Kangaroo Care for Low-Birth-Weight Babies
Short Summary
Kangaroo Care (KC) has a strong evidence base but remains underutilized, making it a highly promising and neglected intervention.
This intervention is expected to be extremely cost-effective, averting one DALY for as little as USD 50.
We are encouraged by the early successes of AIM-incubated charity Ansh and believe there is value in launching another charity to scaling up KC in a new region for low-birth-weight babies.
Thus, we recommend a non-profit that builds healthcare capacity to provide Kangaroo Care—an inexpensive, easy-to-administer neonatal care intervention with strong evidence of reducing neonatal mortality and morbidity.
The Problem
What’s the problem?
Almost 1.9 million newborns died in 2019—approximately 80% of whom were born underweight (<2.5 kg).
KC is a medically proven intervention involving prolonged skin-to-skin contact between low-birth-weight (LBW) babies and caregivers.
It has the potential to prevent nearly a third of these deaths, meaning hundreds of thousands of lives could be saved annually.
Why does it matter?
Newborns are four times more likely to die in their first 24 hours of life than in the following 24 hours and nine times more likely than in their first week life.
LBW babies are at an even higher risk—an issue more prevalent in low-income countries, where incubators are often unavailable.
KC is a simple, low-cost alternative to incubator care, allowing caregivers to provide warmth and protection through skin-to-skin contact until babies can regulate their own temperature.
Neglectedness:
KC coverage remains low, particularly in South Asia and Africa.
Efforts to scale up KC have stalled due to resource constraints and opposition due to entrenched practices.
A new charity could help high-burden countries integrate KC into healthcare systems by embedding capacity within hospitals.
This new charity should target healthcare facilities where incubator care is unavailable.
The Solution
What’s the proposed solution?
A new charity dedicated to embedding KC capacity within hospital systems.
This would involve providing human resources, technical expertise, and essential inputs to ensure effective KC implementation.
This approach may include establishing dedicated KC wards or integrating KC within existing neonatal or maternal wards, staffed and managed by the nonprofit.
Why do we trust this solution?
We are encouraged by the early-stage success of AIM-incubated charity Ansh, which has demonstrated the feasibility of a new charity building strong relationships with key stakeholders critical for success.
Ansh’s successful pilot provided KC to about 2,400 LBW babies.
How robust is the evidence?
KC is a medically proven intervention supported by multiple RCTs and is recommended by the WHO as routine care for LBW babies.
We estimate that KC reduces neonatal mortality by 25% and morbidity by 18%.
While mortality reduction has stronger evidence than morbidity reduction, both effects are well-documented.
The Impact
What impact could this have?
Using data from Ansh’s pilot in India and assuming a new charity adopts a similar lighter-touch approach, we think that an organization could operate in 15 hospitals in Pakistan, ultimately reaching 18,000 babies per year at scale.
Estimated cost-effectiveness:
Embedding KC capacity in hospitals in Pakistan is expected to be highly cost-effective.
Our cost-effectiveness model estimates the intervention could avert one DALY for every USD 50 spent or 20 DALYs per USD 1,000 spent.
Who is best suited to do this?
The founding team would benefit from a healthcare or medical background and familiarity with the target country—either as locals or through prior work experience
A local founder would increase the likelihood of securing stakeholder relationships—a crucial factor for the success of this intervention.
Fluency in the local language, cultural familiarity, and not being seen as an outsider would be significant advantages.