Impact of the H-HOPE multisensory behavioural intervention plus Kangaroo Mother Care on early growth in preterm infants in Malawi.

AIM: To evaluate the efficacy of the Hospital-to-Home: Optimizing the Premature Infant’s Environment (H-HOPE) intervention for early infant growth, we compared mother-preterm infant dyads receiving both H-HOPE and Kangaroo Mother Care (KMC) with those receiving KMC only, the standard of care for all preterm infants, at a single hospital in Malawi. METHOD: A prospective quasi-experimental study design was used at Zomba Central Hospital. Because the intervention took place in a single, large room without any auditory or visual privacy, the enrolment of the two study conditions (KMC only control and H-HOPE + KMC intervention conditions) was sequential to avoid overlap. There were 89 KMC only and 94 H-HOPE + KMC mother-preterm infant dyads in each study condition. Infant birth weight was between 950 and 2400 g. When infants reached clinical stability, the interventions commenced and continued through the 2-week post-discharge follow-up assessment. RESULTS: No significant differences were observed in maternal and infant characteristics at baseline between the conditions. After adjusting for covariates, baseline birth weight was not significantly different. A multivariate mixed-effects regression model indicated a similar pattern in both study conditions from birth until 2 weeks post-discharge, characterized by an initial weight decline followed by a steady increase in a quadratic trend. At the 2-week post-discharge follow-up, infants in H-HOPE + KMC study condition showed greater early growth than infants in KMC only (mean weight = 2017.59 g vs. 1856.55 g, p = .03). CONCLUSION: These results suggest that the H-HOPE + KMC intervention promotes rapid early growth in preterm infants. H-HOPE + KMC is a low-cost, high-impact intervention that complements KMC. These promising pilot results provide initial evidence of the efficacy of H-HOPE + KMC in Malawi and justify the need for an adequately powered study to validate the findings and explore the long-term benefits of an integrated H-HOPE and KMC intervention.