Annual Report 2017 – Helping Newborns Survive and Thrive

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PCI’s ‘Every Preemie’ rolls out model to improve survival of early/small babies in Malawi

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When Sifati Ukasha first gave birth to twins, it was a short-lived celebration. Both arrived early and weighed in at just under four pounds, so Sifati feared her tiny baby girls might not survive.
“My joy turned into sorrow when I saw that they were very tiny. I could not hide my disappointment as I broke into tears on the labor bed,” she said.
In Malawi, where Sifati lives, nearly 1 in 5 babies is born preterm and 1 in 45 newborns dies within the first four weeks of life. Lack of access to warmth, breastfeeding support and basic care for infections and breathing problems contribute to these poor outcomes.
To help turn the tide on these preventable deaths, PCI’s U.S. Agency for International Development-funded (USAID) Every Preemie—SCALE Project introduced the Family-Led Care model in partnership with the Ministry of Health in Malawi. The model focuses on empowering families to directly participate in the care of their preterm/low birth weight babies during their hospital stay and at home while also enhancing health care providers’ skills and knowledge.
Family-Led Care includes promoting Kangaroo Mother Care (KMC), which ensures continuous skin-to-skin contact with babies and facilitates breastfeeding. Once moms and their babies leave the hospital, they receive detailed instructions for newborn care at home, as well as access to the health system through Health Surveillance Assistants (HSAs) and Care Group Lead Mothers. These trained community members encourage families to attend follow-up appointments and seek emergency care for their babies if necessary.
“Slight hope came when the midwife told me that they have an intervention which could help my babies to grow fast and survive,” said Sifati, who was counseled on Family-Led Care along with her mother. After five days in the hospital, she and her babies were discharged.
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Despite the long distance from their village, Sifati and her twins attended seven follow-up appointments at the Balaka District Hospital and were visited three times by the HSA. Her family also received several visits from the local Care Group Lead Mother.
“Today, my babies are healthy and fat,” she said, laughing—her joy restored. As of November 2017, her 3-month-old twins weighed 10.36 pounds and 11.02 pounds, respectively.
“I am a proud mother, and I want to come to the hospital’s KMC unit to encourage other families with small babies,” Sifati said. “I am so happy my babies survived.”
NOTABLE NUMBERS
In less than 12 months of implementing the Family-Led-Care model in six health facilities in the Balaka District of Malawi, preliminary findings show:

A 43% increase in Kangaroo Mother Care (KMC) initiation rates for preterm/low birth weight babies; and
A 19% increase in the survival rate of babies initiated on KMC.

The Ministry of Health recognizes the promise of the model in addressing preterm/low birth weight care and has requested its scale-up to other districts in Malawi.
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