Every year worldwide, approximately 32 million newborns are born small for their gestational age, and 15 million are born prematurely, contributing to 80% of neonatal deaths. The effectiveness of Kangaroo Mother Care (KMC) in reducing mortality rates among preterm births is well-documented. When compared to conventional care, KMC reduces neonatal mortality by 40% among stable preterm births. A more recent multi-country randomized controlled trial discovered that newborns weighing between 1,000 and 1,799 grams at birth who received KMC immediately after birth had a 25% lower mortality rate on the 28th day of life compared to those who received KMC after stabilization through conventional care provided in an incubator or under a radiant warmer.

The proposed multi-country implementation research study aims to develop and evaluate an optimized implementation model within the routine health system to achieve at least 80% immediate KMC coverage among eligible babies born or referred to the immediate KMC facilities. The study will also scale up the optimized implementation model and evaluate its impact on neonatal and other relevant neonatal outcomes.