Your blog category
We always invite people to come early on Day 2 of the Neonatal Care Course to practice their bag-valve-mask skills. We weren’t necessarily expecting all of them! They are a very keen group.
Course number 2 starts tomorrow here in Murambinda, Zimbabwe.
It is an appropriate day to say that nurses from 4 different countries are together teaching and learning on a Neonatal Care Course in Zimbabwe run by NICHE International.
In many countries, nurses with extended skills are critical in caring for newborn babies. They are sometimes working in places where there are no doctors with specialist skills, so their ability to manage vulnerable neonates is invaluable. They also help to train colleagues to improve the standards of care in neonatal units.
Elizabeth, who comes from Uganda, is one of the NICHE trainers currently in the Queen of Peace Mission Hospital, Murambinda running Neonatal Care Courses.
At home in Uganda, Elizabeth is head of paediatric nursing at the Bwindi Community Hospital in South -West Uganda.
The Kampala International University Surgical Society photographed Elizabeth with a sick baby when they visited Bwindi, and have published the photo to mark International Nurse’s day.
“Joining the NICHE Team to Zimbabwe this time was one of the most exciting moments in my life. Knowing how much the knowledge from NCC has saved lives of our babies in Cameroon gives me the zeal to be part of the team to teach NCC in New communities. My desire is that all Sub Saharan African (SSA) countries should receive this basic knowledge of NCC before 2030 so that we in SSA countries can be able to meet the Sustainable Development Goal of reducing the neonatal mortality to 12/1000 live births.”
Elizabeth and Grace are particularly good at their “ice breakers”, little activities to break up a run of lectures and keep people awake. Here is this morning’s:
Men have to sit down if the word begins with “M” and women have to sit down if it begins with “F” (for female). Amazing how difficult it is to remember if one is a man or a woman!
Day 1 was a great success overall. The learners were very well engaged and seemed to enjoy the day. There was much discussion in the workshops about how to best support mothers and babies here in Murambinda.
We’re ready for the off. We are expecting 24 learners – nurses, midwives and doctors – on the course starting tomorrow and 24 more for course 2. It’s a privilege to be here and we are looking forward to sharing our skills this week.
We’ve spent the day today going through the whole course and making sure we have all the equipment in order. We are being very well looked after at the hospital’s guesthouse. After dinner this evening, Grace was going over her lectures and Alison – what is Alison doing?
A multi national faculty from Cameroon, UK and Uganda has arrived at Murambinda Queen of Peace Mission Hospital ready to teach two Neonatal Care Courses and identify 12 suitable people to train as instructors later in the year.
Queen of Peace Murambinda Mission Hospital (QPMMH) was founded and established in 1968 by the Sisters of the Little Company of Mary (LCM), under the auspices of the Roman Catholic Diocese of Harare. The hospital operates under the Ministry of Health and Child Care as a state-aided church-related institution. It is the acting government district hospital for Buhera District, and has 125 beds and around 86 staff.
We are delighted and honoured to have been invited to pump prime neonatal training in Murambinda Mission Hospital, Zimbabwe. Teaching equipment is all packed up, printing and laminated completed, visas and malaria pills procured; ready for the off! 5 international instructors are travelling to Zimbabwe from Cameroon, Uganda and UK to teach the first 2 NCCs with a view to facilitating the first instructor training course at the end of 2026. Funding for the programme is from Friends of Murambinda (About us – Friends of Murambinda Hospital UK Charity 1073978), a small charity run by previous volunteers at the hospital.
Zimbabwe’s neonatal mortality rate figures range from 22 per 1000 live births to 30, depending on the information source. Interestingly, the proportion of deaths attributed to premature birth is higher in Zimbabwe than the world averages and those caused by sepsis therefore make up a smaller proportion. In reality, many preterm births are caused by infection so there is inevitably a bit of crossover in the classification. Fortunately, the Neonatal Care Course contains a lot of material about keeping preterm babies warm and feeding them as well as revamped sessions on recognition and management of sepsis.
Feedback forms were received from 51 learners in all. 4 were nurses, 47 were medical officers (mainly doctors with an MBBS degree). Many of the medical officers had been qualified for over 10 years, one or two had been doctors for over 10 years but had only been caring for babies for the past 1 or 2 years. All 4 nurses are regularly working with birth attendants and attending deliveries. They were research nurses employed by CEL to support the birth attendants. They were not confident in resuscitation skills before the course but learnt quickly with the keenness of people who know they really need the skills. The increase in confidence levels is shown in the diagrams below. Confidence in all areas increased by the end of the course but there were more people scoring 3 out of 4 in all areas pre-course than we usually have, perhaps because of the overall higher level of training of these learners.
Free text feedback comments were all positive from the enjoyment of the course point of view and the perceived usefulness of the skills taught. Most of them had not been taught before using simulation techniques and this aspect of the course was much appreciated.
Interestingly, confidence in supporting a mother to breastfeed was quite high before the course but the questions on breastfeeding in the MCQ exam scored the lowest overall. This mismatch might be worth looking into – is breastfeeding generally thought of as a good thing but people are not so sure of how to help the mother with the practicalities of feeding?
A UNICEF report from 2024 states: breastfeeding is one of the most critical behaviours for child survival and growth. The NFHS-5 (2019-21) shows very low rates of early initiation of breastfeeding (EIBF) within an hour of birth for Uttar Pradesh at 24 per cent.
Key Breastfeeding Data (NFHS-5, 2019-21):
Factors Affecting Rates:
Healthcare Practices: Lack of training for staff in some facilities hinders immediate, “skin-to-skin” contact.
C-Section Deliveries: A major factor causing delays in early initiation.
Social and Cultural Beliefs: Rituals such as delaying feeding until after a bath or discarding colostrum remain prevalent.
