# NICHE International


## Posts

- [Varanasi Feedback](https://nicheinternational.org.uk/varanasi-feedback/): 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 […]
- [Publicity for the Varanasi courses](https://nicheinternational.org.uk/publicity-for-the-varanasi-courses/): It’s a complicated simulation with some challenging moments – as in real life. By the end of the afternoon, the medical officers we were teaching were so much better at running this simulated situation which is more familiar to them in Varanasi unfortunately than we see in the UK. Questions like “when do we stop resuscitating if the heart rate is still not audible and we’ve given 2 rounds of adrenaline?” and “what do we do when the baby is still fitting after glucose and 3 anticonvulsants?” led to long reflective discussions with – I hope – some sort of […]
- [Opening the second course in Varanasi](https://nicheinternational.org.uk/opening-the-second-course-in-varanasi/): Our learners on both courses have been medical officers, mainly medical graduates with some homeopathy graduates and those from an Ayurvedic background (Ayurvedic Medicine: In Depth | NCCIH). We have had over 30 learners on each course with a wonderful sense of engagement with particularly the simulation aspect of it.
- [170,000 newborn deaths in Uttar Pradesh per year](https://nicheinternational.org.uk/170000-newborn-deaths-in-uttar-pradesh-per-year/): The densely populated Uttar Pradesh (UP) state in India is the size of France and has a massive population of over 240 million. Still, it’s toll of around 170,000 newborn deaths each year (around 28 deaths per 1000 live births) is quite shocking. 40% of neonatal deaths occur during delivery or within the first 24 hours after birth. The Community Empowerment Lab believes that 70% of these could be prevented with simple interventions without the need for intensive clinical care and they have done a huge amount of work on trying to prevent neonatal deaths. The leading causes of newborn deaths […]
- [Varanasi course 1](https://nicheinternational.org.uk/varanasi-course-1/): A few photos from day 1 of our 2 courses in Varanasi where we are teaching in collaboration with the Community Empowerment Lab, a not-for-profit community entrenched global health research and innovation organisation based in Lucknow. 31 medical officers from across Varanasi have turned up for a 24 person course. Teaching groups of up to 8 is challenging but we’re loving the enthusiasm.
- [All systems go for Varanasi, India!](https://nicheinternational.org.uk/all-systems-go-for-varanasi-india/): In the excitement of packing, last minute changes to the teaching programme (and content) and a near miss with one of our visas, Ajinkya’s message this morning reminds us all of just why we volunteer with NICHE International:
- [The Indominatable Grace (Cameroon update)](https://nicheinternational.org.uk/the-indominatable-grace-cameroon-update/): This weekend in Mutengene, Cameroon, Grace was invited to help lay the foundation stone of the new Children’s Hospital. We are so incredibly proud of her and what she is doing for newborn babies in Cameroon.
- [Reflections of a Ugandan instructor](https://nicheinternational.org.uk/reflections-of-a-ugandan-instructor/): Julia asked Sadias to reflect on what learning – and now teaching – the Neonatal Care Course had done for him as a clinician and for the care of newborn babies in Uganda. ‎Looking back to 2022, when we had our first Neonatal Care Course (NCC) in Uganda, care for the newborns has since never been the same in my work area, considering the fact that Uganda still faces a challenge of high neonatal mortality rate with birth asphyxia being the leading cause (50%).‎‎Whereas the Neonatal Mortality Rate (NMR) in Uganda stands at 22/1000 live births, I should be proud […]
- [New venture - Varanasi, India](https://nicheinternational.org.uk/new-venture-varanasi-india/): Post written by Dr Ajinkya Kale, neonatologist working with the Community Empowerment Lab (CEL), our collaborating partners for a forthcoming project in Uttar Pradesh where neonatal mortality is still more than 30 per 1,000 live births. Oh yes—that’s me holding a 28-weeker, now 32 weeks corrected.A happy, healthy little girl—IVH-free*, antibiotic-free.It may look like a simple moment, but where I worked, this is nothing short of a quiet miracle. A true achievement for that setup. Visiting this village every month gives me a stark, humbling reality check—of where half the world truly stands when it comes to resources, funding, and […]
- [Kabale courses finished](https://nicheinternational.org.uk/kabale-courses-finished/): It was a chilly start to course 2 but after good interactive lectures and an ice breaker musical session, jumpers and coats were off and we had great all round participation in the workshops. The keeping babies warm and pain management sessions were really enjoyed with participants sharing work experiences and engaging well with their learning going forwards.A visit to the neonatal ward at the hospital with Dr Gilbert (District Medical Officer) concluded the training day. The team then had a nice supper at Baharama guest house whilst celebrating the return of Elizabeth’s phone from the repair shop – it […]
- [Day 1, Course 2 in Kabale](https://nicheinternational.org.uk/day-1-course-2-in-kabale/): The training team is back at work in south Uganda. This is the second of 2 courses that NICHE International volunteers are facilitating. Two Ugandan trainers are working alongside the 2 life support instructors from the UK which greatly enhances the credibility of the project and strengthens it for the future. Kabale is a new venue and so the team will be trying to identify suitable clinicians to be trained as instructors themselves on a future visit. This all requires funding so if you are reading this and wanting to help out in some way – please do click on […]
- [Feedback so far](https://nicheinternational.org.uk/feedback-so-far/): The District Medical Officer has welcomed the NICHE International team to Kabale to carry out this training. The WHO Uganda update from April 2025 (The health of mothers and babies is the foundation of healthy families and communities | WHO | Regional Office for Africa) states that Uganda’s maternal mortality ratio (MMR) stands at 189 per 100,000 live births, with a one (1) in 66 lifetime risk of maternal death. In Kabale, maternal mortality is slightly less but still stands at a shocking 163 per 100,000. The neonatal mortality rate (NMR) nationally has decreased from 27 to 22 per 1,000 […]
- [A visit to Bwama Island Health Centre on Lake Bunyonyi on a day off](https://nicheinternational.org.uk/a-visit-to-bwama-island-health-centre-on-lake-bunyonyi-on-a-day-off/): It was a non teaching day today and the team went with Sheila to lake Bunyonyi to see the local hospital and the women making crafts. The hospital on the island is a level 3 facility, with 25 births per month. They have a good pharmacy and lab with all the investigations needed. Low HIV, TB and malaria rates. They have a new incubator for the babies but not in use yet. They are aiming to develop a neonatal area. Some of the staff from there are excited to attend the training tomorrow. Elizabeth got off the boat onto the […]
- [Against all odds, all members of the team have now made it to Kabale, south Uganda](https://nicheinternational.org.uk/against-all-odds-all-members-of-the-team-have-now-made-it-to-kabale-south-uganda/): “We continue to have too many newborns die during or shortly after birth, with most deaths occurring within the first week of life. The current neonatal mortality rate in Kabale (33/1,000) exceeding the national average (22/1,000).” Kabale’s District Health Officer in August 2025  We were approached by the charity Edirisa UK (www.edirisa.org.uk) which makes free healthcare available at the Bwama Island Health Centre on Lake Bunyonyi. This includes maternity and newborn care, and we were asked to do the training to support staff from this and surrounding health centres. Edirisa UK has contributed funding for the project and Sheila Windridge, […]
- [Independent course run in Uganda in May 2025](https://nicheinternational.org.uk/independent-course-run-in-uganda-in-may-2025/): Elizabeth and team were busy teaching the Neonatal Care Course (NCC) to the rest of the final year nursing students in May. The highly thought of nursing school (Uganda Nursing School Bwindi – Home) is co-located with Bwindi Community Hospital and newly qualified nurses from here will go and work across Uganda, hopefully sharing their neonatal skills and their new found confidence in resuscitation for the good of babies throughout the country. “We are proud of our ambassadors going out to reduce Neonatal mortality” Elizabeth Ariho, nursing lead for paediatric services and course director for these two NCCs. Well done […]
