#031 - Building Newborn Systems in Humanitarian Settings: Lessons from a Decade of Capacity Building

Hello friends 👋

In this episode, Mbozu and Shelly-Ann sit down with Dr. Franck Houndjahoue to explore what it takes to strengthen newborn care in humanitarian and post-conflict settings. Drawing on nearly a decade of experience in the Central African Republic and other low-resource contexts, Dr. Houndjahoue shares how rebuilding newborn services requires far more than equipment: it depends on partnerships, training, data, and local leadership.

Link to episode on youtube: https://youtu.be/P8axstg3-Go

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Short Bio:Dr. Franck Houndjahoue is a pediatrician with extensive experience leading newborn and child health programmes across humanitarian and post-conflict settings in Africa. He serves as Project Manager with Doctors with Africa CUAMM in the Central African Republic, Treasurer of the African Neonatal Association, and Technical Advisor to the Paolo Chiesi Foundation, where he supports neonatal capacity-building initiatives across Francophone Africa. His work focuses on strengthening health systems through clinical training, quality improvement, data systems, and collaborative partnerships.

The conversation covers practical lessons from capacity building, the importance of involving frontline healthcare workers in change, and how networks such as the African Neonatal Association and the Paolo Chiesi Foundation are helping improve newborn care across Francophone Africa. Dr. Houndjahoue also reflects on the experiences that continue to shape his work and the simple principle that guides every decision: giving every newborn the opportunity not only to survive, but to thrive.

Connect with Dr Franck Houndjahoue: fhoundja@yahoo.fr

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The transcript of today's episode can be found below 👇

Shelly-Ann Dakarai (00:01.676) Hello, welcome to another episode of the Global Neonatal Podcast. We are so happy that you are joining us here again today. Mbozu, how are you doing?

Mbozu Sipalo (00:11.739) I'm so excited to be having Dr. Frank join us today. And how are you, Shelly-Ann?

Shelly-Ann Dakarai (00:19.474) I am good. So let's jump right in. Our guest today has spent more than a decade working on newborn and child health across low and middle income countries, including the Central African Republic, Haiti, Sudan, and Chad, with a particular focus on humanitarian and post-conflict settings. Dr. Franck is a pediatrician with Doctors with Africa CUAMM, which translates to University College for Aspiring Missionary Doctors, Treasurer of the African Neonatal Association (ANA), and Technical Advisor to the Chiesi Foundation. Franck, welcome to the Global Neonatal Podcast. We are so happy to have you with us today.

Franck (01:02.712) Thank you, Shelly-Ann. Thank you, Mbozu. I'm so happy to join this podcast, and for this opportunity you are giving me for this conversation.

Shelly-Ann Dakarai (01:11.362) All right, so before all the titles, CUAMM, ANA, the Chiesi Foundation, there was young Franck somewhere choosing medicine and then choosing pediatrics. So we always like to start by asking what drew you to the care of children, and why newborns specifically?

Franck (02:05.784) Thank you once again for this opportunity. After my graduation as a medical doctor, I remember in 2005, I dreamed of becoming a cardiologist. But when I came back to my country, because I graduated in Mali, my first job position as a general practitioner was in the pediatric unit, the emergency pediatric unit. And this experience completely changed my perspective. I discovered a new passion, bringing relief and a smile to parents while taking care of children. So I decided to shift my path, and it was the beginning of a new professional journey.

I'd like to clarify, because colleagues mostly assume that I'm a neonatologist. I'm not a neonatologist, I'm a pediatrician. I want to clarify that. But most of the projects I've led in the past, and I'm still leading, involve 60% neonatal service. That's understandable, because I work in humanitarian or post-conflict contexts, and when you talk about post-conflict contexts, the most affected victims are women and children, mostly in newborn services. So I'm a pediatrician, but I lead most of the neonatal projects.

