In Côte d’Ivoire, the “kangaroo” method to save premature babies

Mounira measures barely 40 centimetres. Mouth open, one cheek flattened against her mother’s chest, this baby born almost two months premature is growing thanks to the “kangaroo” method, increasingly used in Côte d’Ivoire.
According to Unicef, between January 2019 and October 2022, out of 2,391 premature and low-weight newborns received in the country’s “mother-kangaroo units”, 2,274 survived thanks to this method, representing a 95% success rate.
Recommended by the World Health Organization (WHO), this “skin-to-skin method” puts “the mother at the center of her child’s care”, explains Dr. Chantière Somé, at the Treichville University Hospital in Abidjan.
In Côte d’Ivoire, where 30 babies die per 1,000 births – a figure slightly higher than the average for sub-Saharan Africa (27) – a third of these early deaths are due to prematurity.
And according to Virginie Konan, health specialist at Unicef, this “kangaroo” method has “greatly contributed to reducing neonatal mortality” in the country. According to the latest available statistics from the UN body, it fell by 10% between 2016 and 2021.
With her face marked by fatigue, Mounira’s mother recounts her early delivery. “It wasn’t easy”, confides Adjara Traoré, “I wasn’t expecting it, it was really complicated, I almost lost my life”.
A local resident, she picks up her baby in an incubator “every morning”, and stays “until the evening” at Treichville University Hospital, to learn the “mother kangaroo care” (SMK) method.
The mother takes over from the incubator,” explains Dr. Somé, “carrying her child permanently on her bare chest in a cotton cloth.
Day and night, body warmth and affectionate gestures reduce the baby’s anxiety, while the mother’s heartbeat and movements stimulate him and prevent him from forgetting to breathe, to avoid sudden death.
Eight hospitals in the country have an “SMK” service, but the Treichville hospital, the country’s largest, remains the best equipped.
In view of these results, other countries in the region are starting to replicate this inexpensive method, which is financed in Côte d’Ivoire by French funds and Unicef.
“Senegal, Mali, Niger and Burkina Faso are beginning to use the method, but Côte d’Ivoire has the most developed services,” explains Virginie Konan.

– Reluctance –
In Treichville, Jeanne-Marie Setché holds her son, born more than two months prematurely. She has come from Korhogo, over 600 km away in the north of the country, to try SMK.”There’s no more stress” and “he’s gaining weight”, she expresses. “When he’s with me, the milk flows normally”, yet, “when I didn’t see him, I had no milk. Even when I tried to pump, the milk wouldn’t come out, so it really stressed me out, it made me really sick,” adds the new mother.
In the incubator, the baby is also under stress. “There’s too much noise around, too much light (…) he’s constantly disturbed” and can become a stressed adult, explains Dr Somé.
While the technique is natural, some women are initially reluctant. Mothers “are afraid of their baby”, she asserts. “When we give them the baby, some reject it,” she notes.The child’s appearance and size surprise them, but “the biggest fear is hurting,” agrees her colleague, Dr. Marie-José Miézan.”When I first saw her in the incubator, I cried, I was scared,” confirms Josée Don, three years after her daughter’s premature birth. Today, Miracle has no after-effects whatsoever”, she rejoices, “we have a special bond, having been so close all the time”.The luckiest mothers are placed in a nine-bed hospital ward, where they can stay for several weeks.In this room, soft stammerings adorn a soothing silence. Affoussata Sidibé, a broad smile on her face, is learning the method with her daughter.
“She was born at 800 grams. Today, she’s 2 kg and a bit, so I’m very, very happy,” she enthuses.
After a month in the unit, she will now be able to return home with her child.
Agence France-Presse


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