Kiwoko NICU

AdaraNewborn

AdaraNewborn is our evidence-based, high-impact model of maternal and newborn care with the power to halve newborn deaths and stillbirths across 10 health facilities in Uganda over the next decade.

This model, pioneered at Kiwoko Hospital in Central Uganda, has delivered strong results. In 2022, more than 86% of sick newborns in the Kiwoko neonatal intensive care unit survived. Since 2010, maternal deaths as a proportion of hospital births have halved, while births have increased by 400%.

Over the next decade, we plan to reach half a million women and children and prevent over 7,000 deaths through AdaraNewborn. We will impact many more communities by sharing our knowledge and resources with health facilities and professionals locally and globally.

Through this work, we will support Uganda to meet the United Nations Sustainable Development Goals for maternal and newborn mortality.

The five arms of AdaraNewborn

AdaraNewborn works to address the quality and availability of services across the continuum of care. This model provides care to mother and baby from the time of pregnancy through to when they return home after birth.

It improves outcomes across five arms: antenatal care, intrapartum care, inpatient care for small and sick newborns, postnatal care, and follow-up and early intervention.

Regional ‘hub and spoke’ model

AdaraNewborn utilises a regional ‘hub and spoke’ model that can be replicated nationally and internationally, leveraging recent successes with this approach in Uganda.

Together with the Uganda Ministry of Health and other implementation partners, we will establish two regional hubs of maternal and newborn care. A regional referral hospital will serve as the Centre of Excellence at the heart of each hub. We will then strengthen surrounding target hospitals and health centres (known as Health Centre IVs) that perform more basic levels of maternal and newborn care.

Through our first hub, we seek to improve the quality of care across Luwero, Nakaseke and Nakasongola districts in Central Uganda. Kiwoko Hospital is in the middle of this hub, acting as a Centre of Excellence and referral facility that can provide higher levels of care. We have already commenced work with two additional AdaraNewborn sites within this hub: Nakaseke and Luwero hospitals. Two more facilities will be added in 2024.

The second regional hub – comprising five facilities in a separate geographic area – will be selected after close consultation with the Ministry of Health and analysis of national and regional data.

“The Ministry of Health is recognising our effort in a government setting and the newborn survival rate at Nakaseke Hospital stands at 98%. So we feel like this kind of care in a government setting is reducing neonatal mortality and will help us contribute to achieving the Sustainable Development Goals!”

– Beatrice Niyonsaba, Uganda Research, Monitoring and Evaluation Manager

Strengthening the health system

AdaraNewborn will improve referral pathways, build collaboration among facilities and advance local leadership. This will strengthen the health system, leading to better outcomes for mothers and babies. To achieve this, we will focus on four key activities:

Leadership and governance

We will strengthen leadership and governance within the health system to create sustainable change. Each AdaraNewborn facility will receive a tailored leadership and governance training programme, as well as ongoing support to drive systems-level transformation.

Clinical training and mentorship

Our team of expert clinicians have developed clinical guidelines and comprehensive training programmes that provide practical guidance for the provision of quality care. To embed the learnings from this training and create resilient systems for ongoing support, we will provide ongoing mentorship in each facility through a network of experienced health workers who will model and promote best practices.

The tools to succeed

Alongside enhancing clinical skills and knowledge, we will provide each facility with the tools they need to succeed. This includes essential infrastructure upgrades, and a package of lifesaving equipment and supplies. We will also develop biomedical capabilities in each AdaraNewborn facility by training hospital electricians or engineers to maintain and repair equipment..

Quality improvement systems

We will implement quality improvement processes to enhance quality of care. We will also develop onboarding processes for new staff to continue applying these changes, as well as simple education programmes for families.

Inside Luwero Hospital – AdaraNewborn’s third site

Following a successful year implementing AdaraNewborn at our two current sites – Kiwoko and Nakaseke hospitals – we are excited to have begun work with our third AdaraNewborn site, Luwero Hospital in 2023. This is a public facility that registers more than 3,500 births each year and needs to refer many of these babies to other health facilities – including Kiwoko – to receive more specialist care.

The District Health Officer and Medical Superintendent at Luwero requested this partnership as they see the lives of too many women and newborns being needlessly lost.

This year, we will work with Luwero to implement leadership and governance training; carry out needs assessments; roll out clinical training and mentorship; provide biomedical engineering training; and deliver necessary equipment and infrastructure upgrades.

AdaraNewborn Partners

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…to bring quality health and education services to people living in some of the world’s remotest places.

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