Actions undertaken to implement immediate KMC
Substantial infrastructure improvements and expansion of neonatal care capacity were required at all study hospitals to safely implement iKMC. The renovation process at the five study hospitals included the addition of floor space to improve the neonatal units and accommodate adult beds for KMC through repurposing or remodelling of existing space, or construction of a new unit. At Hospital-3, an extension to the existing neonatal unit was constructed, which increased floor space by 124% (Table Floor space before and after renovation in neonatal units at five hospitals in Ugandam




Following these improvements, total floor space in the neonatal units ranged from 58 mFour members of staff from MRC/UVRI (one engineer, one trial coordinator, one site coordinator, and one procurement officer) were involved in planning, design, contract drafting, tendering, scoping, of the improvements, as well as initial and interim site and closure meetings, site survey, and inspection, supported by one driver from MRC/UVRI. An administrator from each of the five hospitals was involved in meetings, site survey, and inspection. The engineer, trial coordinator, site coordinator, procurement officer, hospital administrators, and drivers were estimated to have spent a total of 898, 290, 91, 456, 201, and 104 person-hours, respectively, on planning and design activities for all five sites.All hospital staff completed a comprehensive, 5-day training programme on small and sick newborn care that was developed using established UNICEF and WHO protocols. This programme included Helping Babies Breathe, a neonatal resuscitation curriculum designed for low-resource settings [