Kangaroo Mother Care in Developing Countries With Poor Hygiene or Limited Healthcare Infrastructure: A Systematic Review

Kangaroo Mother Care (KMC) is an affordable, evidence-based intervention widely endorsed for improving survival and health outcomes in preterm and low-birth-weight infants, particularly in resource-constrained healthcare settings. Concerns persist regarding its use in areas with suboptimal sanitation, mainly due to fears of increased newborn infection rates. This systematic review evaluates KMC's effectiveness and safety in contexts characterized by poor hygiene and limited resources. Using the PICO framework, we conducted comprehensive searches across PubMed, Cochrane Library, Scopus, Web of Science, and Google Scholar for publications from January 2005 to July 2024. Eligible studies included randomized controlled trials, cohort studies, and systematic reviews reporting mortality or infection outcomes. Quality was assessed using Cochrane Risk of Bias tools and AMSTAR (A Measurement Tool to Assess Systematic Reviews) 2. Due to heterogeneity, a narrative synthesis was performed rather than a meta-analysis. The evidence consistently demonstrates reductions in neonatal mortality, along with improvements in breastfeeding rates and thermoregulation, even in poor sanitary conditions. No overall increase in severe infections was observed; sepsis rates often decreased. Basic preventive measures (e.g., hand hygiene) effectively mitigate any residual risks. These findings confirm that KMC is appropriate and safe for low-hygiene settings when combined with simple precautionary practices.