The fight against neonatal mortality is a public health priority. Significant resources are mobilized through a variety of strategies and actions for a significant improvement in the survival of the newborn. According to WHO data, 5 million children died worldwide in 2021 including 2.3 million newborns [1] . Sub-Saharan Africa accounts for 47% of these newborn deaths [1] . The main causes of death are infections (28%), prematurity and/or low birth weight (25%) and asphyxia (24%) [2] . Côte d’Ivoire, located in this region of Africa, is one of the countries with the highest neonatal mortality rate [3] . The leading cause of death in this country is attributed to LBW [4] . In order to achieve the United Nations (UN) 3rd Sustainable Development Goal (SDG), the country must implement strategies to improve the survival of LBW.

Among the problems linked to this survival, we have hypothermia and feeding, which can be solved by KMC. This involves promoting skin-to-skin contact by placing the newborn on the mother’s chest, to avoid hypothermia [5] , promote breastfeeding [6] [7] and strengthening the mother-child relationship [8] [9] . It is in this context that the kangaroo unit at the CHU of Cocody began its activities in September 2019. The present study should provide data and information on the characteristics of LBW for which the method could be safely provided. The aim of this work was to evaluate the results obtained in this unit. The general objective was to study KMC practice at CHU of Cocody. The specific objectives were to evaluate the efficacy of SKs in terms of growth, thermoregulation, complications and survival of LBW.

During the study period, 137 newborns were included.

This study enabled us to investigate the activities of the kangaroo unit at the CHU of Cocody. Among the 137 neonates meeting the inclusion criteria, the median gestational age in conventional care was 32 SA. This median GA has been reported by other authors [10] - [12] . At birth, the newborns had a mean birth weight of 1371 gr, comparable to that reported by Menezes et al. [10] - [13] . All newborns had remained in a conventional care unit until stabilization. This should be the rule in KMC units for better safety. This implies that the unit should be located in a conventional neonatology department [14] . The pathologies of premature infants encountered in this care remain the same in sub-Saharan Africa [15] [16] . In this study, they were dominated by neonatal infection (45%). The frequency of neonatal infections remains high, and is in itself a cause of prematurity and LBW [17] - [19] . At inclusion in KMC, 14% of newborns were exclusively breastfed. This rate was 46% in Colombia [20] . Exclusive breastfeeding (EBF) should be favored and encouraged in KMC.

However, there are a number of constraints, namely insufficient milk supply in mothers due to lack of stimulation in the first few days, insufficient weight gain under AME and unavailability of the mother. This percentage should be improved to enable newborns and their mothers to benefit from the advantages of this method [9] [21] - [25] . Mothers and nursing staff should be urged to extract breast milk early on the admission of a newborn. Anemia was the most frequent complication (16.2%) in KMC. Anemia may be the consequence of neonatal infection, which is responsible for erythroblastopenia and hyperhemolysis due to microbial toxins [26] . Average discharge weight was estimated at 1570 g. Higher discharge weights had been reported [27] - [29] .

Average discharge weight is not the only criterion for discharge home. Other criteria are taken into account, notably regular weight gain. In this series, we noted an average daily weight gain of 26 g, as reported by other authors [29] [30] . We noted hypothermia in 17% of cases. The frequency of hypothermia varies from study to study [11] [12] [30] - [32] . Good thermoregulation is the key to the success of KMC. Staff should insist on continuous skin-to-skin contact with mothers. Two deaths were recorded (1.5%). KMC helps to reduce LBW mortality, especially when initiated early [28] .

KMC is beneficial for the survival and development of low-birth-weight babies’ birth in Côte d’Ivoire. Its introduction into our conditions of practice has shown satisfactory results in terms of weight gain and vital status of newborns. However, there are difficulties encountered in implementing the program effectively and efficiently, including raising the rate of exclusive breastfeeding.

All authors have read and approved the final version of the manuscript.