Costs and cost-effectiveness of kangaroo mother care for preterm and low birthweight infants in low- and middle-income countries: a systematic review protocol.

OBJECTIVE: This review will synthesize studies on costs, the impact of these costs, and the cost-effectiveness of kangaroo mother care (KMC) compared with conventional neonatal care for preterm and low-birthweight infants in low- and middle-income countries. INTRODUCTION: Preterm birth and low birthweight are leading causes of neonatal mortality and long-term disability worldwide, and KMC has been promoted as a potentially low-cost, resource-efficient intervention, yet the economic evidence remains fragmented and methodologically heterogeneous. ELIGIBILITY CRITERIA: Studies that include preterm (gestational age <37 weeks) and/or low-birthweight (<2500g) infants receiving KMC, compared with conventional neonatal care, will be considered eligible for inclusion. Full and partial economic evaluations alongside comparative effectiveness data will be included, with no restrictions on date, language, setting, or geographical location. METHODS: A preliminary search in MEDLINE (PubMed) has informed a comprehensive strategy using MeSH terms and keywords for KMC, preterm/low-birthweight infants, and economic evaluation, which will be adapted for multiple databases and gray-literature sources. Two independent reviewers will screen titles/abstracts and full texts, extract data using piloted forms, and assess methodological quality using JBI and Cochrane tools, resolving disagreements by consensus or a third reviewer. Where appropriate, studies will be pooled using meta-analysis; otherwise, narrative synthesis will be undertaken. The JBI dominance ranking matrix will be used to summarize and compare results across different types of economic evaluations. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach will be used to assess the certainty of economic evidence. REVIEW REGISTRATION: PROSPERO CRD42017055742.