Kangaroo mother care (KMC) for low birthweight infants (LBWI) was introduced in a Mozambican hospital with limited resources and without facilities for intensive care. Six months were needed to change policies, organize the ward, train staff and overcome constraints. Facilitating factors were a KMC national policy, the commitment of health authorities, technical assistance and availability of some funds, and the perception of improved quality of care and survival. The obstacles and constraints were resistance to change by the staff, cultural problems, and managerial difficulties. Out of 32 LBWI (< or = 1.800 g) admitted in 3 months, survival was 73 per cent in 22 KMC and 20 per cent in 10 non-KMC infants (p < 0.01). KMC is a feasible and appropriate technology in hospitals with very limited resources.