- [Neonatal Care Course in a remote village in Cameroon](https://nicheinternational.org.uk/neonatal-care-course-in-a-remote-village-in-cameroon/): A few weeks ago, Grace asked for some funds (less than $1000) to help her roll out the Neonatal Care Course training in a remote area of Cameroon where one of her ex-colleagues was working in a government health centre. Mbam is a village in a remote valley of the North-West Region of Cameroon. It is difficult to reach by road and does not have an internet signal.  The population there has increased following civil unrest in the Region, as people have felt safer there, away from larger towns, and are also attracted by the fertile farming land of the […]
- [What, if anything, is Learning?](https://nicheinternational.org.uk/what-if-anything-is-learning/): [Ice and Water Photo by Lanju Fotografie on Unsplash. See article for metaphorical relevance…] Dr Jarlath O’Donohoe, instructor and educator and retired paediatrician, muses on whether learning is the same as performance and whether performance straight after a Neonatal Care Course can equal performance over time. This short essay forms part of his long term preoccupation with skills decay and how best to mitigate for that. These thoughts are based on the ideas in a favourite essay of mine, written by Stephen J Gould: “What, if anything , is a zebra?“ and it is worth mentioning that his thoughts were […]
- [Manikins arriving in Cameroon - all over Cameroon!](https://nicheinternational.org.uk/manikins-arriving-in-cameroon-all-over-cameroon/): The British Medical Association kindly funded more manikins and bag-valve-masks to go to Cameroon to help with on-going resuscitation training. Skills decay is a well known problem in health education; skills need to be practised frequently and a rolling programme of resuscitation sessions has been shown to keep people’s knowledge topped up for much longer than just doing a course every 4 years or so. The teaching equipment for the Neonatal Care Courses in Cameroon is kept centrally and Grace was very keen to have more manikins that could go to the health facilities of the trained instructors where they […]
- [The team is home and the feedback has been analysed](https://nicheinternational.org.uk/the-team-is-home-and-the-feedback-has-been-analysed/): 70% of the learners this time were students with no clinical experience yet. 89% were nurses and midwives or students of those professions. NICHE collects feedback on increased confidence levels in certain skills taught on the Neonatal Care Course. Research has shown that health professionals with confidence are more likely to “have a go” at things they have learnt about and, with this attitude and an appropriate level of supervision, will come increasing competence over time. The increase in confidence in all 5 areas is obvious from the charts. These are the most important factors in preventing deaths within the […]
- [Handing the course over](https://nicheinternational.org.uk/handing-the-course-over/): Today is the penultimate day of NICHE International’s Uganda visit and the penultimate day of the 3 Neonatal Care Courses. Everyone has worked incredibly hard and been made to feel very welcome. Here are a few photos of Bwindi’s instructors in action:
- [Trials and Tribulations of Ugandan wildlife](https://nicheinternational.org.uk/trials-and-tribulations-of-ugandan-wildlife/): The red-tailed monkey is a species of guenon native to central Africa. Other common names include the black-cheeked white-nosed monkey and the red-tailed guenon. Their home range extends throughout the Central African Republic and the Congo, with southern Sudan as the northern boundary and northern Zambia as the southern limit (https://neprimateconservancy.org/red-tailed-monkey/): There are quite a few bold members of the troupe that is based in the trees around the hospital. They steal food from the hospital canteen and anything bright and interesting they find lying around. One of the instructors’ bathroom was raided on an earlier visit of ours to […]
- [Working together as a faculty](https://nicheinternational.org.uk/working-together-as-a-faculty/): For the first course, the visiting international faculty members from Cameroon and UK are taking the lead instructor roles. They will start to hand these over for courses 2 and 3, as the local instructors become more familiar with the material, with time keeping and with the role of debriefer as teacher. It is however a little early to be handing over the role of course director, Jo…. This is one of the Ugandan instructors’ babies. She appeared on this blog a year ago as a good example of breastfeeding in the workplace. Now she has other aspirations and has […]
- [Course 1 well underway](https://nicheinternational.org.uk/course-1-well-underway/): Resuscitation training is easy to photograph, not quite so easy to either teach or learn. Jo keeps a beady eye on all the faculty when they’re teaching to ensure a high standard of instructor and of the training they are delivering. She was head of resuscitation services in Bristol for many years and old habits die hard! 50% of James’ role as a paediatrician in London is as a simulation trainer. He is a Newborn Life Support instructor in the UK and the lead for paediatric simulation training in his home hospital. He seems to be thoroughly enjoying sharing his […]
- [An international faculty in Uganda for 3 more courses](https://nicheinternational.org.uk/an-international-faculty-in-uganda-for-3-more-courses/): The team is teaching 72 hospital staff and nursing students over the next 10 days. They are teaching an overhauled course which we hope will lead to even more effective learning. Fingers crossed that the timings on day 2 work out OK!
- [Back in Bwindi!](https://nicheinternational.org.uk/back-in-bwindi-2/): A team of instructors from UK and Cameroon are currently in the air, flying from Entebbe to Bwindi to meet up with six Ugandan instructors (trained by NICHE last year) for three back-to-back NCCs for staff and students at the hospital and adjoining nursing school. Pictures eagerly awaited!
- [Halifax Hosts the trial run of the rewritten NCC](https://nicheinternational.org.uk/halifax-hosts-the-trial-run-of-the-rewritten-ncc/): The Neonatal Care Course was originally written by Maternal & Childhealth Advocacy International and https://www.alsg.org/ and has stood the test of time well. Before NICHE International was set up, some of us were volunteers with MCAI and taught the course in Gambia in 2014 as well as Cameroon in 2015. The Strengthening Emergency Care (SEC) committee of ALSG keeps an eye on the course content and provides the educational governance for the course and we have certainly added things to it over the years as a result of changes in World Health Organisation policy, relevant new clinical studies or feedback […]
- [Empowering feedback](https://nicheinternational.org.uk/empowering-feedback/): “Two deliveries today with some issues breathing and just with positioning, the babies picked up and are presently on S2SMC [Skin to Skin Mother Care] thanks for the knowledge from Neonatal care work shop“ This is a quote from one of the healthcare workers Grace and her team trained last week in Bamenda. They were a group from Life Abundance Primary Care Staff who are healthcare practitioners working in remote, hard to reach areas of Cameroon. The Neonatal Care Course normally has a limit of 24 per course but Grace was asked to teach 42 at once! Experienced people working […]
- [More training for health workers from a needy area of Douala, Cameroon](https://nicheinternational.org.uk/more-training-for-health-workers-from-a-needy-area-of-douala-cameroon/): NICHE International’s programme manager Grace is now the Maternal and ChildHealth Services supervisor for Cameroon Baptist Convention Health Services, ourpartner in Cameroon. In this capacity she has been visiting various health centres to look at their newborncare facilities and offer support if necessary. Bonaberi is a district of Douala with a rapidly growing population and severe poverty.Internally displaced people from the Cameroonian regions where there is civil unresthave moved to Bonaberi and added to this problem. In the health centre she visited in Bonaberi, she found a range of difficulties. Onreviewing neonatal deaths, she recognised the need for training particularly […]
- [An award from BMA Giving 2024 helps NICHE International with training in newborn care in Cameroon.](https://nicheinternational.org.uk/an-award-from-bma-giving-2024-helps-niche-international-with-training-in-newborn-care-in-cameroon/): NICHE International wants to ensure that the learning which candidates acquire when they attend a Neonatal Care Course, is put into practice in their workplaces.   One way of doing this is to encourage peer to peer learning, which can be led by the health workers that have qualified as Neonatal Care Course Instructors and carried out in the health clinics and hospitals where they work. There is evidence that short informal teaching sessions can embed good practice and reduce skills decay. An award from BMA Giving is enabling us to buy new neonatal manikins to distribute to hospitals and clinics […]
