The presence of physician champions improved Kangaroo mother care in rural western India

UMMS Affiliation

School of Medicine; Graduate School of Biomedical Sciences, Clinical and Population Health Research Program; MD/PhD Program; Department of Quantitative Health Sciences

Publication Date


Document Type



Health Services Research | International Public Health | Maternal and Child Health | Pediatrics | Translational Medical Research


AIM: This study determined the effect of physician champions on the two main components of Kangaroo mother care (KMC): skin-to-skin care and breastfeeding.

METHODS: KMC practices among a retrospective cohort of 648 infants admitted to a rural Indian neonatal intensive care unit (NICU) between 5 January 2011 and 7 October 2014 were studied. KMC champions were identified based on their performance evaluation. We examined the effect of withdrawing physician champions on overall use, time to initiation and intensity of skin-to-skin care and breastfeeding, using separate models.

RESULTS: In comparison to when KMC champions were present, their absence was associated with a 45% decrease in the odds of receiving skin-to-skin care, with a 95% Confidence Interval (CI) of 64% to 17%, a 38% decrease in the rate of initiation skin-to-skin care (95% CI 53% to 82%) and an average of 1.47 less hours of skin-to-skin care (95% CI -2.07 to -0.86). Breastfeeding practices were similar across the different champion environments.

CONCLUSION: Withdrawing physician champions from the NICU setting was associated with a decline in skin-to-skin care, but not breastfeeding. Training healthcare workers and community stakeholders to become champions could help to scale up and maintain KMC practices.


UMCCTS funding

DOI of Published Version



Acta Paediatr. 2016 Apr 25. doi: 10.1111/apa.13445. Link to article on publisher's site

Journal/Book/Conference Title

Acta paediatrica (Oslo, Norway : 1992)


First author Apurv Soni is a student in the MD/PhD program at the University of Massachusetts Medical School.

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Link to Article in PubMed

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