World Breastfeeding Week, running August 1–7 and coordinated globally by the World Alliance for Breastfeeding Action alongside the World Health Organization and UNICEF, makes this case every year, just at a broader scale: breastfeeding is one of the most effective, lowest-cost interventions in global health, and it still isn't reaching enough mothers and babies.
For the smallest and sickest newborns, breastfeeding alone isn't enough. But paired with prolonged skin-to-skin contact and monitoring the newborn for danger signs — a combined practice called Kangaroo Mother Care — it meaningfully improves their odds of survival.
The gap between the evidence and the bedside
Those are exactly the gaps technical assistance is built to close: training and mentoring health workers so the practice sticks after the initial rollout, building data systems that track which newborns received it and for how long, and creating a feedback loop — supervision, coaching, problem-solving — that catches gaps before they become the norm.
Finding out what it would take
The Accelerator is how we decide, systematically, which promising interventions are worth building into programs at scale — and which aren't. Every intervention has to pass the same bar: a strong evidence base, a compelling cost-effectiveness case, and a credible path to reaching people at scale.
Kangaroo Mother Care clears the first two easily. A GiveWell intervention report on Kangaroo Mother Care concludes there is strong evidence the practice reduces neonatal mortality and estimates that it's cost-effective enough to be worth directing additional donations to (in the same range as other programs it considers highly cost-effective). The Center for Global Development's framing of the same evidence base reaches a similar conclusion on both counts: strong evidence, and a compelling cost-effectiveness case.
What's harder to answer is the third question: what would it actually take to deliver Kangaroo Mother Care consistently, at scale, in places where it isn't reaching most of the newborns who need it? Increasingly, we're looking for interventions that can build on health systems already in motion — reaching mothers and newborns through touchpoints and relationships that already exist — rather than standing up something new alongside them.
To find where that might be possible, we looked at the burden of prematurity and low birth weight across the countries where we already work, and at where we had the partnerships to move quickly. That process pointed to Liberia. Syphilis-Free Start, our existing maternal and newborn health program there, has supported the Ministry of Health in driving syphilis screening at antenatal visits from 7% to 88% coverage in 3.5 years — a foothold most countries in our portfolio don't have.
Over the coming months, we'll be in maternity wards and newborn units with Ministry of Health staff, assessing what it would take to help mothers start Kangaroo Mother Care earlier and sustain longer periods of skin-to-skin contact. We also hope to learn how much training, adaptation, and follow-up support Kangaroo Mother Care would need to work in this context, as opposed to the conditions it's been studied in. Through this formative research, we're trying to understand what's genuinely needed to build something cost-effective and sustainable.
It's too early to say whether or when a Kangaroo Mother Care program will launch at scale. What we can say is that a proven intervention, with a real gap between policy and practice, is worth the work of finding out.
