First Embrace is half a year old, and we have lots to share with you in our first update. If you’d like more background and evidence about us and our work, please see the rest of our website.
We look back on our launch in Nigeria so far, and ahead to the next quarter. Thank you for reading!
Scoping
The first months were a whirlwind. Less than a month after completing the Charity Entrepreneurship incubation programme and securing seed funding, we travelled to Kano and Bauchi in Nigeria to begin to deeply understand the local context.
Visits to hospitals, health NGOs, and government stakeholders taught us what it takes to deliver kangaroo care (KC) impactfully. We are grateful to Dr Sufi (public health expert) and Professor Farouk (consultant neonatologist) for guiding the scoping and joining our team.
Progress in reducing neonatal mortality in Nigeria has stalled over the past decade, with 250,000 newborns dying every year. During our scoping, we saw a clear gap in access to KC, with few vulnerable newborns receiving it. In Kano State, no non-governmental organisations are currently implementing KC (or KMC) in secondary and tertiary government hospitals.
We aim to support Nigeria’s national target of ensuring 90% of eligible newborns receive KC by 2030. Our scoping trip confirmed that the opportunity for impact is large.
Pre-pilot & baseline
We established a hospital-level memorandum of understanding (MOU) with our first pilot site in Kano State. In response to space constraints, the hospital agreed to repurpose an unused ward for KC, while our team also supports implementation within the existing newborn wards.
We recruited an experienced local program team alongside newer nurses in December and January. Our MEL Officer Hamdi conducted one month of pre-intervention follow-up with vulnerable newborns delivered at the pilot hospital, through to the end of the neonatal period. We observed a baseline neonatal mortality rate of 26%.
Following whole-team ward preparation and procurement with hospital leadership, Wesley returned to Kano State in February. He supported the team in a week of intensive training led by Professor Farouk, and observed the initial phase of the pilot after approval from the Kano State Ministry of Health.
Pilot
As we were promised, the pilot has been a period of exponential learning and some early impact. 7 weeks in, the data is highly promising:
- 54 newborns have reached the end of the neonatal period, fully completing our program. Before our program started, around 13 of them would have died (based on the observed pre-intervention mortality rate). Since our program started, only 7 have.
- We have enrolled 113 vulnerable newborns into our KMC program, supervising caregivers in giving KMC to 89% of them. 100% have been eligible for KC based on WHO guidelines.
- We supported caregivers in initiating KMC on the first day of life (KC) for 40% of newborns. A WHO RCT in 2021, in Nigeria and four other countries, showed that KC has a 25% additional mortality benefit compared with starting post-stabilisation — which itself has a 33% average mortality-reduction effect compared with incubators.
- Mean KC hours are 3.6 per day so far, and the exclusive breast-milk feeding rate is 30%.
Next steps
We have launched a collaboration with Dimagi and E-Health Africa to refer high-risk newborns into their community KMC pilot. Under this initiative, babies discharged with elevated mortality risk will receive continued KMC support at home from government Community Health Workers, enabling end-to-end KMC care throughout the neonatal period. This will let us compare our follow-up data with theirs — to see if what they find when they visit homes is what mothers are telling us.
We are using real-time data flows to improve the program indicators that aren’t performing well.
By the end of the next quarter we will release our pilot results and our baseline data.
Thank you!
There are so many wonderful people who have contributed to our early progress. We want to thank everyone at Ambitious Impact, our generous seed funders, Dr Sufi & Prof Farouk, the leadership team at our first hospital, our advisors, and Ansh.
We want to maximise newborn survival by scaling KC with the Nigerian public health system.
Let’s give every baby the first embrace they need.
If you’d like to hear about our work in more detail or support us, sign up to our newsletter below. Feedback is welcome by email to info@firstembrace.org.uk.
Yours,
Wesley & Ikra | Co-founders