Kangaroo Mother Care in Nigeria

The Federal Ministry of Health (FMOH) has since made efforts to integrate Kangaroo Mother Care as part of the standards for newborn care. The FMOH has adapted the KMC Training Manual in 2008 and included two KMC indicators in the health management information system in 2013. The FMOH launched the Nigeria Every Newborn Action Plan in 2016, which included KMC as part of essential care for preterm/low-birthweight babies. The FMOH has committed to situating facility-based KMC services within the wider context of newborn health. To achieve this, there is a need for behavior change campaigns, KMC posters to be displayed in healthcare facilities, and awareness activities to engage healthcare providers and mothers. Additionally, there is a need for data quality improvement, data use, and dissemination of findings to propel KMC to become a widely practiced strategy in Nigeria. According to an assessment led by Save the Children in 31 states, 202 facilities out of 757 (27%) reported availability of KMC services. However, differing definitions of what constitutes KMC might have caused the overestimation of this figure. Most facilities that provide KMC are general hospitals (61%), followed by tertiary and specialist hospitals (16%). Some secondary health facilities carry out KMC, while primary-level health facilities do not provide KMC services but instead refer preterm babies to higher-level facilities where babies are initiated on KMC. The FMOH has been working with partners to finalize guidelines for KMC. The Nigeria Every Newborn Action Plan includes KMC as part of essential care for preterm/low-birthweight babies, with coverage targets of 65% by 2020, 85% by 2025, and 95% by 2030. The Essential Newborn Care Course training package, which includes KMC, was launched in 2016. Through the Maternal and Child Survival Program (MCSP), 949 people have been trained in maternal and newborn health practices, including KMC, since March 2014. KMC indicators were included in the national health management information system (HMIS) in 2013. The FMOH is reviewing a proposal to include new indicators and to modify existing indicators in the HMIS. The new indicators and modifications include the percentage of newborns identified as < 2,000 g, the percentage of facilities with inpatient maternity services with operational KMC, and the number of live births < 2,000 g as a denominator to calculate the percentage of newborns initiated on facility-based KMC.