Charpak: Lessons Learned in Implementing Kangaroo Mother Care in LAC Countries Through a Regional...
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Transcript of Charpak: Lessons Learned in Implementing Kangaroo Mother Care in LAC Countries Through a Regional...
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7/28/2019 Charpak: Lessons Learned in Implementing Kangaroo Mother Care in LAC Countries Through a Regional Network
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Lessonslearnedinimple
mentingkan
garoomothercarein
LatinAm
ericanandCaribbeancountriesthrou
gha
regionalnetwork
NathalieCharpak
fundacion.c
om
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051015202530354045
TMN
TMI
TMM5
TasadeMortalidadpor1000NV
1990
2010
50%
57%
52%
Chang
esinNeona
tal,Infanta
ndlessthan5
years
mortalityin
LatinAmer
icancountries
1990-2010
Source:WorldHealthStatistics2012
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7/28/2019 Charpak: Lessons Learned in Implementing Kangaroo Mother Care in LAC Countries Through a Regional Network
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0
.0
5
.0
10
.0
15
.0
20
.0
25
.0
30
.0
35
.0
40
.0
45
.0
1990
2010
TasadeMortalidadpor1000NV
TMM5
TMI
TMN
43%
50%
38%
28%
22%
19%
Fuente:WorldHealthStatistics2012
Mort
alityofles
sthan5ye
arschildren
acco
rdingtoth
ecompon
entinLatin
AmericanCountries1990-2010
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MaindiagnosisofInfantmortalityin
LatinA
mericana
ndCaribbeancountries
Fuente:Estimaciones
deFCH/CAconbasededatosdeHA-OPS,2010
Post-ne
onatal(29%)
N
eonatal(71%)
Infec
tions
32%
Asp
hyx
ia29%
LBW
an
d
prema
turi
ty
24%
Congen
ital
abnorma
lities1
0%
Others
5%
Pneumona
/IRA48%
Diarr
hea3
6%
Desnu
trition
9%
Others
7%
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Kangar
ooMotherC
are(KMC)is
anevidence-
basedtechnologythathasbeen
shownusefu
lfor
amelio
ratingLBWe
ffectsoninfa
ntmortality
and
morbid
ity,nutrition
andearlydevelopment.
Majorcomponents
ofKMCareK
angarooPos
ition
(prolon
gedskin-to-skincontact)
Kangaroo
nutrition(breastmilkbasednutrition)and
kangaroodischarge
policies(ear
lydischargein
kangaroopositiona
thomeorin
aKMCward
and
strictfollowup)
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Oneofthemajorcontributorstoth
eso-called90-10
gaptha
tbringsapart
affluentandle
ssdeveloped
countriesistheinade
quateaccesst
oknowledge
(knowle
dgetransfer)andwhenaccessible,the
insufficienttranslationofthatknow
ledgeintoaction.
Agroup
ofresearchersandhealthc
areprofession
als
decided
totacklethis
doublechallengebycreatin
ga
nongovernmentalno
nforprofitorganizationcalled
theFu
ndacinCanguro(KangarooFoundation)
in
1994in
Bogot,Colom
bia.
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KM
Ctraining:howtodoit?
Traditiona
lly,cooperatio
ninhealthisorganizedand
thoughtinaoneway
direction,
from
NorthtoSou
th
countries.Itoftenmeetsresistance
sbecauseof:
1)Badfun
ctioningoftheprojectonce
thefinancial
supportisover,espec
iallywhenthe
longterm
sustainabilitywasnot
planned.
2)Difficultiesinthemaintenanceofte
chnological
materia
l.
3)Poorac
ceptanceofnewknowledge
becausescien
tific
evidenc
esaretoooftenproducedinthenorthern
countriesandnotada
ptedtolocalcircumstances.
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Current
lySouth-to-So
uthcooperationisinadyna
mic
expansion.Middleinc
omecountrieshavenow
technicalcompetenciesandexcellencecentersin
alot
offoref
rontfieldsincludinghealtha
ndareclaimin
gfor
moreparticipationin
cooperationd
ecisions.