- [A round-up of Comments on the Neonatal Care Course project](https://nicheinternational.org.uk/a-round-up-of-comments-on-the-neonatal-care-course-project/)
- [Information Webinar: what do we do, How, When and Why?](https://nicheinternational.org.uk/information-webinar-what-do-we-do-how-when-and-why/): On 31st July we ran our first Information Webinar for potential volunteers. We were delighted to see many keen people and some Cameroonian colleagues in attendance. The best questions in the webinar were ‘How do we maintain the standards of the Instructors?” and ‘how do we know that what is taught on the course is incorporated into practice?”.  Both of these issues remain a challenge, and are linked to the Holy Grail of skills retention. Dr Jarlath O’Donohoe muses on this further: NICHE has a well developed structure of training, based on educational approaches that are used in resource rich […]
- [Health workers trained by NICHE International support colleagues in Cameroon.](https://nicheinternational.org.uk/health-workers-trained-by-niche-international-support-colleagues-in-cameroon/): Health centres run by the Cameroon Baptist Health Convention, our partners in Cameroon, share their maternal and neonatal mortality data with their Health Districts. They aim to learn from incidents. Grace and her colleagues were invited to Nkoabang Baptist Health Centre, Nkoabang Village on the Eastern edge of Yaoundé this week to deliver 2 days of training to the staff as one of the outcomes of a neonatal death review. The topics covered are resuscitation at birth, new born infections, convulsions, and fluid and electrolyte balance. Three experienced nurses who have trained as trainers with NICHE are leading the training. […]
- [and straight into a Neonatal Care Course (NCC)](https://nicheinternational.org.uk/and-straight-into-a-neonatal-care-course-ncc/): While the international instructors were on their way home after a successful but frankly exhausting week of instructor development and training, Grace was busy preparing to teach 24 healthcare professionals on their next NCC. This course will take the number of nurses, doctors and midwives trained in newborn care in Cameroon to nearly 400. 2 extra people turned up from the local government facility, having heard on the grapevine that the course was going on. All the instructors also teach resuscitation skills to staff in their own healthcare facilities. As Grace says “before, when there was a sick baby born, […]
- [What makes a good instructor?](https://nicheinternational.org.uk/what-makes-a-good-instructor/): Ferenc, the course educator, asked the GIC candidates in Cameroon this week, what they thought made a good instructor:
- [Another 12 instructors trained](https://nicheinternational.org.uk/another-12-instructors-trained/): Alison gave out the certificates of achievement at the end of the 2-day generic instructor course. 2024 marks her 20th year as a volunteer in Cameroon, initially with MCAI charity and for the last 7 years with NICHE International. This is probably the last time she will come in person to Cameroon and we thanked her for her long service to the country – from overseeing the building of a playroom in Bamenda which enticed the children with HIV into their clinic, to the establishment of a breast milk bank in the same hospital, to the training of healthcare professionals […]
- [Instructor Development Programme Graduates](https://nicheinternational.org.uk/instructor-development-programme-graduates/): 16 healthcare professionals have just completed 2 days of Continuing Professional Development facilitated by 5 UK faculty who are in Cameroon to support the local Neonatal Care Course faculty and train 12 more instructors on the GIC at the end of the week. One of the 16, Ethel (second from the left, back row), is a nurse educator and is shadowing Ferenc, one of the European Resuscitation Council’s senior educators (sixth from the left, back row), and learning how to be a GIC educator. It was an intense 2 days, mainly of educational updates but we had also been asked […]
- [Instructor Development Programme (IDP)](https://nicheinternational.org.uk/instructor-development-programme-idp/): Today was the first day of a 2.5 day programme designed to support the on-going professional development of the Cameroonian Instructors who are trainers on the Neonatal Care Course. These Instructors value time to refresh their skills as trainers, and also to discuss clinical issues in neonatal care.  Some have travelled long distances from the North and North West Regions of Cameroon to attend the course. This year NICHE International Instructors are doing the training in Mboppi Baptist Hospital in the urban centre of Douala.  It has been a challenging day, with temperatures of 36 degrees, and variable electricity supply […]
- [Cameroon 2024](https://nicheinternational.org.uk/cameroon-2024/): 5 of the European faculty are in Cameroon this week for the second Instructor Development Programme which NICHE International has run here. We arrived 2 days ago – a fairly easy flight from London via Paris for 4 of us based in the UK (see our route map above), a slightly longer trip for our European Resuscitation Council educator who has travelled from deep snow covered north Sweden where the temperature today is -15, to 36 degrees and 80% humidity of Cameroon, via Stockholm and Addis Ababa. Our journey is of course matched by those of our learners who have […]
- [Fundraising for NICHE](https://nicheinternational.org.uk/fundraising-for-niche/): On Sunday 15 October, Conal McDonagh completed the Amsterdam marathon – his first – to raise funds for NICHE’s work. Conal is the son of Alison Grove, NICHE Trustee. Unable to take part in the run, his partner Gill Monaghan decided to do a ‘plank a day’ for a month to help raise funds. A professional dancer, Gill squeezed in her daily plank while touring in Europe. Thanks to both for their tremendous efforts and for raising funds to support NICHE’s projects. Link to their fundraising page is: https://www.justgiving.com/page/conal-mcdonagh-1695145301040
- [First independent course in Bwindi, Uganda](https://nicheinternational.org.uk/first-independent-course-in-bwindi-uganda/): We were delighted this week to briefly and remotely join Sadias and his faculty for their first 2.5 day Neonatal Care Course since their own instructor training in February. 6 of the trained faculty were teaching 16 trainee nurses from the nursing school which adjoins Bwindi Community Hospital. Julia joined Sadias (remotely) at the first break on day 1 and was impressed with the set up for the course – lovely light rooms with plenty of space and all stations prepared, ready to go. NICHE International had sponsored the refreshment breaks as we believe so strongly that people learn better […]
- [NICHE at the Advanced Life Support Group (ALSG) conference in Manchester, UK](https://nicheinternational.org.uk/niche-at-the-advanced-life-support-group-alsg-conference-in-manchester-uk/): Our newest trustee, Dr Cath Harrison, and Dr Julia Thomson were speaking at the ALSG conference yesterday. Maslow is often quoted in adult learning circles – he developed his hierarchy of needs over 30 years from 1940 to 1970, believing strongly that humans want to grow and develop themselves and others and that – once our deficiency needs are met – we will automatically move up the pyramid. We spoke about the importance of feeding everyone properly on a course (Physiological needs) and ensuring everyone feels part of the team (Belonging and Love Needs) and valued (Esteem Needs). Only then […]
- [Funds raised for NICHE from the North Downs Challenge](https://nicheinternational.org.uk/funds-raised-for-niche-from-the-north-downs-challenge/): On the 22nd July two people took part in the North Downs Challenge to raise funds for our projects. Charlie Crossley battled through wind and rain to complete 50k, accompanied by his friend Josh.  Charlie is the father of premature twins who are now 2 years old. He and his wife were grateful for the care they received from the NHS, and Charlie wanted to support the work of NICHE International which helps to improve the care of new born babies in poorly resourced areas of the world. We are very grateful to Charlie and Julia for rising to ‘the […]
- [Mboppi hospital, Douala](https://nicheinternational.org.uk/mboppi-hospital-douala/): Grace and team have been busy this week with 2 Neonatal Care Courses in Cameroon. 24 keen midwives and nurses attended.
- [Rainy season challenges](https://nicheinternational.org.uk/rainy-season-challenges/): Undeterred, Judith found a microphone, the learners donned diocesan gowns from the vestry, moved their chairs to leeward and the lecture on the “Small Baby” continued.
