Achmad Surjono, Yogyakarta, Indonesia

The implementation of KMC has been launched nationally in 1996 by Ministry of Health as part of the emergency neonatal care programme in health center and community levels to prevent hypothermia in high risk newborn infants. Traditionally hypothetmia is prevented by using hot bottle water or kerosene lamp which was no longer recommended since it could endanger the infants. A guideline handbook with pictorial explanation was established and had been distributed. This KMC programme is based on the previous and on-going feasibility studies on KMC practices in hospitals and community settings. Studies were conducted in various districts with differences in ethnic and cultural background to explore the safety, feasibility and acceptance of KMC. It was shown that village midwives and TBAs were among potential change agents in socializing the KMC practice. In OKU district, South Sumatra, KMC was easily accepted by mothers due to the similarity to local traditional care named 'Bedako'. Among those refusing KMC mentioned the reason of fear due to physical condition of the newborn (tiny, looks very weak). KMC was practiced for 5-9 hours per day in 50% mothers, while standing or lying in bed and for 10-14 hours per day in 30%. The study in Deli-Serdang district, North Sumatra and Maros district, South Sulawesi showed the role of communication skills of the health personnel concerning the benefit of KMC using the similar existing local terms and taking consideration of local habits. The majority of KMC practices was supported by the family (husband, mother, relatives).

In Purworejo district, Central Java and districts in Yogyakarta province the KMC was practiced through training (TOT) on village midwives. Mothers accepted the KMC since they knew that it was done in hospital care and they do follow the advice of village midwives. Some mothers suggested to change the namne of Kangaroo so that 'Perawatan BayiLekat' (closed, attached newborn care) is used. In Belu district, Nusa Tenggara Timur the mothers are familiar with the Kangaroo habits. The training was conducted as part of Integrated Management of Childhood Illness (neonatal section).

Traditionally mothers and her newborn were kept togethere in their hunt for 30-40 days with fire inside. Study in West Seram, Maluku province revealed that local term 'Kussu method' should be used in socializing the KMC. Kussu is local animal which has a pocket to carry its offsprings. Under the intiative of Perinatal section of the Indonesian Society of Pediatricians most teaching and provincial hospitals have practiced KMC.

They will play an important role for disseminating and supervising to the KMC implementation in district hospitals, health centers and community settings in their region