hasn’t turned to blue yet despite giving the baby Kangaroo Care.
2) KangaSling:
Kangaroo Care is proven through hundreds of strong clinical studies to help newborns gain weight, reduce the chances of infection and reduce the overall risk of death. But carrying a baby against one’s chest for at least 8 hours a day can be uncomfortable and tiring. Furthermore, this discomfort can hinder the mother’s ability to provide sufficient Kangaroo Care to babies, especially once they are discharged.
KangaSling is a carefully designed solution which replaces standard methods of carrying a baby with a manual cloth tie.
The sling is designed to be comfortable and ergonomic for prolonged Kangaroo Care as clinical guidelines require.
It provides hip and neck support to the baby to maintain a correct and safe position.
Allows mothers to breastfeed the baby without needing to remove the sling.
Innovation for Infection Control
Our implementation partner noted that there weren’t enough hand washing points near the ward compared to the number of people using it. Hence we are using Happy Tap to ensure all people who come in contact with babies are able to access a handwashing station.
Learning, Failures and Realizations
Modifications to our model
Previously in both our pilots, we were planning on setting up wards in newly built spaces. On further discussions with hospitals and during setup, we found that the hospital administration was not very confident about the new wards. There was hesitancy from the hospital and reservations because of the increased burden of providing basic services like water, cleaning, security and food to the new wards.
This led to some significant changes in our model. We have changed our model: from a new KMC room to dedicated beds in the existing PNC (Prenatal Care) ward.
Currently, the hospitals we are working at have multiple PNC wards. These are rooms where babies are transferred from delivery rooms (unless they are referred to SNCUs). These transfers also include all stable low birth weight babies. We have reached an agreement with the hospital for 10 beds in one of the PNC wards to be used for special care for the low birth weight and vulnerable babies in both of the hospitals.
Pros of the new model
If the model works at reducing neonatal mortality, we will not have to rely on having empty spaces in other hospitals to scale up. We can work within the existing system and space.
Integration with their existing operations (for example, delivery rooms and SNCUs) will be much easier. Establishing new protocols for referrals from delivery rooms and to SNCUs won’t be needed.
Vulnerable babies shouldn’t be handled or moved around too much. Through this model, we make sure that babies do not have to be transferred to spaces that might be far from the delivery rooms.
We wouldn’t need the hospital paediatricians to make rounds to an additional room.
Cons
Our hired nurses will be working closely with the existing healthcare staff. This can have some risks. Currently, the existing nurses are over capacity and taking care of a lot of babies in the PNC wards. They might expect our nurses to help them out in the routine care of normal-weight babies.
We will have less control over Infection Prevention and Control (IPC). We are establishing IPC measures that are necessary and outlined in the government guidelines, but we are uncertain about the control we would be able to have over these protocols being properly implemented.
We will have less control over the overall ambience of the ward including the noise and crowd.
Due to the existing lack of capacity and a high burden in our context, the hospital administration might have issues with keeping babies for at least 72 hours.
We are incredibly excited about the potential of our pilots to save lives and the learning curve ahead of us, and we look forward to sharing updates and stories of progress in the months to come. Thank you for supporting us on this journey to save newborn lives.