Predictors for opting for Kangaroo Mother Care in Pakistan and infant development outcomes: Results of a quasi-experimental study

Background: Although Kangaroo Mother Care (KMC) is recognized to improve maternal and child health outcomes globally, there are cultural concerns for uptake in Pakistan. In this study we aim to (i) identify socio-demographics of mothers who opt for the KMC program, and (ii) to compare the growth and development milestones, mortality, and other health choices between the KMC and a control group after a one-year period. Methods: We conducted a quasi-experimental study in a tertiary health sector of Lahore, Pakistan. KMC was adopted by mothers based on self-selection. A follow up of 200 mothers in each group was performed. Data was analyzed using both bivariate regression and Mann-Whitney U tests. Results: We found maternal socio-demographic predictors for enrollment in KMC to be working mothers, living in nuclear unit, having less children, higher family income, more prenatal visits, higher literacy, and living closer to the health center. Infants who received KMC, compared to the control group, showed significantly higher means for breastfeeding within two hours, breastfeeding exclusively for six months, breastfeeding up to one year, and complete vaccination in first year. Infant development milestones were also significantly higher in KMC groups. Neonatal death of baby was significantly lower in the KMC group. Infant weight gain, length gain, and head circumference gain for children in the KMC group was also greater. Conclusions: We conclude that KMC is an impactful low-cost intervention that should be rolled out across the country to secure maternal and child health targets and meet SDGs. However, partner social and health administrative interventions are critical to support uptake in disadvantaged women and families to overcome cultural and institutional barriers to ensure successful implementation across the large population of Pakistan.