- [Do as I Say and Do](https://nicheinternational.org.uk/do-as-i-say-and-do/): Two instructors and two learners on this second Neonatal Care Course have breastfeeding babies with them. Look at the size of them! Great to have real life role models; we should encourage this on UK courses. 23 countries, including Uganda, have achieved exclusive breastfeeding rates above 60 per cent. The other countries are Bolivia, Burundi, Cabo Verde, Cambodia, Democratic People’s Republic of Korea, Eritrea, Kenya, Kiribati, Lesotho, Malawi, Micronesia, Federated States of Nauru, Nepal, Peru, Rwanda, São Tome and Principe, Solomon Islands, Sri Lanka, Swaziland, Timor-Leste,  Vanuatu, and Zambia. Is your country represented here? Can you do anything to get […]
- [Transitioning to Ugandan instructors](https://nicheinternational.org.uk/transitioning-to-ugandan-instructors/): Skills are taught as a 4-stage procedure – silent run through, demonstration with explanation, learners talking instructor through the skill and then all have a go. This imprints the skill on the learners’ minds. Which is why it is very important for the instructor to get it right and be consistent! There is no piped oxygen in Bwindi Community Hospital. The grey machine on the floor here is an oxygen concentrator. If the ensuing oxygen/air mix is then piped through a bottle of mineral water, the pressure at which it reaches the baby’s nostrils can be increased. Preterm babies’ lungs […]
- [Looking after the mothers](https://nicheinternational.org.uk/looking-after-the-mothers/): Regular readers of this blog will know that we often talk about Skin to Skin Mothercare (S2SMC) or Kangaroo Mother Care (KMC) as the most appropriate way of keeping babies warm, promoting bonding, preventing infection, augmenting growth and supporting breastfeeding. Mothers can also be taught to keep an eye on their baby’s breathing and general health and alert the nurses if any apnoeas (pauses in breathing) or other concerns. But mothers too need looking after. Mothers need washing facilities for themselves and for their clothes and baby’s wraps. They need to be able to prepare food for themselves and to […]
- [And then they could fly....](https://nicheinternational.org.uk/and-then-they-could-fly/): We’ve just finished Day 1 of the first Neonatal Care Course being taught by Ugandan instructors. All 12 instructors passed the Generic Instructor Course yesterday and rose to the challenge of teaching the NCC today. We are running this course in the chapel. Grace is course directing and made sure everyone knew the ground rules. It wasn’t long before the newly trained instructors took over from us:
- [The paediatric ward](https://nicheinternational.org.uk/the-paediatric-ward/): Dr Cath Harrison:  A visit to the paediatric ward today – an amazing set up with the ward being divided up into separate areas to allow patients needing frequent observations and management to be near the nursing station. There is a kitchen at the end of the ward where families are taught by nursing staff the importance of nutrition and how to make nutritionally balanced meals. There is an indoor play area and outdoor space as well for children. We saw a variety of conditions – orbital cellulitis secondary to trauma (fall from a tree), pneumonia and malaria. The pride […]
- [Uganda Nursing School, Bwindi](https://nicheinternational.org.uk/uganda-nursing-school-bwindi/): UK consultant neonatologist, Dr Cath Harrison, is part of the team in Bwindi this year and has written a couple of blog posts for the NICHE website: During preparations for the GIC course, we were fortunate to have a visit to the Bwindi Community Hospital School of Nursing. This was set up in 2013 initially with 100 students. Now 10 years later there are 400 students. The course is 2-3 years long with students graduating with a Diploma in Nursing. The school is about 3 minutes’ walk from the hospital entrance and is a self-contained facility with communal spaces, lecture […]
- [Back in Bwindi](https://nicheinternational.org.uk/back-in-bwindi/): We’re back in Bwindi Community Hospital for the first Generic Instructor Course (GIC) to be run here, followed by 2 x Neonatal Care Courses (NCC) where we will be supervising the newly trained instructors as they facilitate their first 2 courses. U.S missionaries Dr. Scott and his wife Carol Kellerman started the hospital in 2003 when it was a simple outreach clinic under a tree for the Batwa people, who had been evicted from Bwindi Impenetrable forest when it was turned into a mountain gorilla sanctuary. That small clinic is now a fully-fledged hospital with 155 beds, which also houses […]
- [Our 5 Year Anniversary!](https://nicheinternational.org.uk/our-5-year-anniversary/): Five years of NICHE International Report from the lead trustee, Dr Alison Earley Our charity was established because too many babies in low-income countries die in their first month of life.  We wanted to reduce this by delivering training in neonatal care, and to make changes that would be owned and sustained by the healthcare workers we trained. So, after 5 years, how are we doing? Where have we worked?   We have run Neonatal Care Courses in Cameroon, Liberia and Uganda.  Following each course, selected candidates undertake a ‘train the trainers’ Generic Instructor Course (GIC), so that they can train […]
- [Remote support of the GIC candidates in Bwindi](https://nicheinternational.org.uk/remote-support-of-the-gic-candidates-in-bwindi/): 12 candidates for instructor training were selected at the first Neonatal Care Courses that were run in Bwindi in February 2022. They were supposed to be trained in November 2022 but the Ebola outbreak (in a different part of the country) put pay to NICHE International’s travel plans and we had to disappoint the group by postponing the training. We have been doing some preliminary pre-course training with the candidates via a Zoom link. The Pocket Guide to Teaching for Clinical Instructors is the manual for the internationally taught and recognised Generic Instructor Course. Our educator, Jo Lawrence, arranged for […]
- [All systems go for Uganda again!](https://nicheinternational.org.uk/all-systems-go-for-uganda-again/): The Ebola outbreak in Uganda has been declared “over” and the team is busy preparing for the postponed return trip to Bwindi Community Hospital to teach one Generic Instructor Course and two Neonatal Care Courses. We will be training 12 new instructors and then supervising them while they facilitate the NCCs for 48 learners.
- [Sad news](https://nicheinternational.org.uk/sad-news/): We were deeply saddened this week to learn of the sudden death of a young paediatric colleague in Yaoundé, Cameroon. Hildegarde was won of the first Neonatal Course instructors to be trained by NICHE and was one of the team who recently travelled to the far north of the country to teach the first 2 Neonatal Care Courses to health professionals there. She was an enthusiastic trainer and passionate about improving the care of newborn babies in her country. Our deepest condolences to her family and friends as they prepare to attend her funeral tomorrow. She will be sorely missed.
