Strengthening Health Workforce Capacity through Global Learning in Neonatology

SCALE-Neonatology Project 

1.0 Background and Rationale.

Globally, Children face the highest risk of dying in the first 28 days of life. In 2019, an estimated 2.4 Million neonatal deaths were reported amounting to 47% of all under five (5) deaths. The largest percentage of these deaths occur in Low and Middle income countries and represent the disparities in neonatal care between the different regions of the world.

Sub-Saharan Africa remains the region with the highest neonatal mortality rate (27 deaths per 1000 live births). Uganda like many countries in Sub-Saharan Africa has a high rate of neonatal mortality (19 deaths per 1000 live births) which is majorly accounted for Birth Asphyxia (28.6%) prematurity (27.9%), Sepsis (18.2%) and congenital Anomalies (11.7%).

Most of these causes of neonatal mortality in the country can be reduced by having enough skilled health workers to provide high coverage of quality antenatal care, skilled care at birth, postnatal care for mother and comprehensive neonatal care.

With the increase in facility delivery in Uganda (73%), there is a great opportunity for providing essential newborn care and identifying and managing high risk newborns.

However, the lack critical human resource to drive the delivery of comprehensive neonatal care both at Health system and facility level remains a critical health system barrier in reducing neonatal mortality.

In a bid to address the critical lack of skilled health workers to expand the delivery of comprehensive neonatology services, the Ministry of Health Uganda seeks to implement a capacity building program with the UK –The Strengthening Health Workforce Capacity through Global Learning (SCALE) in Neonatology ,  to support training pathways that can increase the number and capacity of these cadres.

The SCALE program will strengthen mutual health workforce capacity development between the UK and Uganda with a focus on developing sub speciality training pathway in neonatology between the two countries.

The program will further provide opportunities for the Placement of UK Health professionals to learn from a rich clinical environment while fostering further opportunities for system and institutional collaboration.

2.0 Proposed Intervention

The overall goal of the program is; to contribute to the collaborative development of critical human resource to improve neonatal care.

Specific Objectives

  1. To develop a distant knowledge exchange and learning program between clinicians in Uganda and the Royal College of Paediatrics and Child Health (RCPCH) in neonatology
  2. To enable Ugandan doctors benefit from the Medical Training Initiative (MTI) Scheme by RCPCH to train in neonatology in the UK.
  3. To facilitate Global Placement of UK neonatologists from RCPCH to support neonatology training, care and research in Uganda.

What SCALE Offers to the Health System

  • Robust Government to Government pathway for health workforce capacity development in neonatology for mutual benefit
  • Proper evaluation of the health system’s impact of professional exchange between Uganda and UK
  • Strengthen bilateral placement, training and collaborative clinical research in Neonatology.

What SCALE Offers to Individual professionals

  • Learn and build clinical competence from the diverse clinical environments and healthcare systems between Uganda and UK
  • Develop fine skills in team work, leadership, communication to support Neonatology clinical care & practice
  • Build robust professional global networks to support Neonatology care and research
  • Build a career in global Neonatology care and health systems improvement


Phase one aims to;

  • Fostering the Virtual Global Clinical learning and knowledge sharing between fellows in Uganda and UK in Neonatology.
  • Build conduits for bilateral collaborative research in Neonatology for care quality improvement and health advancement.
  • Share internationally recognized standards of practice in Neonatology to improve quality of care.

SCALE Sites;

Identification of suitable institutions in both Uganda and UK to develop an institutional partnership in Neonatology.

SCALE Fellows and ALS

A maximum of the 15 fellows to be recruited in Uganda and 15 from the UK in Neonatology under the program and these will form Action Learning Sets.

SCALE Mentors

A mentor from Neonatology in both Uganda and UK will be attached to each Action Learning Set.

SCALE Clinical Learning Schedule

A clinical learning schedule developed and agreed to by the ALS will guide the clinical discussions between the fellow.

Phase two aims to;

  • Enable fellows undertake Short, medium and long-term placements in both Uganda and UK under Neonatology through the MTI and GLP schemes for hands on experience.
  • Obtaining subspeciality qualifications where possible in Neonatology under the SCALE program
  • Participating in Bilateral Clinical Patient Centred Research to inform Neonatology care quality improvement.