Objective: Objective of study was to quantify compliance with WHO-recommended KMC process indicators.
Methods: We conducted a retrospective audit of all neonates with birthweight ≤2 kg or gestational age ≤37 weeks admitted to the Maternal and Child Health Department of Pakistan Institute of Medical Sciences (PIMS) from January to June 2025. Based on an expected initiation rate of 80% (α=0.05, precision=5%), the sample size was 150 dyads, with 157 eligible and 150 included after exclusions. A standardized WHO-based checklist was used to extract data on maternal demographics, infant clinical parameters, and KMC process. Descriptive statistics summarized compliance rates, while χ² tests investigated subgroup associations (p<0.05).
Results: Out of 150 audited dyads, the average maternal age was 28 ± 4 years, with 52% being primiparous and 40% having at least secondary education. Infants had an average gestation of 32.5 ± 2.1 weeks and a birth weight of 1.82 ± 0.30 kilograms. KMC was initiated within 24 hours for 120/150 (80.0%) [6], but only 65/150 (43.3%) met the WHO-recommended ≥4 h skin-to-skin per day [7]. Correct positioning was documented in 105/150 (70.0%) [5], with exclusive breastfeeding at discharge in 125/150 (83.3%) [8]. KMC logs were completed by 100/150 mothers (66.7%), and formal counseling was provided to 110/150 (73.3%). A subgroup analysis revealed no significant differences in initiation based on maternal education (p=0.12) or mode of delivery (p=0.15).
Conclusions: While PIMS has a higher initiation rate than similar settings, full compliance with recommended daily duration, positioning, and documentation remains suboptimal. Systems strengthening—through staff training, protocol standardization, dedicated facilities, and increased family support—is critical to meeting WHO coverage targets and improving neonatal outcomes in Pakistan.
Keywords: Audit, KMC, Neonatal outcomes.
How to cite this article: Amjad N, Rauf S, Aftab S, Batool M, Sharafat S, Tabassum S, Shams A, Compliance with Kangaroo Mother Care Best Practices: A Clinical Audit at PIMS MCH Department. Int J Drug Deliv Technol. 2026;16(2s): 376-382; DOI: 10.25258/ijddt.16.376-382