Kangaroo mother care scaling up in Vietnam

Outline of presentation
1. The history of Kangaroo Mother Care (KMC) implementation in Vietnam 2. Scaling up and the plan for nationwide implementation of KMC

History of Kangaroo Mother Care implementation in Vietnam

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1986: first introduced in department of pediatrics in Uongbi hospital in Northern Vietnam. Four staff were sent to Colombia for KMC training:
1996: 2 staff of Uongbi (in the North) 1997: 2 staff of Tudu hospital (in the South)

1998: LAPPEL supported for KMC implementation in Uongbi and Tudu hospitals (1 in the North and another in the South of Vietnam) From 2000: scaling up with WHO, SC, Netherland and Government support

Uong Bi KMC Center

First introduced and KMC in the North

KMC at the beginning

TU DU KMC Center The biggest obstetric facility in the SEAR

The training unit on KMC in the South

Scaling up

Training activities
2000-2002 National Trainers with international consultant supervision trained: Staff of 14 central/provincial hospitals (7 in the North and 7 in the South) 2003-2012 National Trainers trained: Staff from 30 more provincial hospitals and several district hospitals So far, more than 50 hospitals including district hospitals were under training with a team with at least 2 staff (one doctor and one nurse/midwife) per each hospital

Training activities
Training for international participants from: - Cambodia - Laos - Bangladesh - France - Germany - Australia

- SwedenCampuchia,Lao,Phap,Canada,c, Uc

Development of materials
Manual on KMC from Columbia translated and adapted

WHO Kangaroo mother care guide translated into Vietnamese

KMC content adapted in WHO essential newborn care course Kangaroo Mother Care section developed in National guideline

Implementation

KMC in hospital

Out patient KMC

Supportive group for KMC at community

Sharing information and experience

Every 2 years workshop in Uong bi and Tu du hospitals (1999, 2002, 2006, 2008) Participation of key staff from the two KMC training hospitals in several International workshops National workshop in 2007 conducted by MoH

Every two years workshop in Tudu and Uong bi hospitals

National workshop 2007 in Hanoi

Collaboration activities

Research

KMC in the National guidelines

1. KMC was included as a important topic to put in the newborn care part in the National Guidelines for Reproductive health care services. (approved in 2009 by MOH) 2. KMC recommended in the National guideline used for establishing the Neonatal health care unit at different health facility levels. (approved in 2011 by MOH)

Contents of KMC in the National guidelines

KMC at the community level:
Skin to skin contact immediately after birth.

Support mother to breastfeed the baby within 1 hour after delivery with baby in skin to skin on the mother chests. In the case of referral, encourage to put the baby in skin to skin with mother or other family member during transportation.

Contents of KMC in the National guidelines

At hospitals:
Doctors, midwives and nurses in Obstetric and Pediatric departments need to be trained on counselling and implementation of KMC in hospital. To arrange at least 1 room for KMC

Contents of KMC in the National guidelines

KMC during referral:
Encourage and support mother, family to use KMC on the way to the hospital. Let baby in Kangaroo position when giving care such as: oxygen, tube feeding ect.

Lessons learned
Having key persons who are really interested in KMC implementation and support from hospital leader is very important Successful models have been multiplied in the country by experience sharing between projects related to maternal and child health

International support and collaborations mobilise KMC expansion

National guidelines are the most important factor for national wide implementation of KMC

Challenges
Motivate health staff and strengthen their capacity to practice KMC as part of routine care of LBW/PT babies at all levels of care Enable women and families to practice KMC, especially early initiation of breastfeeding and exclusive breastfeeding by discharge
Get better information on health outcomes of LBW/PT babies and KMC acceptability and results to guide programs

Next steps
Strengthen training programs:
Establish 3 model training units on KMC for 3 regions Scale up KMC training in target provinces

Scale up KMC as part of National Plan for SM & NB care 2011-2015:

Establish KMC and newborn unit in 63 priority districts and related provincial hospitals

Develop a system for monitoring of KMC and follow up of LBW/PT babies after discharge

Thank you for your attention!