Ansh, a Charity Entrepreneurship incubated charity, is dedicated to saving newborn lives by building healthcare capacity in government district hospitals in India. Our mission is to create a scalable and cost-effective model that implements Kangaroo care and other impact-focused newborn care practices such as breastfeeding counseling, monitoring of danger signs, IPC (Infection Prevention and Control) measures, counseling in best newborn care practices and closely working with the hospital on making these services long-term and sustainable.

 

Our main intervention is Kangaroo Care, a highly cost-effective and scientifically proven intervention for saving newborn lives. Kangaroo Care has three components:

1. Skin-to-Skin Contact: Skin-to-skin contact with the mother regulates the infant’s body temperature, reducing hypothermia
2. Close Monitoring: Monitoring mothers and newborns for danger signs
3. Exclusive Breastfeeding: Exclusive breastfeeding provides benefits to the infant's immune system and helps in weight gain

Currently, we have 6 core team members and 55 on-ground full-time staff delivering our programs in four hospitals—Pali District Hospital (DH), Baran DH, Dhaulpur DH, and Pratapgarh DH in Rajasthan—with the aim to replicate and adapt this model for broader implementation in public health systems.

We run two KMC programs in all of our hospitals:

• KMC in Post Natal Care (PNC) Ward Program for Stable Low Birth Weight and Preterm Newborns
• Early Initiation of KMC in Special Newborn Care Unit (SNCU) Program for Unstable Low Birth Weight and Preterm Newborns

We deliver our model in three stages: 

1. Set up Activities: 

• Facilitate stakeholder buy-in and alignment at the district level
• Establish model KC lounges at chosen public facilities (District Hospitals) by repurposing existing space and providing basic infrastructure (i.e. privacy screens, chairs, beds, weighing machines, etc).
• Screen newborns in the PNC wards of the chosen district for risk factors such as difficulty breastfeeding, low birth weight (<2000g), hypothermia, prematurity (<36 weeks), first-time mothers, twin birth, cleft lip or palate, and prior neonatal mortality.
• Hire healthcare staff and provide them training to deliver the following activities to mothers and babies admitted to the KC program:

2. Activities at KMC:

• Counseling families to provide KMC often and safely.
• Breastfeeding and expressed breastmilk (EBM) feeding counseling for those babies identified in screening. Counseling of families to feed LBW babies according to their needs. Typically, this means feeding breastmilk 10 times in a 24-hour period.
• Training families to weigh their babies, take their temperatures and recognize danger signs.
• Providing supplies for LBW baby care, such as KMC wrap, caps, TempWatch, etc.
• Encouraging families to stay in the hospital’s KMC program until the pediatrician clears them for discharge.

3. Post-Discharge activities:

• Following up with families of LBW infants who have left the hospital through phone calls.
• Encouraging families of babies who display the danger signs to seek appropriate care. In cases where hospital care is required, Project staff encourages families to come to the hospital.
• Helping mothers who display danger signs to seek appropriate care. For example, if a mother has postpartum complications including fever, nausea, anemia, convulsions, etc. Project staff encourage her to go for an OPD visit and/or inform PNC staff/the attending doctors.

Monitoring and Evaluation Plans 

Our main goal is to evaluate the impact of our programs and to continuously improve the quality and accessibility of care and KC Coverage. 

Our M&E coordinators for each of our districts (independent of our implementing partner) monitor the Kangaroo Care activities and ensure the quality of the program. The coordinators measure the quality of care, HW training, availability of necessary materials such as slings and weighing machines, hygiene and cleanliness in KC ward, and process outcomes such as weighing at birth. Additionally, we will conduct a performance evaluation to assess the goal of achieving at least 80% effective KC coverage at the population level. The duration of skin-to-skin contact and infant feeding practices throughout the one-month neonatal period will also be assessed. 

 

We have developed an in-house patient and project management application for the collection of monitoring & evaluation data, as well as patient data. 

Our Values 

We are guided by strong evidence and research done in Kangaroo Care, and we are ruthlessly focused on saving lives. The two most important pieces of research that guide our model are: 

The Cochrane review analyzed 21 high-quality RCTs and found that Kangaroo Care was associated with a statistically significant reduction of 33% in the risk of mortality compared to conventional care of incubators. 

Recent WHO evidence found that doing Kangaroo Care in SNCUs/NICUs reduces mortality by an additional 25%. 

 

We have achieved a proof of concept and initial success through our pilots and are now looking to rapidly scale up in a highly cost-effective manner (see here to understand what we mean by cost-effectiveness). 

From Pilot to Scale-up 

Ansh started its pilots in Pali and Baran in January 24 and we successfully completed our pilots in May’24. Building upon the accomplishments of our pilot phase, we are excited to extend our programs to Dholpur, Pratapgarh and Tonk while sustaining our programs in Pali & Baran. This expansion marks the commencement of our scale-up phase, enabling us to reach a wider audience and achieve greater results.

The goal is to expand to 15 high-burden districts across Rajasthan by the end of 2025.