- [NICHE team in Bristol, UK](https://nicheinternational.org.uk/niche-team-in-bristol-uk/): A NICHE team was supposed to be in Uganda at the moment, running the first Generic Instructor Course. The trip has been postponed because of an Ebola outbreak. Jo B-J, head of resuscitation services at Bristol and never one to miss a trick, persuaded 4 of us to go to Bristol instead to teach on the GIC her department was running. It was a great course, well run as always with lots of learning at every level. It was good to meet the new members of the instructor team face to face. Jo is an experienced educator with the Resuscitation […]
- [First Neonatal Care Course in the Far North Region of Cameroon](https://nicheinternational.org.uk/first-neonatal-care-course-in-the-far-north-region-of-cameroon/): Dr Alison Earley The Far North Region of Cameroon is at the Northern tip of the country, between Nigeria and Chad. Its capital is Maroua, which lies to the East of the Mandara mountains. This is where Cameroonian Instructors are currently teaching the Neonatal Care course. Two of the instructors did their instructor training in Yaoundé in April this year, when NICHE International volunteers visited to facilitate the course. Other instructors are more experienced and have taught on several Neonatal Care Courses before. The perinatal mortality is particularly high in this remote region, and the course is much needed. The […]
- [Empowering local healthcare staff](https://nicheinternational.org.uk/empowering-local-healthcare-staff/): The Neonatal Care Course is a short, stand alone course on the care of the newborn baby in the first 28 days of life but the ripple effects of the training are far-reaching. NICHE believes that training local instructors leads to this sort of – hopefully long lasting – empowerment. Many oxygen concentrators are abandoned or broken because they are poorly maintained or not fully understood. Here, Vivian is teaching staff at Nkoabang Baptist Health Centre how to look after this vital piece of equipment. The transcript below is Vivian’s WhatsApp message to Grace in Cameroon, delighted that a baby’s […]
- [International Kangaroo Mother Care (KMC) Awareness Day](https://nicheinternational.org.uk/international-kangaroo-mother-care-kmc-awareness-day/): Dr Alison Earley, 15th May 2022 Skin to skin care, also known as kangaroo mother care, is one of the key interventions suggested by the World Health Organisation to improve survival of babies.  It has so many advantages for new born babies, including preventing hypothermia, promoting breastfeeding, reducing infection and encouraging mother/baby bonding. The feature picture here is from Healthy Newborn Network (https://www.healthynewbornnetwork.org/) to remind us that KMC is an especially important intervention for babies who are born premature. Although the advantages of skin to skin care have been recognised for many years, and in many countries, it is still […]
- [Today is International Nurses' Day!](https://nicheinternational.org.uk/today-is-international-nurses-day/): Dr Alison Earley International Nurses Day is celebrated around the world every May 12, the anniversary of Florence Nightingale’s birth. The theme for 2022 is ‘Nurses: A Voice to Lead – Invest in Nursing and respect rights to secure global health‘ Working in neonatal care in Cameroon, Liberia and Uganda it is very obvious just how crucial good nurses are to the survival of all babies, but especially those who are premature or unwell.  We have also found ‘voices to lead’ among the nurses with whom we have worked, and seen their dedication and abilities. Felicia is a nurse working in […]
- [The European instructors have gone home](https://nicheinternational.org.uk/the-european-instructors-have-gone-home-the-cameroonian-faculty-are-into-the-last-stretch-of-this-intensive-training-period-with-the-second-ncc-being-delivered-now/): THE CAMEROONIAN FACULTY ARE INTO THE LAST STRETCH OF THIS INTENSIVE TRAINING PERIOD WITH THE SECOND NCC BEING DELIVERED NOW by Grace Ngoran The second NCC kicked off today with 28 participants in attendance (the 4 extra being the staff who could not make it down to Yaoundé from Bamenda earlier in the week due to concerns around their safety). The excitement was evident as the instructor candidates came up again powerfully with excellent performance. The workshops were really excited particularly the breastfeeding workshop where everyone used the breast models to demonstrate proper latching technique. Participants were observed to be […]
- [Brighten the corner where you are...](https://nicheinternational.org.uk/brighten-the-corner-where-you-are/): ….is a Cameroonian expression meaning do your best to improve things wherever you find yourself.  During the last 2 days our newly trained Instructor Candidates have stepped up and exceeded expectations in the way they have trained 16 learners on a Neonatal Care Course.  Some of these new trainers come from rural districts in the Northern Abamawa Region, where they work in small isolated units.  They are determined to improve the standard of newborn care in the places they work.  They will indeed be brightening their corner!
- [Supervised instructors in full swing at Cameroon Neonatal Care Courses](https://nicheinternational.org.uk/supervised-instructors-in-full-swing-at-cameroon-neonatal-care-courses/): It is always a great moment as an instructor trainer to watch someone you have just trained stand up and deliver a lecture, facilitate a workshop or teach a skill in the way that the Resus Council’s Generic Instructor Course (GIC) suggests. In the UK, we don’t often have the privilege of seeing this beautiful transition from student to teacher as people disperse after a GIC and teach on their provider courses at a different time. Because of the financial and environmental cost of NICHE volunteers travelling long distances to the countries where we are active, we now attach 2 […]
- ["I am sending them out to blow their trumpets"](https://nicheinternational.org.uk/i-am-sending-them-out-to-blow-their-trumpets/): This is what our programme manager for newborn training in Cameroon said today, as we were coming to the end of their successful “train the trainers” course. Dr Ferenc Sari, European Resuscitation Council educator, and our educator on this week’s GIC course in Cameroon, has been impressed by the progress of the participants over the 2 days. We are privileged to be able to witness and support their first teaching experience which will occur when they teach on Neonatal Care Courses later in the week.
- [The Learning Conversation in Cameroon](https://nicheinternational.org.uk/the-learning-conversation-in-cameroon/): The learning conversation is a term used in adult education, and is a skill required for giving feedback to learners on their performance. A well-managed learning conversation should leave learners feeling “relieved, valued and clear about their next steps”. It is not an easy skill to master, and requires practice. In Cameroon this week, NICHE instructors have spent a day refreshing the skills of newly qualified local Neonatal Care Course instructors. The learning conversation was one of the skills we spent time on together. During these sessions we sat in a circle with the candidates, sometimes know as “circle of […]
- [Instructor Development Day, yaounde](https://nicheinternational.org.uk/instructor-development-day-yaounde/): Dr Alison Earley This is the group of 11 Instructors who attended the first Instructor Development Day that NICHE has run. They came from 5 different Regions in Cameroon, and did their instructor training in 2016 and 2018. They are a mixture of doctors, nurses and midwives. All were keen to refresh and develop their skills as trainers and the course was lively and enjoyed by everyone.
- [En route to Cameroon after being grounded for 2 years!](https://nicheinternational.org.uk/en-route-to-cameroon-after-being-grounded-for-2-years/): We are delighted to be welcoming Dr Ferenc Sari to the team for this week’s trip to Cameroon. An emergency department doctor and an educator with the European Resuscitation Council, he has lots of experience of living, working and teaching overseas. We were on tenterhooks for his Covid PCR result as he has only recently recovered from the illness but all 4 instructors had negative results yesterday and are now en route to Yaoundé from Sweden, Northern Ireland and the UK. The team has a heavy week ahead of them. They are facilitating the first ever Instructors Development Day (IDD) […]
- [Back to cameroon later this month](https://nicheinternational.org.uk/back-to-cameroon-later-this-month/): NICHE Instructors are excited to be returning to Cameroon later this month. We are piloting a specially written Instructors’ Development Day for the faculty members there to support their Continuing Professional Development. This will be followed by a Generic Instructor Course with two of the Cameroonian faculty beginning to train as instructor trainers themselves (see step 9 of the “10-steps to sustainability” plan) and two more Neonatal Care Courses (NCCs). Over 300 healthcare professionals in Cameroon have been trained in the care of the newborn infant in the first 28 days of life and the team is beginning to see […]
- [Bwindi feedback](https://nicheinternational.org.uk/bwindi-feedback/): There were 29 feedback forms from the first two NCCs in Uganda. All candidates were frontline healthcare workers and 25 (86%) of them had had previous experience of neonatal resuscitation. Proving that neonatal mortality is falling as a result of our project is our long-term aim but measuring this outcome is a challenge.  There are so many confounding factors in any clean data that is actually collected that it is almost impossible to prove that one intervention like this has any statistically significant effect on neonatal mortality.  It is more productive to measure shorter term outcomes which are known to […]
- [Suffering for the Cause!](https://nicheinternational.org.uk/suffering-for-the-cause/): We are back in Entebbe now after 2 very successful Neonatal Care Courses, full of enthusiasm about returning in November to train the instructors we have identified.
