QI in Action: Improving Preterm Infant Care with Kangaroo Mother Care
Winner - Clinical Excellence and Patient Safety, ACHSI Quality Improvement Awards 2025: Hung Vuong Hospital, Vietnam.
Hung Vuong Hospital, located in Ho Chi Minh City, Vietnam, is a leading 900-bed facility specialising in obstetrics and gynaecology. Founded in 1900, it handles approximately 35,000 deliveries annually.
In 2025, Hung Vuong Hospital was awarded with the ACHS International Quality Improvement (QI) Award in the Clinical Excellence and Patient Safety category for its submission, ‘Improving Preterm Infant Care through Early and Continuous Kangaroo Mother Care in Neonates ≥30 Weeks at Hung Vuong Hospital.’ This initiative significantly improved outcomes for preterm infants from 30 to 33+ 6/7 weeks’ gestational age, and their mothers.
Project Background
Early initiation of Kangaroo Mother Care (KMC) is an evidence-based strategy for preterm infant care recommended by the World Health Organization to be applied immediately after birth.
Early skin-to-skin contact promotes thermoregulation, stabilises cardiorespiratory function, enhances breastfeeding, and strengthens maternal–infant bonding.
However, despite strong global evidence, domestic data evaluating early and continuous KMC in frontline Vietnamese hospitals have been limited. Traditionally, infants born at ≤34 weeks’ gestation were separated from their mothers and admitted directly to the Neonatal Intensive Care Unit (NICU). This separation delayed breastfeeding initiation, increased exposure to hospital-acquired infections, and placed pressure on limited intensive care resources.
Recognising these challenges, Hung Vuong Hospital sought to redesign its neonatal care pathway.
From Classical to Early and Continuous KMC
KMC has been implemented at Hung Vuong Hospital since 2009, initially with just three Kangaroo beds. By 2015, this increased to 14 beds, and by 2023, 48 beds were operational. Annual KMC cases rose from 250 to 955 infants. The programme expanded further in 2023 to include infants born at 34–37 weeks in postpartum and postsurgical wards, achieving implementation rates above 90%. Within the Neonatal Department, 80% of preterm infants received KMC.
Building on this foundation, the hospital introduced an innovative “early and continuous KMC” model in 2024 for infants born between 30 and 33+6/7 weeks’ gestation.
Early KMC was defined as initiation within two hours of birth. Continuous KMC required uninterrupted skin-to-skin contact lasting more than 24 hours, maintained across care settings, from delivery room or operating theatre to postoperative ward and neonatal unit.
Evaluating the Impact
To evaluate the impact of early and continuous Kangaroo Mother Care (KMC), outcomes were compared between infants who received KMC and those who received conventional care. The results showed clear improvements.
For infants born at 32–33+6/7 weeks, the median length of stay decreased from 11 days to 7 days. For those born at 30–33+6/7 weeks, hospital stay was reduced even more significantly—from 21 days to 8 days. Overall, early and continuous KMC shortened hospital stay by an average of 8 days.
Breastfeeding outcomes also improved markedly. Exclusive breastfeeding rates reached 91.2% in the KMC group compared to 74% in the conventional care group.
Importantly, there was no increase in infection or mortality rates. In fact, there was a trend toward fewer complications among infants receiving early and continuous KMC.
These findings confirm that early and continuous KMC is both safe and highly effective in improving outcomes for preterm infants.
By shortening hospital stay, improving breastfeeding outcomes, and reducing NICU burden without compromising safety, early and continuous KMC represents a scalable, family-centred model of neonatal care. The program demonstrates how evidence-based innovation and strong leadership can deliver measurable improvements in both clinical and system-level outcomes.
Read our Quality Initiatives Publication 2025 to view the full submission (pg.6) as well as other outstanding projects from our QI Awards 2025 Winners and Highly Commended.