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How 'Kangaroo' Care Saves Premature Babies In Senegal

First established in Colombia, kangaroo care for underweight babies relies on constant mother-child contact and avoids costs and complications of incubators that rarely arrive in Africa.

Twin boys strapped to their grandmother’s chest in Malawi.
Twin boys strapped to their grandmother’s chest in Malawi.
Rémi Barroux

DAKAR — Three moms are occupying the cream-colored room of the Albert-Royer Children Hospital, in the Fann neighborhood of Senegal's capital. Each is caring for her newborn of little more than four pounds. Resting skin-to-skin, the contact between mother and child provides the warmth necessary to treat premature babies. This is called the "kangaroo method."

As she is cuddling her little Adama, one mother named Comba Fall wears a special homemade T-shirt that has a slit to let her son's head out. The 23-year-old mom has been there for four days, after realizing that her son, born during the eighth month of pregnancy, was losing weight. He was only 3.5 pounds at birth. But so far, the kangaroo method is working: Adama is gaining around 0.3 ounce per day.

From their beds, the two other mothers report similar progress, and all are expected to soon be allowed to go back home.

"We have to be sure that the child is regaining weight and that the mother understands the instructions, that she breastfeeds her baby every two or three hours, because the child is sleeping most of the time and doesn't indicate when they need to eat," explains Fall Aida, who heads this special Kangaroo Unit in the Dakar hospital.

Three nurses and a pediatrician are in charge of the service. Issa Niang, 22, is set to go back home. Her child weighed 3.7 pounds at birth. "He will stay in kangaroo until he will weigh 6.6 pounds, the mum will have to carry him strapped to her until that moment," Aida adds.

The Albert-Boyer hospital was created in 1982 with Canadian aid, but this service was inaugurated in 2011 and it has already helped care for 181 children. The first baby the Center took charge of was from Tuba, around 125 miles east of Dakar. Born in the sixth month of pregnancy, he weighed only 28 ounces at birth and was declared "non-viable." A few months later, the child went home, healthy.

The Colombian pediatric team of Edgar Rey and Hector Martinez inaugurated this method for the first time in 1983, in order to treat preterm newborns. It represents an alternative to cumbersome and expensive incubators, a solution particularly welcome in countries where malnutrition risks weight loss for already premature babies.

Emotional advantages

Supported by the World Health Organization (WHO), this technique helps fight against infections and gives a "thermal protection" to the babies. It also allows for mothers to breast-feed their children andit is positive for the newborns' development as "emotional connections" are easier to establish.

"Our incubators could not solve all the problems," explains Haby Signaté, Head of the Hospital Neonatal Unit. "The whole concept is based on the mothers. At the beginning, many of them are afraid, and it goes against the custom of mothers here carrying the babies on their back. But the kangaroo method is reliable and affordable."

The model's simplicity is the secret of its success. It was borrowed from the Kangaroo baby and its development inside a marsupial pouch, that typically lasts for 250 days."We decided to expand the kangaroo to a national scale,"declared Dr. Bocar Daff, Head of Reproduction Health and Child Survive to the Senegalese Health Ministry."Since we lack the means, it is a priority. We have ten units like the Albert-Boyer, but it is not enough." With the help of UNICEF — United Nations Children Fund — pediatricians and nurses are trained in the method.

Neonatal health troubles are still significant in Senegal, with the rate of assisted labor by qualified staff at just 65% in 2012. "All the others are giving birth helped by traditional birth attendants or grandmothers,"says Nestor Pepe Azadegbe, Health Advisor for the United Nations Population Fund. "In 2000, this rate was 47%, so the evolution is positive."

To support Senegalese health policy, France contributes to the Muskoka Health Fund, which help 11 countries in Western Africa to decrease mother and child mortality, as part of the Millennium Development Goals. "The international help represents a third of the health expenditures in Senegal,"notes Daff.

The beauty of the kangaroo method, notes Nestor Pepe Azandegbe, is that it is innovation that eventually can arrive at zero fixed cost.

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