Town Hall Meeting on Immediate Kangaroo Mother Care (iKMC) in Ethiopia
Activity report by the Ethiopian Pediatrics Society (EPS), November 13 - 14, 2024, Rori Hotel, Hawassa, Sidama, Ethiopia.

Meeting Overview
The Town Hall Meeting on Immediate Kangaroo Mother Care (iKMC) was successfully conducted in Hawassa, Ethiopia, on November 13–14, 2024, at Rori Hotel. This pivotal event was a collaborative effort of the Ethiopian Pediatrics Society (EPS), American Academy of Pediatrics (AAP), Bill and Melinda Gates Foundation (BMGF), Ethiopian Ministry of Health (MoH), Hawassa University, and the Saving Little Lives (SLL) 360 Project.

The meeting’s primary objective was explained by Professor Bogale Worku, who served as the master of ceremony. He explained that the town hall meeting aimed to foster collaboration among key stakeholders, enhance the implementation of iKMC, and identify strategies to address critical barriers to its scale-up in Ethiopia.

Opening Remarks
The event commenced with an opening speech by the guest of honor, Dr. Tafesse Matewos, Vice President for Research and Technology Transfer at Hawassa University. Representatives from UNICEF, the Ethiopian Society of Obstetricians and Gynecologists, the Ethiopian Pediatrics Society, and the Ministry of Health also delivered opening remarks.

Dr. Tafesse Matewos,
HU Research and Technology Transfer Vice President, giving the opening speech.

Participants

A total of 69 attendees participated, including representatives from diverse stakeholder groups:

1. Governmental and Health Institutions:
   • Ministry of Health (MoH)
   • Regional Health Bureau (RHB) delegates from Sidama, Oromia, Amhara, and Tigray regions
   • Administrative staff (CEOs, medical directors), department heads (Labor and Delivery, NICU), physicians, nurses, and midwives from hospitals:
   • Tikur Anbessa Specialized Hospital
   • St. Paul’s Millennium Medical College
   • Zewditu Memorial Hospital
   • Gandhi Memorial Hospital
   • Tirunesh Beijing General Hospital
   • Felegehiwot Referral Hospital
   • Mekelle General Hospital
   • HUCSH (Hawassa University Comprehensive Specialized Hospital)
   • Bushulo MNCHSC (Maternal, Neonatal, and Child Health Specialized Care Center)
   • Adare General Hospital
   • Hawela Tula General Hospital
   • Motiti Fura Primary Hospital
2. International Organizations:
   • UNICEF
   • USAID
   • NEST360
   • Clinton Health Access Initiative (CHAI)
   • JSI-QHA, JSI-LHA, and JSI-L10K
   • American Academy of Pediatrics (AAP)
3. Academia and Implementation Teams:
   • Addis Ababa University: Center for Implementation Sciences in Health (CIS), School of Public Health
   • Hawassa University: College of Medicine and Health Sciences
4. Families of Preterm Babies:
   • Two mothers, a father, and a surrogate (aunt) who experienced iKMC care
5. Others:
   • Representatives from the iKMC Implementation Research Team and Saving Little Lives 360 Project

Meeting Objectives

• Highlight the importance and implementation of iKMC in Ethiopia
• Share personal stories and testimonies from families and healthcare providers on iKMC experiences
• Provide practical skills for iKMC implementation through workshops, facility visits, and simulations
• Facilitate knowledge-sharing and collaboration between local and international experts to scale up iKMC practices

Event Overview

Master of Ceremony:
Prof. Bogale Worku, Executive Director of EPS, facilitated the event and introduced the agenda.

Key Activities and Discussions

1. Round Table Introductions

   Participants introduced themselves, representing various institutions.

2. Personal Stories and Testimonials

   Families of preterm babies shared emotional and inspiring experiences about iKMC:

   • Surrogate�s Experience: A surrogate mother shared her pride in providing iKMC for a tiny baby whose mother had undergone a Caesarean section.
   • Mother�s Experience: A mother took over iKMC on the second day after her Caesarean section due to preeclampsia.
   • Father�s Experience: A father of a baby weighing less than 1000 grams shared his emotional journey in the NICU, expressing determination despite challenges.
   • Healthcare Providers� Reflections: Highlighted challenges and strategies for initiating and scaling iKMC.
   
3. Presentations
   • Dr. Mahlet: Delivered a historical overview of KMC in Ethiopia, progress made, and challenges faced.
   • Shared experiences from Ghana, Nigeria, and India on enabling environments, barriers, and strategies for successful iKMC implementation.
   
4. Panel Discussion on iKMC in Africa

   Facilitated by Dr. Beena Kamath (Senior Vice President, AAP), the panelists included:

   • Dr. Harrish Chellani (India, Virtual)
   • Professor Ebunoluwa Adejuyigbe (Nigeria, Virtual)
   • Dr. Naana Wireko Brobby (Ghana)
   • Dr. Fitsum W/G and Dr. Mahlet Abayneh (Ethiopia)

   Key points discussed:

   • Importance of iKMC and strategies for scaling up.
   • Collaboration with NICU and labor and delivery units.
   • Engaging community leaders and mothers to promote iKMC.
   • Inclusion of iKMC in pre-service curricula and church-based women fellowships as seen in Ghana.
   
5. Site Visits to Bushulo MNCHSC and HUCSH

   Participants observed exemplary changes in facilities to accommodate iKMC, achieved through committed leadership and health worker efforts without external support. Observations included:

   • Organized workflow to facilitate iKMC implementation.
   • Clean NICUs with effective infection prevention measures.
   • Impressive family involvement, including fathers participating in iKMC.
   • Collaboration among NICU, delivery room teams, biomedical engineers, and support staff.
   
6. Simulations

   Neonatologists and pediatricians conducted hands-on iKMC simulations, demonstrating best practices for newborn care.

   
7. Presentation on Scaling iKMC

   Dr. Amanuel (NCH desk, MoH) provided updates on:

   • Progress and challenges (e.g., space, equipment shortages, training gaps).
   • Next steps for scaling up iKMC.
   
8. Breakout Sessions by Regions

   Teams from Addis Ababa, Oromia, Amhara, Sidama, and Tigray developed action plans focusing on:

   • Leadership engagement and advocacy.
   • Staff training and mentoring.
   • Space reorganization and resource mobilization.
   • Experience-sharing visits and awareness creation.
9. Partner Commitments
   • UNICEF: Aligned support with government priorities, focusing on capacity building.
   • USAID: Committed to equipment procurement and infrastructure support, especially in conflict-affected regions.
   • BMGF: Emphasized leveraging existing investments and fostering evidence-based decision-making.
10. Key Takeaways and Next Steps
    • Strengthen collaboration between MoH, RHBs, and partners to address challenges.
    • Mobilize resources for equipment, facility upgrades, and capacity building.
    • Enhance advocacy efforts through community engagement and awareness campaigns.
    • Develop region-specific action plans and follow through on priorities.
11. Closing Remarks

    Delivered by Tigist Daniel (MoH), highlighting:

    • MoH�s commitment to scaling iKMC through guidelines, mentorship, and procurement plans.
    • Importance of collaboration, strong M&E systems, and community advocacy for sustainable iKMC implementation.

Vote of Thanks: Prof. Bogale Worku (EPS) and Dr. Beena Kamath (AAP) expressed gratitude to participants, families, and collaborators for their contributions.

Special recognition was given to Hawassa University, Bushulo MNCHSC, and HUCSH for hosting the site visits, and to EPS for organizing the event.