- [Kangaroo Mother Care saves lives](https://nicheinternational.org.uk/kangaroo-mother-care-saves-lives/): Keeping babies warm is one of the things that reduce neonatal mortality. We promote it strongly throughout the course. It also promotes breastfeeding, reduces the risk of hospital-acquired infection, is important for bonding and leads to faster growth. When we went to the neonatal unit initially, there were 5 babies (including a set of twins) between 33 and 35 weeks in incubators or being held by their mothers in piles of blankets. The doctor asked for help because none of them were putting on weight. Grace went to work… All 5 had been discharged by the end of our week […]
- [Keeping the show on the road](https://nicheinternational.org.uk/keeping-the-show-on-the-road/): Having 2 of the 4-member team nipping off to the neonatal unit in the middle of the day is not easy on the 2 left behind holding the baby – literally. Jarlath and Kirstie have been doing sterling work covering for our disappearing acts. At one point, we came back to the lecture theatre to find that Jarlath’s lecture on convulsions had attracted a 16th learner.
- [helping out clinically in the lunch breaks](https://nicheinternational.org.uk/helping-out-clinically-in-the-lunch-breaks/): A premature baby (probably about 28 weeks gestation) was born on our first day in Bwindi. He weighed 1kg (2.2lbs). The paediatrician had just left the hospital and we were asked to help the young doctor pictured above who was covering the paediatric unit. Grace and Julia have visited daily for the last 5 days and supported the nurses in their excellent care of the tiny little boy who is now off CPAP and in skin to skin care with his mother for much of the day. It is normal for these babies to lose up to 10% of their […]
- [2 NCCs completed!](https://nicheinternational.org.uk/2-nccs-completed/): We have been made most welcome here in Uganda for the first 2 Neonatal Care Courses and have been very impressed with the standard of care at Bwindi Community Hospital and the thirst for knowledge amongst the health professionals here. We have identified 12 potential instructors and aim to return in November to run a Generic Instructor Course and 2 more Neonatal Care Courses. Fund raising over the next few months will be aimed at this next step of the 10 steps to sustainability plan.
- [Congenital malaria](https://nicheinternational.org.uk/congenital-malaria/): My favourite lecture is the one on jaundice – a pet topic of mine. I was challenged today on my statement that congenital malaria can cause jaundice. Actually the challenge was whether the malaria parasites can cross the placenta. Grace – with a lot more experience of congenital malaria than me – came to my rescue. In Cameroon, she is now doing peripheral blood smears for babies born to mothers known to have malaria during delivery and is finding more cases than expected in the neonates being treated for sepsis. This evening, I looked it up. Here are a few […]
- [Eyebrow linguistics](https://nicheinternational.org.uk/eyebrow-linguistics/): Dr Jarlath O’Donohoe There’s more to language than the words that we say. Our learners are still wearing masks most of the time and gauging the mood of the lecture theatre is occasionally challenging. I was wondering why people were looking at me like I was crazy – it was the eyebrows. When Ugandans raise their eyebrows (at least in this part of Uganda) they mean “yes, definitely” (or “you can take it to the bank” as one of the Americans staying in the guest house with us put it). I saw it as an expression of doubt or enquiry […]
- [Day 2 NCC in Uganda](https://nicheinternational.org.uk/day-2-ncc-in-uganda/): All 15 candidates passed the first course and we have identified 7 potential instructors who we will train later in the year (all being well with the fundraising). The standard was high overall and we were very impressed in particular with the learners’ level of engagement with the scenario / simulation training this afternoon. There is a sim lab in the nursing school here and it showed in the way everyone got involved. Well done everyone! We are going through the feedback forms at the moment but here is a flavour. We collect information on confidence levels before and after […]
- [Day 1 of the first NCC in Uganda](https://nicheinternational.org.uk/day-1-of-the-first-ncc-in-uganda/): Timings have been a bit of a challenge today: Devotions over ran, half our learners had to do a ward round before the teaching could start and Julia and Grace were called for clinical duties in the neonatal unit at lunch time as the paediatrician is away and a new 1kg baby was admitted. Jarlath and Kirstie did sterling work keeping the show on the road and we came in at 5.45pm with only one lecture left out and everyone still smiling.
- [How big is the problem?](https://nicheinternational.org.uk/how-big-is-the-problem/): NICHE International was set up to train local health professionals to teach the Neonatal Care Course (NCC). We follow the model used by life support organisations all over the world – clinicians do the course themselves, some are recommended as instructors, they train as instructors, form their own faculty with a bit of support initially from senior instructors, start training their peers and eventually begin to train their own instructors. The NCC sits under the umbrella of the Advanced Life Support Group (ALSG) in the UK. The overall aim of the Neonatal Care Course is to reduce neonatal mortality rates […]
- [Bwindi community hospital](https://nicheinternational.org.uk/bwindi-community-hospital/): Bwindi Community Hospital cares for more than 120,000 people living in the South Western corner of Uganda. It was set up by American missionaries in 2003, starting as a clinic under a tree and expanding over the years to a thriving, award winning community hospital with 135 beds, a Nursing School with 400 students and Uganda College of Health Sciences Bwindi. Quite a bit of research goes on here, human and the other primates who inhabit the forest.   Tomorrow we start the course. We have 16 students for the Neonatal Care Course and are excited to get going. We’ve […]
- [I think i've been here before...](https://nicheinternational.org.uk/i-think-ive-been-here-before/): This was the 12 seater plane that brought us to Kihihi yesterday, the nearest airstrip to Bwindi Community Hospital.  We were the only ones on it with our 2 pilots, and we are very grateful that we were allowed to bring the extra teaching equipment with us.  The photos are reminiscent of Liberia in 2019. Storm Eunice over the UK threatened our departure plans and Grace had fun and games with her visa from Cameroon but we all arrived safely and in good spirits. It is just great to be out doing this again after 2 years grounded in our […]
- [Uganda - step 1](https://nicheinternational.org.uk/uganda-step-1/): We are delighted and very excited that we are at last going abroad again – tomorrow! I (and the family cat) have been packing up 4 teaching sets and trying to keep the weight down as our internal flights from Entebbe to Kihihi allow rather less baggage than we normally take with us. We are going to Bwindi Community Hospital to teach the first two Neonatal Care Courses and to recruit some keen would-be instructors. We have a multinational team instructing this time around – Jarlath joining us from Ireland, Kirstie and Julia from the UK and Grace from Cameroon. […]
- [World prematurity day](https://nicheinternational.org.uk/world-prematurity-day/): Dr Alison Earley The statistics on premature birth remain of great concern:  12% of babies are born too soon in the poorest countries, compared with 9% in higher income countries.  One million babies die each year from complications of premature birth, and prematurity remains a leading cause of mortality globally. Education for health care workers, enabling them to provide better care for pregnant women and new born babies, is vital if this situation is to improve. Kola sent these pictures from Liberia this morning – a celebration of their babies born too early! Most of the nurses in these pictures […]
- [bag-valve-mask questionnaire](https://nicheinternational.org.uk/bag-valve-mask-questionnaire/): Gathering the evidence for the work we do, both for funders and to inform our direction of travel as an organisation, is not at all easy! Alison has been working with Grace in Cameroon to collect information from health clinics about their use of bag-valve-masks which NICHE International provided them with a few months ago. 3 out of the 5 units who had the questionnaire responded which doesn’t give us statistically robust information but does give us a fascinating insight into the obstetric services at these centres, the numbers of deliveries, trained staff and how many babies were born in […]
- [Teaching again after the pandemic](https://nicheinternational.org.uk/teaching-again-after-the-pandemic/): It is great to be back teaching face-to-face again, albeit still only in the UK. UK NICHE instructors have to teach on a certain number of life support courses per year to maintain their instructor status. Julia was teaching the UK Resuscitation council Newborn Life Support (NLS) course this week in her home hospital in London. There are some differences when stabilising a preterm delivery at birth. The 2021 guidelines suggest that babies born under 32 weeks gestation should be put into a plastic bag at birth and placed under a radiant heater to stop them getting cold and dehydrated. […]
- [Neonatal resuscitation training in Liberia - also june 2021!](https://nicheinternational.org.uk/neonatal-resuscitation-training-in-liberia-also-june-2021/): Not to be outdone, Kola has been busy in Liberia with neonatal resuscitation training at the same time as the Cameroonian course was running. WhatsApp was alive with photos coming in for a couple of days – heartening stuff to our NICHE team still unable to leave the UK to train more instructors.
