Improving Kangaroo Mother Care in a Rural Kenyan Hospital: a Multi-Component Implementation Strategy to Strengthen Neonatal Care Delivery

Neonatal mortality remains a leading contributor to under-five mortality globally, particularly in low- and middle-income countries (LMICs). Kangaroo mother care (KMC) is an effective, low-cost intervention for improving outcomes among preterm and low birth weight infants; however, implementation remains inconsistent in resource-limited settings. We conducted a quality improvement study at a rural Kenyan hospital using three sequential six-week cycles. Interventions addressed key barriers to KMC, including provider knowledge, caregiver engagement, and environmental constraints. Primary outcomes were initiation of KMC within 24 h of delivery and mean daily duration of KMC. Secondary outcomes included the proportion of eligible hospital days during which neonates received ≥ 1 h of KMC and the proportion of eligible hospital days during which neonates received ≥ 8 h of KMC. A total of 45 neonates were enrolled. KMC initiation within 24 h increased from 8.3