The Kangoroo fathers of Bungoma: Supporting men to embrace KMC

Prematurity is a cause of about 12% of all child mortality in Kenya. Caring for premature and low birth weight babies requires well trained staff  and specialised equipment such as incubators and respirators. In many health facilities in Kenya, staff  lack the specialised skills to handle small babies and to operate newborn equipment. Gaps in infrastructure also present many challenges: the number of incubators is limited, and where they are available, they are o  en poorly maintained.

A lack of a reliable power means that the temperatures fluctuate, which cause hypo or hyperthermia, and babies may have to share incubators, leading to nosocomial infections. Research shows that Kangaroo Mother Care (KMC) is a proven innovation that can be taken to scale to address this problem. KMC is continuous, prolonged, early skin to skin contact between a mother and her newborn for up to 24 hours per day, and is the recommended care for stable preterm and low birth weight (LBW) babies who do not require incubator care. Mothers initiate KMC at the health facility, and require a suitable space to stay while caring for their babies and getting support from other women and health workers.

Save the Children is implementing a CICF-funded scale up project aiming to increase access to and use of quality KMC services at 18 health facilities in Bungoma County. This project has demonstrated that men too can provide warmth to their babies, hence earning the name Kangaroo fathers. Normally this would not be remarkable, but it is a resounding achievement in a context where pregnancy and childbirth are predominantly women’s a airs and strong social norms assign limited roles to men. For instance, among the Sabaot community of Mt. Elgon Sub County, men are not even supposed to hold very small babies and in some cases women are sent back to their parents immediately a  er delivery since they are considered unclean and cannot be allowed to share a bed with their male partner. Among the Bukusu community, men who accompany their wives to the health facilities are considered either weak or overpowered by their wives.

Case study: Meet Kevin Wanyonyi, a Kangaroo father

Kevin Wanyonyi is a 20-year-old father of one who earns his income from providing casual labour to farm owners in his village. He is married to Femina Nasimiyu, who is 18 years old. The couple has been married for slightly over a year now, a period they describe as having been pure bliss. They fondly describe how they counted down every day when Femina was pregnant with their first child, Michelle. They eagerly waited for July 2017 when their newborn was due. But on 24 May 2017, the unthinkable happened. Femina developed severe abdominal cramps that started like false labour but increased in intensity and pain. She was rushed to Webuye County Hospital where she gave birth to baby Michelle, preterm and weighing only 2 kilogrammes. As Femina explains: “I didn’t expect to deliver at seven months. I just started feeling pain and then I was taken to hospital. When we reached, the nurses told us that I was going to deliver the baby. I delivered safely but the baby was so small… I didn’t have enough milk, the baby turned yellow and she was taken to the nursery and stayed there for three days.”

Health workers introduced Femina to KMC and trained her how to do skin-to-skin thermal care. While KMC helped Femina bond with her baby and eventually be able to produce enough breastmilk, she became very tired and worried about her baby. Luckily, Kevin was always available and willing to help her practice KMC. It wasn’t easy for Kevin at  firrst.

“Before my baby was born, I had never seen such a small baby. I was sure she couldn’t survive. But I was reassured when health workers showed us a   lm where a baby was born so small and yet survived a  er KMC. I got courage and resolved to support my wife to give KMC to our baby.” 

Impressed with the progress baby Michelle was making and the couple’s commitment to providing KMC, they were allowed to go home and continue with KMC there. Kevin reminisces how frends and villagers were surprised to see him with a baby tucked on his chest: “It was a new thing in our village. Bukusu men don’t carry babies. Some of my friends who came to visit got very surprised and thought something must be wrong with me. Some chided me for taking up a woman’s role. But I don’t agree with them, from what I heard in hospital and what I have seen both mother and father should work together. It is about the life of the baby.”

Baby Michelle has gained weight, now weighs 2.8kg and is out of danger. She is among over 50 preterm babies who have been saved using KMC since September 2016 when the concept was introduced there. Ebby Alema, is a nurse at Webuye County Hospital whose daily routine includes attending supporting mothers provide KMC to their preterm babies. She attests to the change that KMC has brought to her newborn care unit: “I went through the KMC training in July 2016. I have a passion for babies and I have provided conventional care over many years and witnessed many challenges.  In my view, KMC has
more benefits and is less costly both in terms of financial and human resource. Before KMC, back in the year 2012, we could lose three or four babies in one shift and we used to struggle resuscitating and would never rest. It was very sad to see the preterm babies die. KMC has helped me a lot since I don’t have to be with the baby all the time, and the mother and father can play a leading role in recovery of the baby. It
gives me great joy when I see preterm babies gain weight and survive.”  

While this success story rearms the effectiveness of KMC, we learn from Kevin that male involvement in KMC is the new frontier. Perhaps time to have a new acronym, KFC for Kangaroo Father Care.