A Hybrid Implementation-Effectiveness Review on Community Strategies, Digital Health Innovations, and Post-Discharge Continuation

Background: Low birth weight (LBW, <2500 g) and preterm births (<37 weeks) drive most neonatal deaths across India. Kangaroo Mother Care (KMC)—continuous skin-to-skin contact (SSC), exclusive breastfeeding, and early discharge—decreases neonatal mortality by 30–40% in stable neonates and by 25% when initiated immediately after birth (Immediate KMC / iKMC). Despite strong trial efficacy, implementation gaps in achieving universal KMC coverage persist across Indian health systems, with effective population coverage remaining below 20%. Methods & Focus: Using JBI scoping review principles and CFIR 2.0 framing, this review synthesizes evidence across micro- (infant, mother, family), meso- (clinical teams, SNCU/MNCU units, frontline workers), and macro-levels (policy, HMIS, equity). It maps barriers across six care settings, appraises quality improvement (QI) initiatives, clarifies community Home-Based Newborn Care (HBNC) vs Home-Based Care for Young Child (HBYC) visit schedules, evaluates digital health tools, and incorporates growth milestones (proportion reaching ≥2.5 kg by 40 weeks postmenstrual age [PMA]). Conclusion: Achieving sustainable scale-up requires zero-separation Mother-Newborn Care Units (MNCUs), hospital QI routines, family redistribution of KMC to surrogate caregivers, empowered ASHA networks, and duration-sensitive HMIS metrics.