- [It's official! skin to skin care saves lives](https://nicheinternational.org.uk/its-official-skin-to-skin-care-saves-lives/): https://www.nejm.org/doi/full/10.1056/NEJMoa2026486 takes you to the full text of this 2021 publication from WHO comparing survival data of low birth weight infants nursed skin to skin from birth with a cohort who only received a couple of hours a day of skin to skin care. The trial had to be cut short because the babies in the control group (couple of hours a day) had a significantly higher risk of dying than the babies in the intervention group (around 17 hours a day skin to skin). Grace gathered 9 of the trained instructors in Cameroon this month for a Neonatal Care […]
- [Today is International women's day](https://nicheinternational.org.uk/today-is-international-womens-day/): Dr Alison Earley It’s a day for dressing up in much of the world, a day to celebrate the work women do to make the world go round, a day of empowerment. The picture here is of Cameroonian women on International Women’s Day in 2018, learning how to resuscitate babies dressed in their International Women’s Day material that they make into powerfully beautiful dresses every year. We should make more of it in the UK really. There are many achievements to celebrate on International Women’s Day, but we mustn’t forget that in resource poor areas of the world, maternal mortality […]
- [Miller's hierarchy of learning](https://nicheinternational.org.uk/millers-hierarchy-of-learning/): Dr Jarlath O’Donohoe To truly know whether our learners are achieving what we want them to achieve we should assess them in the setting that we expect these skills to be delivered. Miller’s pyramid depicts four levels of learning which a student of a subject must pass through to truly perform: “knows”, “knows how”, “shows how” and “does”. In the Neonatal Care Course, our novice learners gather facts and take an MCQ paper to “show that they know”. Workshops, discussion groups, skills sessions and simulations get them to the orange and green levels. The local champion and trained instructors then […]
- [Maintenance, booster and refresher training](https://nicheinternational.org.uk/maintenance-booster-and-refresher-training/): Dr Jarlath O’Donohoe, always in pursuit of the Holy Grail – a solution to the “skills decay” problem…. Resource: Sullivan, Anne & Elshenawy, Summer & Ades, Anne & Sawyer, Taylor. (2019). Acquiring and Maintaining Technical Skills Using Simulation: Initial, Maintenance, Booster, and Refresher Training. Cureus. 11. 10.7759/cureus.5729. Learning Curve: shows a relationship between the amount of practice / experience of a skill and the degree of competence achieved. Forgetting Curve: the relation between the decay of a learned skill and the time elapsed since the skill was learned. Experience Curves: combines the learning and forgetting curves. Activities to overcome skill […]
- [International day of education](https://nicheinternational.org.uk/international-day-of-education/): Dr Alison Earley On January 24th 2021, the UN General Assembly proclaimed the ‘International day of Education’ to celebrate the role of education for peace and development. “At the peak of the pandemic, schools were actually closed for 91% of learners, or 1.5 billion pupils and students. It then became apparent to everyone that education was a global public good and school was more than just a place of learning: it was also a place that provided protection, well-being, food and freedom. (…) On this International Day of Education, UNESCO invites you to promote education as a fundamental right and […]
- [Best breastfeeding videos!](https://nicheinternational.org.uk/best-breastfeeding-videos/): I have linked to the Global Media videos before. Such an amazing repository of videos for parents and healthcare workers across the world. We owe the families who agreed to take part in this project a debt of gratitude. This one has some excellent information on proper attachment of the baby to the breast: https://globalhealthmedia.org/portfolio-items/breastfeeding-attachment/?portfolioCats=191%2C94%2C13%2C23%2C65
- [today is world prematurity day!](https://nicheinternational.org.uk/today-is-world-prematurity-day/): What is world prematurity day? – a global movement to raise awareness of prematurity. Across the world an estimated 15 million babies are born too early every year, and 1 million of them die.  Some survivors live with disabilities. As usual, low and middle income countries are the worst affected, with higher rates of prematurity and lower rates of survival. The strategies that NICHE International teaches in the Neonatal Care Course, for example early breast feeding and skin to skin mothercare, have been shown to save as many as three quarters of premature babies. We must continue to try to […]
- [Zooming to Cameroon](https://nicheinternational.org.uk/zooming-to-cameroon/): Local Cameroonian instructors, who are now organising their own Newborn Care Courses, ran an NCC last week in Yaoundé, Cameroon.  Some NICHE Instructors joined them for parts of the course via zoom from UK, to try out the technology and assess the feasibility of remote training. We were able, remotely, to: 1. Demonstrate how to run a simulation (this was management of a baby having fits).  NICHE Instructors from their homes in London and N. Ireland did this on zoom at the request of Cameroonian Instructors who watched. 2. Deliver one of the lectures on the NCC course via zoom […]
- [Universal health coverage (UHC)](https://nicheinternational.org.uk/universal-health-coverage-uhc/): “Universal Health Coverage (UHC) means that all people can access quality essential health services, without having to suffer financial hardship to pay for health care.”  Says the World Bank which teamed up with WHO in 2017 to monitor progress with this target. https://www.worldbank.org/en/topic/health/publication/universal-health-coverage-study-series “Each year, close to 100 million people are being pushed into extreme poverty because of health expenses, and 800 million spend more than ten percent of their household budgets on health care. Achieving UHC is not just about better health outcomes. The overarching goal of the Sustainable Development Goals (SDGs)–ending extreme poverty–will remain out of reach without […]
- [Feedback from mboppi course](https://nicheinternational.org.uk/feedback-from-mboppi-course/): “This course was very resourceful, I have gained more skills and will transmit the knowledge gained to my colleagues so that together we can improve the neonatal care outcome in Cameroon“ Grace and Dr Ngu Ernest, paediatrician in Douala, have just completed a Neonatal Care Course in Mboppi Hospital, one of the Cameroon Baptist Convention Heath Services institutions. 21 candidates attended and all passed the course. The programme used was the ALSG/MCAI one that NICHE instructors have used in the past. It was nice to see that Grace had also included an update for everyone on presentations from the 2nd […]
- [A socially distanced neonatal care course in douala, cameroon](https://nicheinternational.org.uk/a-socially-distanced-neonatal-care-course-in-douala-cameroon/): Covid has not deterred our Cameroonian colleagues from running their independent Neonatal Care Courses. Here they are, working hard at the Mboppi Baptist Hospital in Douala this month. Covid has highlighted the importance of training local instructors. While we have to sit on our hands in the UK, unable to travel to teach, the instructors we have already trained in west Africa are busy cascading best neonatal practice and continuing our joint mission of reducing neonatal mortality. 1m+ social distancing in the classroom keeps the learners as safe as possible. Credit to Grace and her team for keeping the programme […]
- [COVID-19 in West Africa](https://nicheinternational.org.uk/covid-19-in-west-africa/): There are 14 confirmed cases in Liberia at the moment, 3 deaths.  Cameroon has many more – 658 cases and 9 reported deaths on 6th April.  Grace recently sent a picture of 2 midwives in full PPE having just delivered a premature baby of a young woman with COVID-19.  Cameroon, at least the francophone part, will be better equipped to deal with this than Liberia but we are certainly all willing the hot weather to slow the spread of this virus in parts of the world that simply don’t have the equipment to support the lives of people with respiratory […]
- [Peer to peer review and mentoring](https://nicheinternational.org.uk/peer-to-peer-review-and-mentoring/): Medical and nursing staff in the UK now have to undergo annual appraisals, usually with a peer who coaches them through their appraisal paperwork, discussing issues and highlights of the year with them and helping them to develop themselves as a health professional.  Although there’s always a mad rush at the end of the year to get all the relevant bits of paper uploaded to one’s appraisal file in time for the allotted meeting, the process if done well encourages the health worker to focus on their goals for the next year, helps to prevent burn out and allows us […]
- [Breastfeeding workshop](https://nicheinternational.org.uk/breastfeeding-workshop/): The Neonatal Care Course (NCC) is an educationally robust product.  We teach about the four main areas that the World Health Organisation identifies as contributing maximally to neonatal mortality rates: resuscitation at birth, early breast-feeding, keeping babies warm and early recognition and management of sepsis.  https://www.who.int/maternal_child_adolescent/topics/newborn/enap_consultation/en/).  Our feedback forms show increased confidence of learners in all 4 of these areas. Increased clinical confidence correlates with increased performance over time. Here is Grace, a one time NCC learner and now in-country NICHE champion and convener of their own independent NCCs, delivering a workshop on breastfeeding to local midwives.  This is what empowerment […]

## Pages

- [OUR BUSINESS PLAN](https://nicheinternational.org.uk/front-page/our-business-plan/): We’ve published our 2025–27 plan. How will we help reduce neonatal mortality? Our goal is to support local partners, train healthcare workers, and protect the health of babies and children through sustainable, collaborative action.
