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Lottery of birth
Lottery of birth

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2.3 Kangaroo mother care

You may have heard of ‘kangaroo care’. It’s a technique that has been used to reduce newborn deaths.

The Save the Children report, ‘State of the World’s Mothers 2013’, that you read from in the previous section, explores it’s use in the USA. You will read an extract from the report below.

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Figure 6

What can be done to reduce first-day deaths in the United States and elsewhere in the industrialized world? Investments in education, health care and sexual health awareness for youth will help address some of the root causes. Wider use of family planning will also improve birth outcomes and reduce newborn deaths. In the United States, 49 percent of pregnancies are unplanned and these babies are at higher risk of death and disability. Efforts to improve women’s health would also have a positive impact on survival rates of babies. High-quality care before, during and after pregnancy (including home visits by nurses or community health workers if appropriate) and access to the appropriate level of care at the time of delivery can result in healthier mothers giving birth to healthier babies. More research is needed to better understand the causes of prematurity in high-income settings and to develop better solutions to prevent preterm births.

Lessons without borders

In recent years, a number of solutions that were pioneered in developing countries have been gaining acceptance – and saving lives – in richer countries. For example: kangaroo mother care is now being used to improve newborn survival outcomes and support parent-child bonding; community health workers have been trained to reach marginalized communities where there are fewer doctors; and the emphasis on breastfeeding that started in developing countries has now begun to catch on in Australia, Canada, New Zealand, the United States and many European countries, with an increase in baby-friendly hospitals and the adoption of other efforts to encourage breastfeeding.

Kangaroo mother care (KMC) – also known as skin-to-skin contact – originated in low-income countries, but it provides high-quality, cost-effective care in high-income settings as well. Many developed countries are now taking KMC to scale and moving away from incubators and other invasive approaches. Countries where large percentages of neonatal intensive care units now routinely offer kangaroo mother care include: Denmark, Finland, Iceland, Japan, Norway, Sweden and the United States.

Community health workers have become significant providers of health care, not only in low-income countries, but in industrialized countries as well. The first prominent large-scale community health worker programs were in Latin America, Tanzania, Mozambique, Malawi and China as early as the 1960s. Since then, the model has been picked up in many high-income countries, driven by the need for mechanisms to deliver health care to culturally-distinct, marginalized, and/or minority communities and to support people with a wide range of health issues. In New Zealand, health workers from the Maori community deliver services to some of the most marginalized families throughout the country. In Canada, the United Kingdom and the United States, community health workers in urban areas have been successful in increasing the number of women who initiate breastfeeding and exclusively breastfeed their babies. And in Ireland and the United States, they have increased the number of low-income children who are immunized.

(Save the Children, 2013, pp. 56–9)

Next, you will go on to look at the kinds of reproductive choices that exist and how these play a part in the lottery of birth.