Our Impact
Tanzanian NICU Impact
- We have changed the narrative that small, sick babies rarely survive in Africa. Our outcomes demonstrated that even the smallest baby can survive and thrive. In our Tanzanian NICU, we achieved a 92% adjusted survival rate among nearly 3,000 small and premature babies.
- Specifically, the survival of preterm babies weighing <1000 grams (2.2lbs) and at least 26 weeks gestation increased by 4-fold to 85%.
- These outcomes were published in an article called “Every breath counts: Lessons learned in developing a training NICU in Northern Tanzania” in the journal Frontier in Pediatrics.
Education and Training Impact
Since 2021, TFBS has trained 829 African doctors and nurses from 203 hospitals in 20 sub-Saharan African countries.
We offer a diverse array of over 90 unique lectures and advanced skills workshops facilitated by 50 esteemed instructors hailing from academic institutions spanning 13 countries.
ICHA doctors treat hundreds of critically ill NICU babies each year.
We offer a diverse array of over 90 unique lectures and advanced skills workshops facilitated by 50 esteemed instructors hailing from academic institutions spanning 13 countries.
ICHA doctors treat hundreds of critically ill NICU babies each year.
Growth of Tiny Feet, Big Steps
Conferences Impact (2024 Participants)
Tiny Feet, Lasting Impact: A Physician’s Journey
Impact of Our Work - An Update From Ghana
Below is review of the 2024 Tiny Feet, Big Steps conference by a physician in Ghana who attended the 2024 Tiny Feet, Big Steps conference. She outlines how she is applying her learnings to her home NICU from the conference.
Below is review of the 2024 Tiny Feet, Big Steps conference by a physician in Ghana who attended the 2024 Tiny Feet, Big Steps conference. She outlines how she is applying her learnings to her home NICU from the conference.
Written by Dr. Josephine at Komfo Anokye Teaching Hospital in Ghana, who attended TFBS 2024, and shared with Dr Swanson in February 2025
100 Days After Tiny Feet, Big Steps: Transforming Newborn Care in My Facility: It has been over 100 days since I attended the Tiny Feet, Big Steps Conference in Tanzania, and I am deeply grateful for the knowledge, skills, and connections I gained. The experience has had a profound impact on both my practice and my facility, and I would like to take a moment to express my appreciation and highlight the changes that have taken place since then.
100 Days After Tiny Feet, Big Steps: Transforming Newborn Care in My Facility: It has been over 100 days since I attended the Tiny Feet, Big Steps Conference in Tanzania, and I am deeply grateful for the knowledge, skills, and connections I gained. The experience has had a profound impact on both my practice and my facility, and I would like to take a moment to express my appreciation and highlight the changes that have taken place since then.
Empowered by Knowledge and Skills
The topics covered at the conference were incredibly valuable to me as a neonatology resident. I gained essential skills, including the administration of surfactant using the Laryngeal Mask Airway (LMA)/Supraglottic Airway. I was fortunate to receive a few LMAs to bring back, and after training my fellow residents at Komfo Anokye Teaching Hospital (KATH) in Kumasi, this technique has now been adopted as our standard method for surfactant delivery. Exceptions are made only for extremely small preterms, for whom I continue to use the LISA method with a tiny endotracheal tube.
Beyond my hospital, I have also trained doctors at district hospitals that refer preterm babies to KATH. Many of these hospitals already had CPAP and surfactant available but had not been using them optimally. Now, they have started administering surfactant via the LMA method before referring preterms to KATH, improving their initial care and stabilizing them better before transfer.
Structural and Clinical Changes in My Facility
Inspired by the conference, my hospital has restructured doctor shifts in the NICU to enhance newborn care. A dedicated resident doctor is now assigned solely to preterms in the NICU. Their role includes daily monitoring, infection prevention and control (IPC), staff training, and the implementation of best practices from the Every Breath Counts initiative, which was shared at the conference. This change has significantly improved the continuity and quality of preterm care in our unit.
