Message of the WHO Representative to the Philippines

Globally, an estimated 2.4 million children died in their first month of life in 2019. This translated to 6,700 newborn deaths every day, and accounted for 47% of all child deaths under the age of 5 years. The world has made substantial progress in child and newborn survival since 1990. However, 75% of newborn deaths continue to occur in the first week of life and about 1 million newborns die within their first 24 hours of life. In the Philippines, an estimated 63,000 of 1.7 million children born in 2019 died before their fifth birthday, with half occurring among newborns. Preterm birth, intrapartum-related complications such as birth asphyxia, infections and birth defects, caused most neonatal deaths in 2019. While child deaths decreased by one-half between 1990 and 2018, newborn mortality declined at half that rate. Along with asphyxia and sepsis, complications of prematurity are the main causes of newborn deaths. Preterm (< 37 weeks gestation) and low birth weight (LBW) (<2500 g) babies have immature immune and organ systems, low fat reserves and reduced muscle mass, placing them at a much higher risk for hypothermia, infection, and death, compared to babies born with normal weight. Kangaroo mother care (KMC) is a technique of caring for preterm and LBW babies which consists of keeping them in skin-to-skin contact (SSC) on the chest of the mother (or other family members), as early and as long as possible, exclusive breastfeeding, and early discharge from the hospital with close monitoring on an outpatient basis. KMC has been demonstrated to reduce mortality in small babies by almost half compared to conventional incubator-based neonatal intensive care. Other benefits include prolonged duration of exclusive breastfeeding and better growth rates. Thus, the World Health Organization (WHO) recommends KMC for babies less than or equal to 2,000 grams. We also support widespread calls to introduce, accelerate, and sustain quality KMC implementation. It is with this note that I congratulate the Kangaroo Mother Care Foundation Philippines, and the research authors for all their original scientific papers on KMC. The publication of these studies, present added evidence that KMC is a cost-efficient, readily available, effective strategy for saving the lives of babies born either prematurely, or with low birth weight for age. Rabindra Abeyasinghe, MD, MSc, DTM&H (Public Health) WHO Representative to the Philippines