iKMC-IR is an implementation research and effectiveness study in India. The proposed study is aimed to integrate immediate KMC into functional systems of care for preterm and LBW infants within the district health systems, and to scale up and increase coverage across districts. The study is conducted in two phases. In a model optimization phase, an implementation model was developed in district Ambala in the state of Haryana, India. In phase 2, the final model will be scaled up in another district of Haryana. The study is proposed to be conducted in four countries across six sites including India, Bangladesh, Ethiopia and Nigeria. Implementation outcome of the study is acceptability, adoption, adaptation, cost effectiveness and fidelity of the iKMC intervention. This study is funded by BMGF.