SMALL AND SICK NEWBORN CARE: LEARNING FOR IMPLEMENTATION ACROSS AFRICA AND BEYOND: Supplement 2

In 66 NEST360 Alliance hospitals (Jan 2021–Dec 2024), 51.3% of eligible preterm/LBW neonates received KMC, and adjusted predicted survival was higher with KMC in every severity group.

• Why it matters: KMC can reduce neonatal mortality, but in sub-Saharan African hospitals its uptake and care quality vary, leaving uncertainty about how provision relates to survival.
• What they did: Using routinely collected neonatal inpatient data, the study analyzed KMC coverage and a quality-of-care cascade from eligibility through documented, timely, and sustained KMC, then modeled survival to discharge with mixed-effects logistic regression.
• The result: Among KMC starters with documented start dates, 29.2% began on day 1, and quality losses occurred at each pathway step; receiving KMC was linked to improved survival, with the largest absolute benefit in the most critically ill (adjusted predicted survival 7% vs 80%).

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