The Story of Razia and Ali – Introducing Kangaroo Mother Care in Shikarpur District
20 year old Razia lives in a small village of Shikarpur District, Sindh. She was married off when she was only 15 to Mumtaz, who was 21 at the time. Razia conceived within the first month of her marriage. Her only source of guidance on health issues related to her pregnancy was her mother-in-law and other elder women from her village. There was hardly any awareness in her village about proper healthcare for mothers, antenatal visits or good nutrition for newborns and pregnant mothers, and most babies were delivered by dayees or Traditional Birth Attendants (TBAs).
When Razia first became pregnant, she was often nauseous, suffered from loss of appetite and consequently grew weak. Despite this she did not consult a doctor and instead, followed the local TBA’s advice, and her condition grew worse. The baby was delivered at home with the help of a TBA. Sadly the baby developed complication and passed away at the age of two months.
When Razia was with child again the following year, her mother-in-law made sure that she regularly consulted a doctor. In 2015, she gave birth to a healthy baby girl at District Headquarter (DHQ) Rai Bahadur Udhuwdas Tarachand (RBUT) hospital in Shikarpur through normal vaginal delivery. She was very satisfied with her experience at the hospital, and returned there for her second delivery in 2017.
On 22 July 2017, Razia gave birth to a baby boy, Ali, at DHQ RBUT. While the delivery was normal, Ali weighed only 1.7 Kgs at the time of birth. After the delivery, Razia was admitted in general OPD to recover overnight where Cinderella, a Lady Health Visitor (LHV), appointed by Save the Children at the Kangaroo Mother Care (KMC) ward in the hospital, visited Razia. Since the baby’s weight was below the healthy birth weight of 2.5 Kgs, she counselled Razia and her mother-in-law on the KMC approach and how it can help her baby to recover faster.
The KMC technique involves newborns with low birth weight being carried, usually by the mother, with skin-to-skin contact and offers a low-cost alternative for neonatal care. Under the Integrated Maternal, Newborn and Child Health (IMNCH) project, Save the Children worked in close coordination with the District Health Department to establish a fully equipped KMC centre in the paediatric ward of DHQ RBUT, which has been functional since April 2017.
Ali was admitted in the KMC ward on 22 July 2017. The KMC counsellors explained the procedure to Razia and Ghulam Bano through illustrated charts and practical demonstration. She followed the instructions well. Since Ali was too weak to start breastfeeding, he was given infant formula milk for the first two days, after which he gained the strength to start breastfeeding. Since Razia was in recovery, Ghulam Bano also practiced the skin to skin care technique on Ali. By the third day, Ali’s weight had increased to 1.9 Kgs – an increase of 0.2 kilos.
Razia had to take Ali home after four days. However, she promised to keep practicing the KMC technique at home and come for regular follow-up visits.
“The biggest challenge I faced in using the KMC technique was being physically present with my son. I felt very weak after the delivery and needed time to get well. The fact that the counsellor taught the KMC technique to my mother-in-law made it possible for me to recover along with my child,”says Razia.
eeping her word, Razia came for two follow-up visits with Ali – once on 29 July and again on 12 September. Ali weighed a healthy 2.8 kgs on his last visit to the KMC ward. Razia told the counsellors that she as well as her mother-in-law and brother-in-law practiced KMC technique at home. Initially, she was hesitant to practice it in front of her neighbours and relatives since it seemed strange, but as everyone witnessed an increase in Ali’s weight, they started to be more accepting towards KMC. Razia says:
“Seeing Ali’s health, all mothers in my neighbourhood are open to the idea of using KMC technique now. My son is a healthy, happy baby and the change in his health within just two months has been remarkable. I am thankful to Save the Children for this initiative.”