{
  "abstract": "Background Small and Vulnerable Newborns (SVNs)—those born under 2,500 g and/or before 37 weeks—are at high risk for developmental delays and increased morbidity and mortality. In Guatemala, prematurity and low birth weight (LBW) rates are 10.7% and 15.6%, respectively. In our community-based neonatal health program serving Maya Kaqchikel communities, we reach about 700 newborns annually and have observed disproportionately high LBW rates. Due to strong resistance to hospital-based care, we are expanding home-based strategies to reduce complications and promote healthy early growth in SVNs.Methods Neonatal Technicians conduct home visits using a smartphone app to track weight, temperature, and other vital signs, providing real-time clinical guidance. They support breastfeeding and help identify danger signs. To improve home-based care for SVNs, we introduced targeted interventions including Kangaroo Mother Care (KMC), passive feeding techniques, and the provision of low-tech equipment such as breast pumps, baby carriers, and infant warmers. We aim to improve thermal regulation, nutrition, and weight gain in the home setting.Results From July 2024 to March 2025, over 270 newborns received 2–4 home visits. LBW and prematurity rates were 23.6% and 11.8%, respectively. Neonatal referrals increased by over 100%, primarily due to LBW. Exclusive breastfeeding rates reached 87%. However, uptake of KMC has been limited by cultural modesty norms, and referral acceptance is challenged by deep-rooted mistrust of institutional care.Conclusions We describe an expansion of a community-based neonatal program strengthening home-based care for SVNs through targeted, low-cost interventions that can improve developmental outcomes.",
  "authors": [
    {
      "affiliations": [
        "Wuqu’ Kawoq | Maya Health Alliance, Tecpán, Guatemala",
        "Harvard Medical School, Boston, USA"
      ],
      "name": "Anahí Venzor Strader"
    },
    {
      "affiliations": [
        "Wuqu’ Kawoq | Maya Health Alliance, Tecpán, Guatemala"
      ],
      "name": "Esteban Castro Aragón"
    }
  ],
  "title": "51 Strengthening home-based care for small and vulnerable newborns in indigenous communities of Guatemala",
  "uid": "032c929f-a4bc-5684-a380-a567d7b0c8f5"
}