Table 2

Differences in content or implementation of the final model across different sites (vis a vis the ‘common’ model)

SitePrefacilityFacilityPostfacility
Haryana

  • No major difference.

  • KMC implementation established at private facilities in addition to large public facilities.

  • Dedicated family KMC area created outside the KMC ward.

  • Additional KMC nurses deployed by the state government.

  • Families empowered to contact community health workers for home visits postdischarge.

Karnataka

  • No major difference.

  • KMC implementation established at private facilities in addition to large public facilities.

  • On-site mentoring of staff by nurse mentors.

  • Supportive visits by a team from a medical college.

  • Skill-building via neonatal emergency drills/ perinatal audits.

  • New mothers supported by experienced KMC mothers referred to as ‘AKKA’ chain (AKKA in local language refers to elder sister).

  • KMC activities in postnatal wards.

  • Family level microplanning tool to help community health workers support KMC at homes and problem-solve.

  • Animated videos in local television cable network/radio interviews/media.

Uttar Pradesh

  • Referrals to KMC-implementing facilities from private facilities promoted.

  • Self-help groups encouraged referrals to KMC-implementing facilities.

  • Reclining chairs placed in special newborn care unit for intermittent KMC.

  • Nurse coaches reviewed and improved nurse performance in KMC unit.

  • Additional KMC nurses deployed by the state government.

  • Data-driven monthly performance review by government.

  • Interfacility social network of providers for sharing challenges, solutions and success stories.

  • Planning for home transition with the mother/family at discharge (schedule for KMC at home, use of wrap/binder for ambulatory KMC, etc).

  • Helpline and counselling for KMC available 24×7.

  • Baby-care teams including doctors and nurses made home visits for follow-up.

  • Vouchers given to mothers for community health worker home visits.

Amhara

  • Champion mothers and their families (who benefited from KMC) facilitated early identification and referral of LBW babies at monthly meetings of pregnant women.

  • Referral audit used to see the quality of referral services provided and clinical outcomes.

  • KMC cases from busy referral hospitals offloaded to primary hospitals.

  • Peer education among KMC practicing mothers and families.

  • No major difference.

Oromia

  • Birth weight assessment and referral of <2000 g only in health facilities.

  • Champion mothers to promote KMC in the community.

  • KMC promoted in labour and delivery wards and neonatal intensive care units, in addition to KMC units.

  • Family integrated newborn care introduced in one of the sites.

  • Expanded counselling and support team with staff and experienced mothers in addition to doctors and nurses.

  • No major difference.

SNNPR

  • Home birth identification and referral network strengthened.

  • Enhanced counselling support, audio-visual tools and mother support groups.

  • No major difference.

Tigray

  • Use of pregnancy cohort register for following pregnant mothers.

  • Use of life event celebration in the community of KMC infants when they reach 6 months of age.

  • KMC provided in health centres, in addition to hospitals.

  • Group counselling of mothers on KMC.

  • KMC counselling using a checklist and supported by pictures and videos.

  • Use of two cards for postdischarge follow-up: one by health extension workers (HEW, community health worker) and the other by HEW supervisors.

  • KMC, Kangaroo Mother Care; LBW, low birth weight; SNNPR, Southern Nations, Nationalities and Peoples’ Region.