Knowle
dgetransferis
usuallybetteracceptedbec
ause
contentsaremoreap
propriate.Professionalsfrom
middle
incomecountrieshavethee
xperienceofm
ore
depress
edterritories
withlowlevel
ofdevelopme
ntin
theirow
ncountriesandveryoftenhaveseenlife
inthe
samesituationinpastyears.
Itallowsamoreegalitarianandrespectfulknowle
dge
transfer,moredirectandmoreadaptedtolocal
situatio
nwithmorep
ossibilitiestobesuccessful.
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Since1
994moreth
an60multid
isciplinaryhealth-
carete
amsmainlyfromcrowdedcities'hosp
itals
inmorethan25developingcountrieshaveb
een
trained
inBogotin
ourcenterw
iththefinancial
supportofvariousofficialandnonofficialNG
O
andinstitutions.Wewantspeciallytothank
USAIDS,PegMarshall,GoldyMa
ziasandJorg
e
Herminda,whosup
portedusdu
ringthesela
st2
yearsforthetrainin
gofSalvador,Honduras,
Guatem
ala,Nicarag
ua,RepublicaDominican
aand
theFrenchembassyofHaitiwhosupportedKMC
implem
entationinthiscountry(2andsoon3
KMCP)
incollaborationwithUnicef
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Moret
han60teamsfrom25countrieshavebeen
trainedin
Bogota,
Colo
mbia.
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ThetrainingmodeloftheKF
Seeon
e,
doone,t
eachone
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Themo
delofKMCdiffusionwecho
seisseeone,
do
one,teachone,meaningthatinordertotranslat
e
KMCto
anothergeographicallocationweinvitehealth
carelea
derstobetrainedinKMCin
ourcenter(see
one),im
plementaKM
Cprogramin
theirhome
institutions(doone)a
ndafterwards,trainother
centers
intheirregion
andhelpthemimplementit
(teacho
ne).Thesuccessofknowledgetransferin
Central
AmericaandCaribbeancountrieshasbeen
high:ne
arlyallteams
trainedinBog
otimplemen
ted
withsuccess,
despite
specificneeds
anddifficultie
s
encoun
teredbyeach
programinea
chsetting.Various
KMCprogramsalread
ybegananationalKMCtraining
diffusio
nprogramintheircountries
(Republica
Dominicana).
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Trainedteamsare
alsoprovide
dwiththebasic
tools
fortranslatin
gknowledgeintohealth
care
actions.
Anew
multimediaKMCkitisn
owavailable
on
ourh
omepage,constructionw
assupporte
dby
theColombianhealthministry
andtheWorld
Food
Programand
EnglishtranslationbyM
CHIP,
JSIan
dtheKangarooFoundation.Wejust
receivedagrantfo
rtheFrench
translation.
Wedevelopthism
ultimediaKMCkit,
free,easy
toread,tosuppor
tlocaldiffusionandto
empo
werthenew
lytrainedKM
Ccentreas
an
excellencecentre
intheircoun
try
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Co
mments
Guideline
sbythemselv
esarenotenoughtodevelopa
goodqualityprogram.
Ourexperienceshowsthattrainingandexposure
to
successfulpracticeha
nds-on
trainin
g
inreference
KMCcent
ershasbeenkeytosuccessfuldissemina
tion
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Mayor
difficultie
sintheK
MCdiffus
ion
Rightcho
iceoftheteamto
betrained
Adaptatio
nofthe3componentsofKMCtolo
calcircumstances,
patientneedsandlevelofc
are.
Earlydischargeandambula
toryfollowupclin
ic
InsufficientaccesstoKanga
roonetworkands
cientificliterature
on
KMC
Insufficientlocalresearchandmonitoringcap
ability
Costs:Dir
ectcostoftrainingkangarooteam,costofKMCstaffa
nd
physicals
tructure
Quickturnoverofadministrativeandmedical
staff
Sustainab
ility
Integratio
ninthepublichealthpoliciesoftheheathministry