Muhimbili national hospital - dar es salaam - tanzania

Neonatal collaboration

"Empowering Pediatricians to Become Neonatologists: PHI - Supporting Tanzania's First Neonatology Training Curriculum with Administrative, Teaching, and Training Assistance."

 
 

The Muhimbili National Hospital’s (MNH) neonatal unit has during recent years been transitioning to offer level three Neonatal Intensive Care. The bed capacity may go up to 200 neonates in peak season. The unit is staffed by two neonatologists, experienced pediatricians and nurses from the hospital and the university. With the huge patient load, the unit faces considerable staffing challenges for both nurses and doctors, as well as having limited skills in specialized services required by a Neonatal Intensive Care Unit (NICU). Specialist training to become a neonatologist has been possible in Dar Es Salaam since 2021. PHI has played a significant and supportive role in the planning and implementation of this specialist training, the first ever in Tanzania.

NICU Muhimbili

“These first four doctors completed their training in Tanzania to become neonatologists. They are now just posted by the Tanzanian Ministry of Health in different regional hospitals in Dar es Salaam to leverage their acquired skills to lower-level health facilities. With this, there is an evident continuation for the collaboration between MNH and PHI to extend activities to other hospitals to increase the outputs of efforts”

As the unit currently has been transformed to provide some intensive care, more advanced training for both doctors and nurses is needed. 

The hospital, with great support from the Tanzanian Government and various stakeholders and partners, has teamed up to improve quality of services in the unit to bring about the changes we are seeing today. PHI is happy to be one of them. 

Over the last few years, the neonatal staff at Muhimbili have expressed a desire for a workshop in neonatal care, which they identified as an area in need of support. From 2016-2024, a great number of neonatal workshops and teaching activities in basic neonatology to care for very sick newborns has been conducted within the PHI collaboration. 

Workshop Neuroprotective nursing Muhimbili 2022

Since 2018, PHI- colleagues at Muhimbili National Hospital have been organizing Tanzania's national neonatal conferences -  "Every breath counts". They have been highly successful events and between 100-150 participating doctors and nurses from all over Tanzania have taken part. PHI contributes to the faculty for these conferences where Swedish neonatologists, neonatal nurses and doctors have facilitated and lectured.  The main areas of teaching include preventive care for the neonate such as neuroprotection, optimizing respiratory support, nutrition, pain management and infection prevention. More advanced skills such as performing diagnostic ultrasounds has also been included.

Dr Martha Mkony (PHI coordinator) at Tanzania’s first neonatal conference - “Every breath counts” in November 2018

Dr Martha Mkony, neonatologist MNH (PHI coordinator) at Tanzania’s first neonatal conference - “Every breath counts” in November 2018.

Martha’s words about PHI: ” A friendly way of sharing knowledge and skills that has resulted in strong collaboration”

Activities In neonatology

With support from the Government of Tanzania and various partners, Muhimbili National Hospital has developed a more comprehensive internal program of ongoing education. PHI has here been involved in different activities. Our neonatal PHI team-members visits MNH at least once a year were bedsideteaching, hands-on training, and seminars are the major parts of the activity and discussions and reflection with the staff is a great way to move forward. Other ways to share knowledge and build new networks have been through weekly webinars that are conducted by the residents in Neonatology at MUHAS/MNH. The resident has prepared the topic and one PHI-neonatologist/neonatal nurse has had a facilitating role.

Staff exchange

The bilateral staff exchange of doctors and nurses from Muhimbili National Hospital and Karolinska University Hospital is a key component in our activities. The staff exchange is contributing to the networking and capacity-building activities where sharing experiences and building trust are the most important factors. A yearly three week long staff exchange occurs where health care personnel from MNH neonatal unit come to the neonatal units at the Karolinska University hospital in Sweden. The clinical rotation includes clinical auscultation, scenario training, skills training, and networking. The clinical rotation is a base for long term collegial relationships and has been very appreciated from both sites. The latest staff exchange was April 17th to May 6th.

Karolinska May 2022

Karolinska May 2023

Activity plan for 2024/2025

Study visit(s).

A team of two doctors and two nurses from MNH will spend three weeks at ALB in May 2024. They will job shadow at different wards and participate in training activities within the department. 

Supervision/training

Training program for specialist nurses in neonatology, aiming to commence in early 2025. The work includes the developing of a curriculum with training modules that will be delivered by the Swedish team both in Tanzania and during study visits to ALB.

“Meeting with representatives from MUHAS to continue to plan the training of specialist nurses in Neonatal care”


Holistic curriculum for neonatal care, neonatal intensive care, and newborn follow-up for the regional hospitals around MNH. This will be done in close collaboration with the recently graduated neonatologists starting with a needs assessment for the involved hospitals to target interventions.

 

Neonatal network development, including a support network for neonatologists following graduation, offering mentorship and resources to ease their transition into professional practice. Provide continuous learning opportunities and professional development initiatives tailored for recent graduates.

 
Dr Viveka Nordberg (PHI coordinator Sweden) and pediatric resident Dr Victoria are practicing together in the Neonatal care unit Muhimbili National Hospital.

Dr Viveka Nordberg and pediatric resident Dr Victoria are practicing together in the Neonatal care unit Muhimbili National Hospital.

Bed-side teaching on respiratory support strategies, NICU Muhimbili