I also have a background in clinical nutrition. When you talk about nutrition, we know the impact of nutrition on the future of children. When nutrition is neglected in the newborn period, you can imagine the consequences on their future, it will impact even their neurodevelopmental outcomes and put them at risk of chronic conditions in adulthood. So for all of those reasons, I'm biased, of course, but I also focus on neonatal services.

Mbozu Sipalo (05:01.809) Thank you, Dr. Frank, for that clarification, that you're a pediatrician with a focus on newborn babies. I think that 60% is still quite wide in breadth. You're based in the Central African Republic, and you also did your med school in Mali, correct?

Franck (05:30.818) Yes.

Mbozu Sipalo (05:31.375) If you could just share a bit about what the Central African Republic looks like for you as someone who has their hands in many, many pots, and how your schooling in Mali affected or impacted you as you returned to the Central African Republic post-med school.

Franck (05:54.856) I left Mali in 2005, so 20 years ago, and I was trained as a pediatrician in my home country, Benin. I couldn't have imagined that one day I would work in the Central African Republic. But this opportunity was given to me through my experience with Emergency, an international organization. I worked with them starting in 2016, that was my first experience in the Central African Republic, in a post-conflict context. I had worked in Chad two or three years earlier, which was also a post-conflict context, but the Central African Republic was different.

This organization, Emergency, based in Italy, gave me the opportunity to work in this challenging context, challenging for professional reasons, challenging for socioeconomic reasons. But when you realize that with small actions, with small improvements, you can contribute to saving the life of a newborn, of a child, you can contribute to improving life for the whole family, you feel the reason you are working, and this gives you enough energy to keep working, to keep improving what you're doing, to impact the lives of other people, knowing they're coming from a really complicated situation.

We're talking about war, and you can imagine what that means. The system was completely destroyed. Basic care was completely destroyed, antenatal care, postnatal care, immunization programs, all of it was destroyed. And this led to a high mortality rate, high prematurity rate, everything you can imagine. I moved there five, seven years ago, and compared to what's going on now on the ground, I really feel confident about what we've done and how we've impacted the life of this population, with the support of the whole system.

Shelly-Ann Dakarai (08:38.796) I want to camp here a little bit and talk about humanitarian, post-conflict interventions. I have two questions. First, on the personal side, how did you get connected with this organization to have the opportunity to become one of their project managers? And second, what does it look like when you go into a post-conflict area? Is there a roadmap, "we set this up first," walk us through what that looks like on the ground.

Franck (09:15.694) I got this opportunity in 2016 when I moved to the US. I had the opportunity to meet someone working with this NGO in New York, and when he saw my resume, he told me, we're not going to let you go, because we need you in the pediatric area in the Central African Republic. I'd also like to highlight that I speak French, and it's not easy for them to find a pediatrician at that moment with experience, speaking French, and ready to jump into such a complicated context.

When we're talking about humanitarian or post-conflict settings, caring for a newborn means working in an environment where the health system is compromised, even destroyed. When this happens, even the physical infrastructure may not exist or work adequately. The outcome is a high mortality rate, a high prematurity rate.

My responsibility was to rebuild the system, to strengthen it, starting from basic care and moving toward advanced care. This includes implementation of Kangaroo Mother Care (KMC), initiating immediate breastfeeding, promoting exclusive breastfeeding, implementing newborn follow-up. At a more advanced level, we reorganized the referral and counter-referral system, we introduced and scaled up respiratory distress syndrome support such as CPAP (Continuous Positive Airway Pressure), and we designed training programs to equip the staff and make sure they're kept updated.

One of the most important, and really challenging, components of this package was implementing the data collection system and database. Reliable data helps guide clinical practice and monitor outcomes, and to make any adjustments based on your targets. That's what I'm doing, of course, within a team, this international organization's team. Currently, I'm no longer with Emergency, they left the Central African Republic five years ago, in 2019. Now I'm with Doctors with Africa, in the same hospital. So we moved from an emergency situation to strengthening the health system, and transferring capacity to the local staff so they can lead the system themselves, and feel real ownership of what we've put in place.

