Human Resources

To build capacity of the local healthcare staff, at different levels.

Many healthcare facilities still face quality gaps in the care of small and sick newborns. Therefore, it is essential to work not only on theoretical knowledge but also on strengthening practical skills, ensuring that health workers are prepared to apply what they learn in real-life clinical settings.

To address this, Chiesi Foundation focuses on building the capacity of local healthcare staff through structured, continuous, and context-specific training programs, delivered across all levels of the healthcare system — from referral hospitals (hubs) to peripheral health facilities (spokes). These programs aim to be formally recognized by national health authorities and integrated into existing training frameworks.

Training could cover:

• Essential newborn care, emphasizing family-centered care, with staff supporting family involvement and well-being.
• Complex care, using standardized WHO-endorsed training, supervision, and monitoring tools.
• Data-driven quality improvement, encouraging hospitals to monitor progress and guide future interventions.
• Organizational development, helping healthcare facilities to improve efficiency and impact.

Overall, training must be locally appropriate, continuous, officially recognized, and embedded in broader development efforts. In this regard, the Foundation prefers and recommends methodologies that include South-to-South learning, Training of Trainers (ToT), and support for local champions.

Infrastructures

To improve the distribution and reorganization of the neonatal spaces to promote zero-separation and a continuum of care

Historically, neonatal units were designed to separate newborns from families to prevent infection. Today, evidence shows that zero-separation — when paired with proper infection prevention protocols — not only supports bonding and breastfeeding but can also reduce the risk of hospital-acquired infections. Therefore, Chiesi Foundation promotes a distribution and reorganization of the neonatal spaces to promote zero-separation and continuity of care, prioritizing the reorganization of existing spaces over new construction — which is often costly and dependent on funding that may not be sustainable. Each case is carefully evaluated based on the local context and specific needs.

Key goals include:

• Mother-baby wards with access to beds, food, and hygiene facilities.
• Reserving NICUs only for babies needing advanced care, allowing others to stay with their mothers.
• Spaces to facilitate Kangaroo Care (KC), equipped with beds or comfortable armchairs
• Establishing Maternal-Newborn ICUs (M-NICUs) to promote proximity and bonding.

Beyond interventions aimed at improving infrastructure and spaces at each facility level, Chiesi Foundation engages decision-makers to support the implementation of a hub-and-spoke model with efficient referral and back-referral systems aimed at decongesting central facilities.

While the Foundation does not provide direct funding for transport services, it actively supports capacity building through training and raising awareness on ensuring optimal care during neonatal transfers, including the importance of maintaining zero-separation.

Equipment & Commodities

To ensure that essential neonatal care equipment is appropriate, affordable, and maintainable within the local health system.

Providing quality care for small and sick newborns requires the right medical equipment and supplies — selected, managed, and maintained appropriately for the context. Equipment must be simple, robust, cost-effective, and easy to use and maintain. High-tech solutions may be inappropriate if they cannot be repaired locally or require complex maintenance. In many low-resource settings, equipment ends up unused due to a lack of training, spare parts, or unrealistic expectations about their sustainability.

Additionally, hospitals should also source basic comfort items (e.g., beds, reclining chairs, kangaroo care kits) to support Family-Centered Care.

To ensure proper use and sustainability:

• Any purchase should be based on a needs assessment involving clinical, nursing, and biomedical staff to ensure that the equipment matches real requirements
• The hospital governance should commit to ensuring ongoing maintenance and repair
• Every time new technology is introduced, the supplier must provide training on use and maintenance to clinical staff and identify local technicians or biomedical engineers responsible for upkeep
• Planning must also include cleaning protocols to prevent infections and sepsis, as improper use and hygiene of devices can pose serious risks
• Strong supply chain and stock management systems are needed to ensure the availability of spare parts and consumables.

Chiesi Foundation supports the acquisition of low-cost, context-appropriate technologies aligned with the facility’s actual level of care. Investing in usable, sustainable equipment and training local staff is far more effective than supplying high-end machines that cannot be operated or maintained. This approach ensures better health outcomes and long-term resilience of neonatal care services.