- [LATEST BLOG POSTS](https://nicheinternational.org.uk/front-page/latest-blog-posts/)
- [LIBERIA VIDEO with thanks to ALL SPONSORS](https://nicheinternational.org.uk/liberia-video-all-sponsors/): Your browser does not support the video tag.
- [Liberia Video with thanks to the BMA](https://nicheinternational.org.uk/liberia-video-bma-x-2/): Your browser does not support the video tag.
- [training package](https://nicheinternational.org.uk/training-package/): NICHE International is a small charity carrying out one or two overseas trips per year. The volunteer instructors donate their time for this teaching and training service in their annual leave from full time jobs as healthcare professionals in the UK. The volunteer trustees fundraise throughout the year for the charity’s activities and work on the educational and promotional material as well as organising the trips overseas. Our commitment to a country, using the 10-step to sustainability training package, is usually for between 5 and 8 years. We strongly believe that training local instructors in newborn care saves lives. We […]
- [Video: A PROJECT IN LIBERIA](https://nicheinternational.org.uk/front-page/our-project-in-liberia/): Your browser does not support the video tag.
- [hELP fUND oUR wORK](https://nicheinternational.org.uk/front-page/help-fund-our-work/): All the NICHE International trustees and instructors are volunteers. We have no paid staff, rent or other overheads. All the money we raise is spent on training courses. Make a donation
- [Truly Sustainable Training](https://nicheinternational.org.uk/front-page/truly-sustainable-training/): Our 10 step route to training self-sufficiency provides a timeline from the first training course delivered in a country to the moment when NICHE International can withdraw its UK instructors, leaving a fully functioning local faculty able to run their own Neonatal Care Course and their own instructor development courses.
- [Blog](https://nicheinternational.org.uk/blog/)
- [Our Trustees](https://nicheinternational.org.uk/our-trustees/): Dr Alison Earley MBBS FRCP RCPCH DTM&H Consultant Paediatrician (retired) Alison was a consultant paediatrician in Buckinghamshire. She retired early from full time NHS work, in order to gain some experience of international paediatrics. She did the tropical medicine diploma at the London School of Hygiene and Tropical Medicine in 2003. Since 2004, she been involved with the charity Maternal and Childhealth Advocacy International, initially as project lead for Cameroon and latterly as one of the neonatal trainee educators in Liberia.  She is an NLS Instructor and was heavily involved in setting up the Neonatal Care Course in Cameroon.  Alison […]
- [Educational resources](https://nicheinternational.org.uk/educational-resources/): Make a donation The manual used for the Newborn Care Course is MCAI Pocketbook of hospital care for neonates and infants 2015 and it is available from Maternal and Childhealth Advocacy International at http://www.mcai.org.uk/pdf-downloads-for-textbook–pocket-book.  There is an updated version available for download at the same website. There are many truly superb videos about all aspects of caring for well and sick babies at https://globalhealthmedia.org/videos/. Clear 10 minute video on resuscitating at birth in a community setting at http://www.medicalaidfilms.org/film/what-to-do-when-a-newborn-baby-is-not-breathing/.   Available in English, French, Swahili and Somali.  A more detailed video from the same group, 20 minutes long and covering all aspects of newborn resuscitation […]
- [Generic Instructor Course](https://nicheinternational.org.uk/generic-instructor-course/): The Generic Instructor Course (GIC) is recognised as one of the best “train the trainer” short courses there is and it is the course that all UK instructors have to pass through in order to instruct on the ALSG and RC(UK) life support courses. NICHE International instructors are all fully accredited GIC instructors and aim to select three or four candidates per Neonatal Care Course (NCC) for training as instructors in their own right. We can train up to 12 instructors on one GIC, depending on how many GIC instructors we take on an overseas trip. Every GIC course must […]
- [Volunteer as an instructor](https://nicheinternational.org.uk/instructors/): We recruit volunteer doctors, nurses, midwives and resuscitation officers. Experience needed: an appropriate clinical background currently active as a Generic Instructor Course (GIC) instructor and also an instructor on at least one of the following ALSG or Resus Council provider courses: NLS APLS PHPLS POET MOET EPALS excellent communication skills ability to teach in English previous experience of volunteering overseas in resource poor settings would be helpful We are a small charity and run 1 or 2 overseas trips a year, usually for 10 days at a time.  The work is challenging and immensely rewarding; we look forward to welcoming […]
- [newborn, infant and child health international](https://nicheinternational.org.uk/): Latest posts
- [Our Projects](https://nicheinternational.org.uk/front-page/our-projects/): We currently run courses in Cameroon, Uganda and Liberia: the Neonatal Care Course (NCC) teaches health professionals best practice in the care of the newborn infant in the first 28 days of life, and the Generic Instructor Course (GIC) trains selected candidates in how to teach the Neonatal Care Course.  The whole  approach is based on a 10 steps to sustainable learning programme which we have devised.
- [Contact Us](https://nicheinternational.org.uk/contact-us/): help us fund our lifesaving work
- [Support Our Work](https://nicheinternational.org.uk/want-to-donate/): Newborn, Infant and Child Health Education (NICHE) International Registered as a CIO 1174977 in England WE NEED YOUR SUPPORT All the NICHE International trustees and instructors are volunteers. We have no paid staff, rent or other overheads. All the money we raise is spent on training courses. As instructors, we give our time freely, but travel to poorly resourced areas of the world is costly and we do not wish to be a financial burden to our hosts.   A group of 5-7 instructors can train as many as 48 candidates in Neonatal Care over the course of a week, as […]
- [Neonatal Care Course](https://nicheinternational.org.uk/newborn-care-course/): the countries in Africa where niche is active have some of the highest neonatal mortality rates in the world* *25 babies per 1,000 live births die in their first month of life. This is ten times the neonatal mortality rates of high income countries. We hope to bring this rate down by teaching the Neonatal Care Course to local midwives, nurses and doctors and by training local instructors to continue this work in the future. The Newborn Care Course was put together by two UK charities, the Advanced Life Support Group and MCAI (Maternal and Childhealth Advocacy International) and then […]
- [We exist because too many babies in low-income countries die in their first month of life](https://nicheinternational.org.uk/front-page/mission/): help us fund our lifesaving work


[comment]: # (Generated by Hostinger Tools Plugin)