Mbozu Sipalo (13:40.177) Thanks for sharing that, Dr. Frank. I can hear that you're working at a high level, but also at the grassroots level, it sounds like you have a very good scope. Just so our listeners have a better understanding of the work you're doing at Bangui Hospital, could you give us a few examples of the capacity-building initiatives you've led, and some snapshots of how things were before the intervention versus after, and a bit about the healthcare workers you work with?

Franck (14:25.922) Yes, of course. Let me give you this example. When I arrived at this hospital in 2016, we had, for the whole country, three or four pediatricians. For the whole country, I'm not talking about just the hospital. And all of them were working at this hospital. Nowadays, we have 16 pediatricians, all trained within the system. I was a senior pediatrician working in the pediatric intensive care unit, where I participated directly in training, but now I've shifted to technical advisor of the organization, and recently, in 2026, I became the head manager of the project. One of my roles is to identify training needs among staff, I work with nurses, general practitioners, and our fellow pediatricians.

Not only do we have 16 pediatricians, but among them we now have subspecialization. We have an oncology pediatrician, a nephrology pediatrician, and now one training in endocrinology and another in cardiology. We identify needs together with colleagues and design training accordingly. Last year we brought in two experts, one trained the staff in transfontanellar ultrasound, so now we're able to perform it in our neonatal department, even in the ICU. Another expert came from Senegal to train in newborn resuscitation and in the initiation and monitoring of CPAP, because for the first time this hospital had the opportunity to use CPAP to support newborns in respiratory distress.

All of these activities improved the newborn mortality rate. A few years ago, the mortality rate was more than 10%. Now we're at 4.5%. So you can see the progress we're making, and we still have a lot to do, we need to implement IPC (Infection Prevention and Control), quality improvement across different areas, improved antibiotic prescription, guidelines, and so on.

Shelly-Ann Dakarai (18:00.736) IPC as in infection prevention control, okay.

Franck (18:02.636) Yes, infection prevention control.

Shelly-Ann Dakarai (18:07.746) Thanks for that overview. I don't mean to oversimplify it, this has been a 10-year process. You went in 2016, and we're talking about what's currently there in 2026. Still, 10 years is a short time to have built that kind of infrastructure, that's pretty remarkable. I wonder if you could speak to someone who might not be in a post-conflict setting but wants to improve their care, how can they translate some of this? When I listen to the work you've done, and others who've worked with Doctors Without Borders, and they go into very challenging situations, they're able to start services from almost nothing and quickly get certain things off the ground. Whereas in established healthcare systems, sometimes people still struggle to make progress, there's medical culture, hierarchy, and so many factors. Sometimes it seems like progress is slower than it should be in places that started with more infrastructure. What are your thoughts on that?

Franck (19:46.478) Thank you. What I mean through this history is not to say everything is perfect in the Central African Republic, of course we need to keep making progress, keep improving the system, to give newborns the opportunity not only to survive but, most importantly, to thrive. When we talk about how to put these systems in place, even outside of post-conflict situations, don't forget that we're not in an emergency situation in the Central African Republic anymore. Now we're in a situation where we need to strengthen what we've put in place and keep building.

The first thing, in my experience of more than 10 years working in such contexts, is to put in place a network. You cannot work alone in this world. You need to think at the local level, national level, and even global level, that means you need to challenge yourself internally, challenge your own system, and compare it with more advanced systems from other countries or places. Each system has its weaknesses and strengths, you need to learn from their strengths, and to do that you need to be open, flexible, and integrated into a network, to exchange knowledge, learn from each other, and share what you've done well and not so well. Learning from other systems will tell you a story.

