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Melinda Gates on “kangaroo care” for reducing newborn deaths

Last night I went to an inspirational talk by Melinda Gates, chair of the largest philanthropic organization in the world, where she discussed innovative approaches to reducing infant mortality in the developing world.

To the crowd of mostly Stanford engineering students, Gate’s message was somewhat surprising. She said that sometimes the most effective solutions to global health problems are low tech and the hard part is figuring out how to spread these life-saving ideas in a culturally appropriate way.

She shared a story about a typical birthing procedure in northern India to illustrate her point. In remote villages there, newborns are placed on the bare ground for extended periods of time while a birth attendant tends to the mother’s well-being. After the mother’s condition is stable, the attendant scrubs the birthing debris off the newborn with a gritty, sandy paste from a nearby river and then rubs mustard oil over the baby’s skin for protection. While most people well versed in germ theory would blanch at this scenario, it is a generations-old tradition in this region that is hard to change.

Gates and her global health partners discovered that by convincing the power brokers in this culture — the mother-in-laws — to make four simple changes in their birthing procedures, they could reduce newborn deaths by half. The list:

  1. Immediately place a newborn on the mother’s chest and wrap both mother and child in a sari, a protocol often referred to as “kangaroo care.” This protective pouch keeps a newborn warm and stimulates the mother’s breast milk production.
  2. Clean the infant with a more sanitary solution.
  3. Rehydrate the newborn with breast milk rather than river water.
  4. Use sunflower oil on the infant’s skin rather than the more astringent mustard oil, which can often cause allergic reactions.

To spread the word on the success of this checklist, the foundation is leveraging the most efficient social network available in this region — the women who talk while cooking, washing and tending their children.

In addition to reducing infant mortality, Gates has also launched a campaign to expand access to contraception. She discussed the initiative and why family planning looms so large in both her heart and her mind in the latest issue of Stanford Medicine.

Previously: Simple program shown to reduce infant mortality in African country and Simple program shown to reduce infant mortality in African country
Photo by DFID - UK Department for International Development

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