We have also begun feed fortification for a select group of preterm babies. While our facility strictly adheres to the national policy of exclusive breast milk for preterms, three babies who were failing to thrive despite best efforts were counseled and started on feed fortification. Their progress has been promising, and we continue to monitor outcomes.
Advancing POCUS in My Practice
The Point-of-Care Ultrasound (POCUS) training I received at the conference has been invaluable. It has enhanced my ability to quickly diagnose and manage critical conditions, particularly in newborns with difficult IV access, cardiac concerns, and IVC assessments. The skill has also proved beneficial beyond neonatology, improving my clinical decision-making during my rotations in the Pediatric Emergency Unit and PICU.
Resources That Keep Giving
The Every Breath Counts pocketbook has become my trusted guide in the NICU, helping me and my colleagues with quick, evidence-based clinical decisions. I was fortunate to receive an extra copy, which I donated to a sister teaching hospital in Accra for their NICU. They have found it extremely useful and extend their heartfelt gratitude.
I am deeply grateful to the organizers, speakers, and mentors who made this conference possible. The knowledge gained has empowered me, transformed my hospital, and even impacted other facilities in Ghana. These past 100 days have truly been a journy of growth, and I look forward to continuing this journey of improving newborn care. Asante Sana!
Dr. Josephine, Komfo Anokye Teaching Hospital, Ghana
The topics covered at the conference were incredibly valuable to me as a neonatology resident. I gained essential skills, including the administration of surfactant using the Laryngeal Mask Airway (LMA)/Supraglottic Airway. I was fortunate to receive a few LMAs to bring back, and after training my fellow residents at Komfo Anokye Teaching Hospital (KATH) in Kumasi, this technique has now been adopted as our standard method for surfactant delivery. Exceptions are made only for extremely small preterms, for whom I continue to use the LISA method with a tiny endotracheal tube.
Beyond my hospital, I have also trained doctors at district hospitals that refer preterm babies to KATH. Many of these hospitals already had CPAP and surfactant available but had not been using them optimally. Now, they have started administering surfactant via the LMA method before referring preterms to KATH, improving their initial care and stabilizing them better before transfer.
Structural and Clinical Changes in My Facility
Inspired by the conference, my hospital has restructured doctor shifts in the NICU to enhance newborn care. A dedicated resident doctor is now assigned solely to preterms in the NICU. Their role includes daily monitoring, infection prevention and control (IPC), staff training, and the implementation of best practices from the Every Breath Counts initiative, which was shared at the conference. This change has significantly improved the continuity and quality of preterm care in our unit.
We have also begun feed fortification for a select group of preterm babies. While our facility strictly adheres to the national policy of exclusive breast milk for preterms, three babies who were failing to thrive despite best efforts were counseled and started on feed fortification. Their progress has been promising, and we continue to monitor outcomes.
Advancing POCUS in My Practice
The Point-of-Care Ultrasound (POCUS) training I received at the conference has been invaluable. It has enhanced my ability to quickly diagnose and manage critical conditions, particularly in newborns with difficult IV access, cardiac concerns, and IVC assessments. The skill has also proved beneficial beyond neonatology, improving my clinical decision-making during my rotations in the Pediatric Emergency Unit and PICU.
Resources That Keep Giving
The Every Breath Counts pocketbook has become my trusted guide in the NICU, helping me and my colleagues with quick, evidence-based clinical decisions. I was fortunate to receive an extra copy, which I donated to a sister teaching hospital in Accra for their NICU. They have found it extremely useful and extend their heartfelt gratitude.
I am deeply grateful to the organizers, speakers, and mentors who made this conference possible. The knowledge gained has empowered me, transformed my hospital, and even impacted other facilities in Ghana. These past 100 days have truly been a journy of growth, and I look forward to continuing this journey of improving newborn care. Asante Sana!
Dr. Josephine, Komfo Anokye Teaching Hospital, Ghana
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