Training a neonatal health care work force in a low-resource setting in Sub-Saharan Africa

Abstract

Abstract: The 2016 World Health Organisation (WHO) bottleneck analysis for newborn care highlighted Zambia’s limited healthcare workforce specifically trained to care for small and sick neonates. This skills-constraint contribute to the country’s high neonatal mortality rate (NMR) and are limiting efforts to achieve the Sustainable Development Goal (SDG) NMR target of less than 12/1000 live births by 2030.
In 2020, a one-year skills-based postgraduate diploma (PGDip) in neonatology was introduced under the auspices of the Zambia College of Medicine and Surgery (ZACOMS). Nine medical doctors were enrolled in the first year and seven in the second year. An annual programme evaluation was undertaken to assess its strength and weaknesses and inform future training. All sixteen candidates completed the requisite logbook procedures and passed examinations to attain the PGDip in Neonatology. Candidates reported increased confidence in the management of neonatal conditions, which was also reflected in instructor and external evaluations. Trainees have established and taken ownership of a newborn community outreach programme - establishing Kangaroo Mother Care (KMC) units in communitybased facilities. These satellite KMC units decongested the Lusaka University Teaching Hospitals- Women and Newborn Hospital, and markedly improved patient experience and quality of
care for patients needing advanced neonatal care. Concurrently introduced neonatal nursing training programmes providing newborn care skills to nursing staff has further improved quality of care on the unit with about 40% reduction in neonatal mortality over the past two years. This article focuses on the establishment and execution of the PGDip in neonatology.