I want to explain why I'm telling this story: ANA, the African Neonatal Association, focuses on newborn healthcare, improving it across the continent. We have a Francophone group, an Anglophone group, and a Portuguese-speaking group. In the Francophone group, we organize a monthly webinar, we choose a specific topic and invite an expert to present, and we discuss and share knowledge and experience. Recently, about a week ago, our webinar focused on retinopathy of prematurity, and we discovered during that conversation that, for example, in Mali, they're able to treat it. The team from Gabon was surprised, the professor from Gabon said, "I didn't know that in Mali you're able to treat such conditions, that means we don't need to send patients to Morocco or France or elsewhere."

So if you don't open yourself up, if you don't build a network, you won't know what opportunities are close to you, and you'll limit yourself while other solutions are right there. You need to open yourself to other colleagues, other systems, and challenge yourself. One thing really important to highlight is the implementation of data collection. We have a collaboration with the Children's Hospital Neonatal Consortium, and we conducted a survey two or three years ago within ANA countries to assess the availability and utilization of newborn data. The findings from that survey helped us design a quality improvement course that we're going to start next month.

So you need to be involved in a group, in a network, to learn and to progress.

Shelly-Ann Dakarai (24:41.344) It's important that you mention data. Sometimes people see data collection as an extra burden, something out of reach. So it's interesting that you talk about including it from the beginning, that data collection, analysis, seeing what's working and what's not, and quality improvement, is so important for everyone, not just the administrative side, but for frontline workers too.

Franck (25:21.58) Yes. Reliable data helps generate evidence that can guide clinical practice, monitor outcomes, and support quality improvement initiatives. That's one thing we're working on in ANA, we want each country to understand the usefulness of data. Without data, you can't understand what you're doing or where you're going, it means you have no direction. It's really important.

Mbozu Sipalo (26:03.345) Dr. Frank, just to explore the data aspect some more, I can imagine that in a humanitarian or post-conflict context, it's quite difficult to collect data. Even in non-conflict but resource-limited settings, building a culture of data collection in newborn care is still an evolving story in developing contexts. I'm curious how CUAMM has been supporting Bangui Hospital in building capacity around data management. And is CUAMM only supporting Bangui Hospital, or other hospitals in the Central African Republic too? I'd love to know how you're building that culture of data in the pediatric space.

Franck (27:29.102) Let me start with the last question. CUAMM, or Doctors with Africa, isn't only supporting the pediatric teaching hospital in the capital, Bangui, they have other projects in rural areas, Bossangoa, Bangassou, and other regions. I've never been to those specific sites myself, but from meetings with other project managers, I know that in Bossangoa, the project also includes newborn care, and in other rural areas, they manage malnutrition through CMAM (Community Management of Acute Malnutrition). CMAM is also active in other countries, Sierra Leone, Sudan, Burkina Faso, and Ivory Coast.

The second part of your question means a lot to me, because that's also one of my responsibilities as project manager. While we're supporting this hospital, we put in place a data collection culture linked to the Ministry of Health's data collection system, because it's really important that you can't work in a country without following the Ministry of Health's guidelines. We have a specific person dedicated to collecting data. Monthly, the head of each unit in the hospital collects data, we have a defined list of items, because it depends on the level of the hospital you're managing, you don't want too long a list, otherwise you never get it filled out properly. So you simplify based on the team's experience and skill.

In the Central African Republic, and mostly at the pediatric teaching hospital, we have a specific unit led by a very skilled woman, she's responsible for collecting all the data coming from each unit into an Excel table. My role is to support her, make sure she's not facing any challenges, and that she has the data on time. Each month, we need all the data from each unit, mortality rate, morbidity rate, which conditions we're managing, split by age, split by sex, and so on.

Then, about a week later, we organize a meeting involving all the pediatricians and heads of each unit to make sure the data we have is reliable. That's what we do monthly. Then, quarterly, we have a bigger meeting with the whole hospital, nurses, general practitioners, the head of the hospital, to analyze the data, discuss what lessons we're learning, and decide what actions to take on the ground.

