(200) Immediate kangaroo mother care for low birth weight babies reduces neonatal mortality: A cost-effectiveness analysis

Thursday, February 9, 2023

10:30 AM – 12:00 PM

Objective: Kangaroo care is a highly effective intervention for reducing infant mortality, however, timing of initiation can vary neonatal mortality outcomes. In this study, we compared immediate kangaroo care versus the standard kangaroo care protocol.

Study Design: A decision-analytic model was constructed in TreeAge to compare immediate kangaroo care versus the standard kangaroo care protocol in theoretical cohorts of pregnant women in select low and middle income countries. Model inputs were derived from literature. The primary outcomes measured included costs, quality-adjusted life year (QALY), neonatal mortality, suspected sepsis, and hypothermia.We defined our cost-effective threshold as three times the gross domestic product per capita, per country.

Results: Immediately initiating kangaroo care in low birth weight babies resulted in decreased neonatal death, sepsis, and hypothermia (Table 1). In Malawi, the only low income country included in this study, there were 76,783 and 100,668 neonatal deaths by day 28 using immediate kangaroo care versus standard kangaroo care protocol, respectively. This intervention alone led to 23,885 fewer deaths of low birth weight babies within the first 28 days of life. In addition, promptly starting kangaroo care resulted in increased effectiveness by 716,612 QALYs and cost savings of $51,928,111 within the theoretical cohort. When implementing immediate kangaroo care in other resource limited countries, such as India, Nigeria, Tanzania, and Ghana, comparable results were found. Depending on the country, this led to between 33,104 - 895,939 fewer deaths of low birth weight babies within the first 28 days of life. Moreover, it also proved to increase effectiveness as well as cost savings.

Conclusion:
In this study, immediate kangaroo care for low birth weight babies in low and middle income countries was a cost-effective and cost-saving strategy for reducing neonatal mortality, sepsis, and hypothermia. Our results suggest that immediate initiation of kangaroo care should be recommended in the neonatal setting of resource limited countries.

Primary & Presenting Author(s)

Helen Samuel, BS (she/her/hers)
Ms.
Oregon Health and Science University
Portland, Oregon, United States

Coauthor(s)

Sarina R. Chaiken, BA (she/her/hers)
Medical Student
Oregon Health and Science University
Portland, Oregon, United States

UD
Uma Doshi, BS (she/her/hers)
Medical Student
Oregon Health and Science University
Portland, Oregon, United States

Megha Arora, BS
MD-MPH Candidate
Oregon Health and Science University
Portland, Oregon, United States

Aaron B. Caughey, MD,MPH,PhD
Professor and Chair
Oregon Health and Science University
Portland, Oregon, United States