A Systematic Review of Community-Based Kangaroo Mother Care Promotion and Preterm Infant Survival in Malawi: An African Perspective, 2015

Preterm birth is a leading cause of neonatal mortality in Malawi. Kangaroo Mother Care (KMC) is an evidence-based, low-cost intervention, but its adoption within community settings remains inconsistent. Assessing the impact of organised promotion strategies is therefore essential for wider implementation. This systematic review aimed to synthesise evidence on the effect of a community-based KMC promotion programme on preterm infant survival in the Mchinji district of Malawi. A systematic search of multiple academic databases and grey literature sources was conducted. Included materials comprised peer-reviewed studies and programme reports evaluating the specified community KMC programme in Mchinji. Study screening, selection, and data extraction followed established systematic review protocols. The quality of the included evidence was appraised. The review identified a limited number of relevant studies. The available evidence suggests a positive association between the community-based KMC programme and improved preterm survival rates in the district. Findings indicated a reduction in preterm mortality alongside increased reported adherence to exclusive KMC practice among participating mothers. Community-based promotion appears a promising strategy for increasing KMC uptake and improving preterm outcomes in this Malawian context. However, the evidence base is constrained by the small number of evaluations and their methodological limitations. Further robust, longitudinal research is required to strengthen the evidence. Programme implementers should adopt systematic documentation of outcomes. Policymakers should consider integrating community KMC promotion into national maternal and child health strategies, supported by appropriate training and resources. Kangaroo Mother Care, preterm infant, neonatal mortality, community health, Malawi, systematic review This review consolidates existing African evidence on a specific community KMC model, offering insights for practitioners and policymakers in comparable low-resource settings and delineating critical evidence gaps.