Data System

To implement a system of data recording and management (statistics, medical records, etc.) to monitor progress and improve quality of care

Data is a powerful tool for improving neonatal care. In LMICs, reliable data is often lacking, and the perceived value of collecting and using data is low. The Chiesi Foundation works to promote a cultural and behavioral shift, empowering local healthcare teams to see data not as a bureaucratic burden, but as a resource for learning, improving, and advocating.

Accurate data allow facilities to:

• Track progress over time and identify areas for improvement
• Improve clinical outcomes by learning from patterns and trends in their own care practices
• Collaborate more effectively with other hospitals and levels of the health system
• Provide evidence to national authorities and donors that an intervention is working, and that it is cost-effective
• Inform other contexts and scale up good practices.

The Chiesi Foundation supports the development of simple, context-adapted systems for recording and analyzing data, including support for digitization when feasible. Local health workers are trained not only to collect data, but also to interpret and use it meaningfully in clinical audits and quality improvement cycles.

Ultimately, data is essential to build credibility, accountability, and long-term sustainability, and to demonstrate that investments in care for small and sick newborns truly make a difference.

Communication

To ensure that communication—at all levels—is a strategic tool to improve quality of care, coordination, participation, and impact.

Communication within the health system: Effective communication among healthcare professionals is essential to ensure continuity of care, particularly across departments and levels of the health system. Promoting a continuum of care approach in Maternal, Newborn and Child Health (MNCH) means recognizing the interconnected needs of mothers and newborns from pregnancy through the postnatal period, nd facilitating integrated services from the community to referral hospitals.

Communication with families: Clear, respectful, and empathetic communication with parents is a cornerstone of the Family-Centered Care approach. It enables meaningful participation of parents in newborns throughout the care journey — from admission to discharge and follow-up. Effective communication should be culturally appropriate and adapted to different literacy levels. When healthcare workers and families understand their roles and collaborate, the quality of care improves, and trust is strengthened.

Advocacy and institutional communication: This type of communication plays a vital role in influencing policies, mobilizing resources, and building public awareness around maternal and newborn health. Hospitals and healthcare facilities can be key players in supporting change at the local, regional, or national level, often in collaboration with other partners.

Advocacy efforts should aim to:

• Promote the inclusion of MNCH (Maternal, Newborn & Child Health) priorities in local and national health planning and policy discussions
• Engage local stakeholders — including health authorities, community leaders, NGOs, and civil society — to build support for improved maternal and newborn care
• Mobilize resources and funding by demonstrating the impact of quality care through local success stories and measurable outcomes
• Empower communities through health education and outreach, fostering awareness of maternal and newborn health rights and services.

In this context, in 2023, Chiesi Foundation joined the Partnership for Maternal, Newborn & Child Health (PMNCH), the world’s largest multi-stakeholder platform focused on women’s, children’s, and adolescents’ health. This strategic engagement allows the Foundation to align its work with broader global efforts and amplify its advocacy voice — not only to improve care on the ground, but to help build more supportive systems and policy environments for maternal and newborn health worldwide.

Protocols & Guidelines

To develop a set of protocols, manuals, and guidelines that support consistent and quality care

Standardized protocols are essential to ensure that all newborns — especially small and sick ones — receive high-quality, evidence-based care regardless of where they are treated. In many LMICs, protocols are either lacking, outdated, or inconsistently applied, contributing to variability in care and outcomes.

The Paolo Chiesi Foundation supports local teams in creating practical, context-adapted clinical and operational protocols. These protocols should:

• be based on priority topics (high-impact clinical areas) identified through needs assessments (e.g., nutrition, thermal care, infection prevention)
• be easy to consult, include visual aids where useful, and be easily accessible at the point of care (e.g., printed wall charts, pocket manuals, digital formats)
• be paired with measurable indicators: Developing associated indicators to monitor compliance and effectiveness, and revising protocols based on real-world data.

The protocols should align with international standards and evidence-based guidelines, while adjusting to the specific capacity, language, and workflows of local health facilities. To ensure coherence and local ownership, the Foundation works with national and regional stakeholders — such as the African Neonatal Association — to harmonize efforts and advocate for institutional endorsement.