We've learned a lot. I remember five years ago it was a monthly meeting, but we realized the team couldn't sustain that pace, so we moved to quarterly meetings, though data is still collected monthly. At the end of each year, we have an annual report that synthesizes all the information, and we share that with donors and the Ministry of Health, what we've done through the year, what we've learned, and our perspectives for the year ahead.

Shelly-Ann Dakarai (32:03.756) To clarify, is the data person you're talking about a clinical staff member, or is this solely their role?

Franck (32:10.88) No, it's only her role. She's not a clinical person.

Shelly-Ann Dakarai (32:17.228) I think you bring up a great point, having the structure

and systems in place to support what's important. Sometimes we say data is important, and we're all doing our best, but when the frontline person is also busy caring for babies and everything else, it's hard to also be the one collecting all the pieces. So having it be systematic, a structured part of how the system runs, is a great way to support it.

Franck (33:02.334) Exactly. And that's why the pediatricians support this structure on the ground, but we have a person dedicated to this activity. Let me tell you how useful this is: in this hospital, we're shifting from totally free care to targeted free care. If we don't have our historical data, we won't be able to plan what we need, the drugs, the supplies. Without it, it's like swimming in a big ocean without knowing where you're going, and of course you can't save yourself that way. So it's important, every pediatrician, every medical doctor, should be aware that data collection is mandatory in the system they're working in.

Mbozu Sipalo (34:30.705) Yes, definitely. Data is the North Star we need to invest in to make progress, especially to meet the SDG (Sustainable Development Goal) of fewer than 12 deaths per 1,000. Thank you for sharing that snapshot of how CUAMM is working with the Ministry of Health and has hired that data collection lead. Just to explore the partnership you've built with the Ministry of Health, is the data collection person linked to both the Ministry and CUAMM, or primarily a CUAMM person? I'm curious how you liaise with the Ministry of Health to ensure synergy between the partners on data collection.

Franck (35:37.806) The lady in charge of data collection is not staff of CUAMM, she's staff of the hospital, and CUAMM supports the activity. That's important to highlight, she's not from CUAMM, doesn't have any contract with CUAMM, but CUAMM ensures the activity is running properly, because we don't want to be surprised after a few months that we don't have information about the activities. She's directly linked to the Ministry, because the Ministry has a specific department in charge of managing data collection in the country, and they have their own periodic meetings to make adjustments and collect data from each hospital.

After our quarterly meeting, we share the data with the Ministry of Health, because we also need to be aware of how we're progressing on the ground, they have their own targets, their own perspective for the country, and they need to know what each organization is doing, whether the organization is meeting the criteria or not, and what challenges and solutions are being used. We also have meetings with the Ministry of Planning about the activities. So we're not working alone, we're not working independently, our activities are linked to the country's targets. This person belongs to both the hospital and the Ministry of Health.

Mbozu Sipalo (37:57.841) Okay, that's great, that does make sense, that it's a ministry-led activity partnering with CUAMM. Another question that popped into my mind, when it comes to projects, they usually have lifespans, an end date and a start date. What does the legacy plan look like for CUAMM? How does CUAMM navigate the realities of funding and project timelines?

Franck (38:36.714) The lifespan of a project is linked to the donor, linked to funding. For example, the project I'm currently leading is funded by Italian cooperation, for three years, from 2024 to 2026. We have objectives and goals that we share with the Ministry of Health, but also with the donor, to show how we're meeting the criteria and the targets we set at the beginning of the project.

At the country level, I have my headquarters above me, and their role is to raise funds and ensure the activity keeps going. I hope that by the end of this funding, they can secure more, but that's not my responsibility. My responsibility is to lead the project on the ground, not to look for funds. Each level has its own responsibility, and I hope, since we're working in this hospital, in this country and in others, they know they have an internal system in charge of supporting the work we're doing.

Coming back to the collaboration with the Ministry of Health, that collaboration goes beyond data collection, it also involves how to strengthen the health system. Data collection supports the system, but strengthening the system itself is really important, we periodically exchange with the Ministry's team to show them how we're moving beyond data collection, how we're training staff, how we're supporting IPC, infection prevention and control, how we want to equip the hospital, how we want to support the drug supply, you can't treat a patient without drugs. So the collaboration is about managing and strengthening the system, and improving the quality of care to reduce newborn mortality.

Shelly-Ann Dakarai (41:53.922) And with that in mind, in terms of capacity building, I know there are various frameworks that systematize that kind of process. This is a good point to switch gears and talk a little bit about the NEST model. As technical advisor to the Chiesi Foundation, you're connected to the NEST model, Newborn Essentials for Survival and Thriving. Can you walk us through that framework and how it impacts neonatal capacity building?

Franck (42:45.89) Yes. NEST stands for Newborn Essentials for Survival and Thriving. This model isn't from CUAMM, it's led on the ground by the Chiesi Foundation, in a few selected Francophone countries. The Chiesi Foundation decided to focus this specific model on Francophone countries, because we have many models and diverse programs supporting Anglophone countries, so it seemed like Francophone countries were being left behind, and in global health we need to integrate all countries.

This model is a pragmatic and collaborative program with four pillars. The first is data, once more. The second is advocacy and networking. The third is training. The fourth is space.

Data is about collecting and maintaining a correct database system, learning from it, and making adjustments accordingly. Advocacy and networking aims to build partnerships with local and international institutions, when I say local institutions, I mean the Ministry of Health, academic institutions, hospitals. Through this model, the Chiesi Foundation has established partnerships with these different institutions, locally and internationally. The training pillar aims to identify any gaps and design training programs to implement and monitor outcomes. And finally, the space pillar is about reorganizing the neonatal unit to prevent or reduce infection and promote zero separation between newborn and mother.

The Chiesi Foundation is using this model in six Francophone countries: Burkina Faso, Burundi, Benin, Ivory Coast, Togo, and recently Senegal, each with a case study. Through these activities, the Chiesi Foundation supports all of these hospitals, we document the activities and share outcomes through international scientific conferences, we did this in Kigali last year, in August 2025, and we also publish evidence to show how this model can impact newborn care and reduce barriers to accessing it. It promotes equity, bringing quality of care closer to the population, that's the purpose of this model.

Shelly-Ann Dakarai (47:35.5) Thanks so much for sharing that. Like you said, capacity building creates infrastructure, you have all these pillars to consider. Thank you for sharing that specific model. I know we want to get into your work with ANA, your resume is so extensive it's hard to fit everything into one podcast, we might have to bring you back. But before we switch to that section, given your experience setting up healthcare systems and collaborating with different organizations, from the Ministry of Health to various NGOs, you've seen all levels, from top-level admin to on the ground. Do you have advice for translating things from big meetings, where people meet and have ideas, into what actually happens on the ground? Sometimes things sound like a great idea in a meeting, but getting buy-in from the people doing day-to-day care is a separate step. How do you make that translation happen?

Franck (49:07.758) I want to make sure I understand your question, do you mean how top-down and bottom-up interact and support each other, or something else?

Shelly-Ann Dakarai (49:21.344) Sorry, sometimes things happen in meetings that seem like a great idea, but they never really get off the ground because frontline workers don't see the day-to-day utility of the change. How do you translate those meeting decisions into things that actually move forward?

Franck (49:47.906) Thank you. If you don't involve the frontline staff in a decision, implementation becomes a big challenge, because they won't understand where the decision came from or what its purpose is, they won't feel like they belong to the decision. So even at a higher level, you need to put in place a system that involves the frontline staff, and communication is really important. Even if you make the decision at a high level, you need a system to communicate with them and get their feedback, because sometimes valuable input comes from the workers who are actually going to implement the decision, since you're not always on the ground yourself and can miss details. If you skip that step, challenges will occur during implementation.

So whatever decision you're going to make, in my experience, I've learned to involve all the groups who are going to implement it. Depending on how many groups there are, I find a system to make sure that, before starting implementation, I communicate with them and confirm they understand and agree with what we're going to implement. Otherwise, you're going to fail.

Mbozu Sipalo (51:55.185) Thank you for sharing that, Dr. Frank. A good reminder that you have to carry everyone along, regardless of their level of expertise, for ideas and projects to be implemented. Before we move on to ANA, I have maybe a silly question, but I was curious, what does it actually mean to be a technical advisor to the Chiesi Foundation, considering you're also project lead at CUAMM and involved with ANA? What does that mean for you practically?

Franck (52:51.79) I was waiting for this question. What's important to clarify is that I'm not working full-time with the Chiesi Foundation, I'm working full-time with Doctors with Africa, CUAMM, that's my main job, my main role. From my position as senior pediatrician and technical advisor at CUAMM, project manager, I've learned a lot, and that's helped me technically advise the Chiesi Foundation on their newborn care services.

What does it mean to be a technical advisor of the Chiesi Foundation? I'm not alone in this, and my role in this group is to advise, I'm not the one making decisions, I'm there to show them a path if they want to take it. We have a very fruitful collaboration, and I'm there to advise on any specific decision, education program, training program, research gap we identify, how to implement surveys, what we've learned from findings, and what the next steps should be, and of course, to monitor outcomes.

For example, we just conducted a survey about CPAP availability and use in ANA countries, we're going to present it in two weeks in Senegal at our next meeting. What we've learned through this survey helps us support the countries involved in NEST, and we also share our findings across ANA more broadly. The Chiesi Foundation is one of the main donors, one of the main supporters of ANA, we work closely with them, and they've supported our journal from the beginning, in March 2023, until now.

I hope that answered your question.

Mbozu Sipalo (55:48.195) Yes, and I think that'll be helpful to our listeners too. This is a good segue to the African Neonatal Association. You've touched on something important from ANA, the journal, could you share a bit about that, your role in it, and where you hope it leads?

Franck (55:56.046) The African Neonatal Association journal was created in March 2023, the first issue launched that month. It's a quarterly, bilingual journal. We created it to raise the voice of neonatology in Africa, knowing that less than 2% of published papers in neonatology include African authors, so you can imagine the disconnect, the issues are in Africa, but the researchers publishing on them are often outside of Africa.

To fill that gap, we created the journal, and when we were designing it, we agreed that financial barriers should never prevent a clinician or researcher from sharing their experience in our journal. That's why we kept the publication fees low, around 50 to 55 US dollars. It's a peer-reviewed journal, linked to African Journals Online, and we're working toward full indexing. That fee is intentionally low, to allow every author in Africa doing research or gaining experience to be able to share their work through this window.

My role is to lead the activities of the journal and stay in touch with authors, making sure they're submitting on time, addressing any feedback, and following through to publication. I think we're seeing a very positive impact from this approach. At one point, someone suggested increasing the application fee, and we said no, our goal is to keep this window open for all researchers and clinicians. That's the perspective we've chosen. I'd also like to take this opportunity to thank our editor-in-chief and all of our editorial members across the continent. Thank you.

Shelly-Ann Dakarai (59:31.618) Thank you for sharing about the journal, exciting research that's going to be published, and for lowering the bar so that information is accessible to everyone who needs it. We're getting to the end of our time together, so I wanted to ask, is there a story, maybe about a patient, that you'd be willing to share, that could inspire someone and remind us all why this work is so important? Sometimes people are ready to give up, maybe working in a situation without everything they need. Is there a story you cling to that reminds you why you do what you do, that might inspire someone else?

Franck (01:00:34.958) I have many stories, but the one that comes to mind is from my time in Chad, around 2020 to 2023. That was also a conflict context, not post-conflict. I went there to implement immediate Kangaroo Mother Care at the hospital. When I arrived, one of the challenges was the staff, the nurses and doctors at that hospital didn't embrace immediate KMC, they didn't fully understand its benefits, and they kept finding reasons to avoid it.

We communicated a lot, through literature review, through sharing our experience, and eventually they agreed to try it. Luckily, it worked out well, because we received a newborn in our unit weighing 800 grams at birth, and we started immediate KMC right away. One thing I learned is how much parents support their child's care when you involve them, when you explain things to them.

This newborn stayed in our unit for about a month, 30 to 40 days. The mother was able to call us when the monitor turned red, she knew when the readings were good and when they signaled risk. We were so excited the day we discharged that newborn, the weight was around 1,300 to 1,400 grams. When we saw that she felt confident going home, confident to breastfeed her baby, confident that her baby could survive and thrive, the staff truly understood how simple, but deeply impactful, Kangaroo Mother Care is for a premature newborn's life.

From that experience, they genuinely understood why they needed to start immediate KMC. By the end of the mission, I didn't need to insist anymore, they spontaneously knew they had to initiate it.

I have many stories from the Central African Republic too. We had children with kidney failure, and at the beginning we didn't have dialysis, we had to refer them elsewhere, some families could afford it, others couldn't, and those children died. But now we have a nephrologist, she's doing very good work, she's able to perform peritoneal dialysis, and the government now offers remote dialysis support too, so we can save those children now.

All of these situations, when you look back, you feel like, wow, we're making progress, and we need to keep working to give every newborn the opportunity not only to survive, but to thrive. That's my message to every pediatrician: continue working to give newborns the best possible start. No newborn should be born to die from a preventable disease, wherever they're born, no matter the limitations of the health setting, we need to do our best to give them that opportunity, and to give their parents a reason to smile. Thank you.

Mbozu Sipalo (01:05:59.899) Thank you for that inspiring close to our conversation. I'm sorry to add one last question, because we almost always ask this about mentorship. You have such a wonderful portfolio, and you've explored so many sides of pediatric care. Who has inspired you on this journey, from clinical care to organizational leadership? And could you end with an inspiring note for pediatricians or medical doctors, in Francophone contexts and beyond, on how they can lean into mentorship or draw inspiration from the people around them?

Franck (01:07:01.102) My inspiration comes from different sources. I used to listen to famous people like Nelson Mandela, and Oprah Winfrey, to learn from their lives, to understand how I could be useful to the people around me, wherever I am. Of course, my specific medical inspiration came from my professors in Benin. But I've shaped my life through the people I've listened to, and everywhere I go, I ask myself, how can I be useful to these people? When it comes to my professional life, I don't need to know who you are or where you're from, the only thing I have to do is make sure to save the life of your child. That's it. I'm working every day to improve the quality of care, to improve children's lives.

For younger pediatricians, that's the only advice I can give: work to save lives for children, do what you can to save a life, and be useful in your environment.

Mbozu Sipalo (01:09:27.038) Be useful, I love that. That's a good way to close this chat. Thank you, Dr. Frank, for making the time to chat with us. Before we let you go, for our listeners who want to follow your work or connect with you about CUAMM, ANA, or the Chiesi Foundation, where's the best place to find you? If they want to connect with you, would that be LinkedIn or your email?

Franck (01:10:11.053) My email, yeah, my email.

Mbozu Sipalo (01:10:13.155) Okay, great, we'll add that to our show notes. Thank you,

once again, for joining us on this call, and to our listeners, thank you for joining us on this episode of the Global Neonatal Podcast. We hope you found this conversation as inspiring as we did, we took you on a journey through so many facets of Dr. Frank's story. If any of this resonated with you, share this episode with someone else who you think would find it valuable. And if there's someone you think we should have on the podcast, we'd love to hear your suggestions. Until next time, take care, keep making a difference, and let's go further together for newborn care. Thank you.

Franck (01:11:04.28) Thank you so much for this opportunity. Thank you.