#367 - 🌍 Building Neonatal Care Across Zambia: Training, Mentorship, and Impact with Jean Musonda-Chintende

Hello friends 👋

In this episode, Mbozu and Shelly-Ann are joined by Jean Musonda-Chintende, a critical care nurse and national trainer in advanced newborn care with the Ministry of Health in Zambia. Jean shares her decade-long journey in neonatal intensive care and her leadership in building and mentoring neonatal units across the country.

She discusses the process of setting up special care baby units in hospitals that previously lacked neonatal services, including assessing facility readiness, training staff, and ensuring standardized care through continued mentorship. Jean highlights partnerships with organizations such as UNICEF and Clinton Health Access Initiative that support equipment and training efforts.

The conversation also touches on the challenges of workforce retention, the importance of continuous education for nurses, and the power of recognition in maintaining morale. Jean reflects on her role in Zambia’s historic 2017 conjoined twins separation, how that experience shaped her approach to critical care, and her personal mission to reduce neonatal mortality through training and compassion.

A deeply practical conversation about scaling neonatal care in resource-limited settings and the dedication it takes to make lasting change.

----

Short Bio: Jean Musonda Chintende is a highly experienced Critical Care Nurse with over a decade of service in specialised intensive care units across Zambia’s public, private, and mining hospital sectors. She currently serves at the Women and Newborn Hospital, University Teaching Hospital in Lusaka, working in the Neonatal Intensive Care Unit. Jean holds a BSc (Hons) in Professional Practice in Critical Care from Birmingham City University (UK) and is currently pursuing a Master’s degree in Cardiac Nursing. She also serves as a National Trainer in Advanced Newborn Care under the Ministry of Health, where she leads training and mentorship programs for doctors, nurses, and other healthcare professionals across Zambia. Her clinical expertise includes neonatal resuscitation, advanced respiratory support, invasive monitoring, and the management of critically ill newborns. Jean has also contributed to multiple national guidelines on neonatal and critical care and is a published researcher in neonatal health practices. In recognition of her exceptional service, she received the President’s Insignia of Meritorious Achievement for her role in the successful separation of Zambia’s conjoined twins, Bupe and Mapalo, in 2017. Beyond the hospital, Jean is passionate about mentorship, research, and improving neonatal outcomes through training, evidence-based practice, and advocacy.

----

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

Shelly-Ann: Hello everyone, welcome back to another episode of the Global Neonatal Podcast. Mbozu, how are you doing today?

Mbozu: I'm doing well. How are you, Shelly-Ann?

Shelly-Ann: Doing great as always! I’m very excited when we have another interview to share with our listeners. Can’t wait to delve into the discussion.

Mbozu: Yeah, me too. I’m very excited to introduce today’s guest. We’re here bringing another amazing changemaker in the neonatal space, Jean Musonda-Chintende, who is a highly experienced critical care nurse with over a decade of experience in specialized intensive care across Zambia’s public, private, and mining hospital sectors.

She currently serves at the Women and Newborn Hospital, University Teaching Hospital in Lusaka, working in the Neonatal Intensive Care Unit. She also serves as a national trainer in advanced newborn care under the Ministry of Health, where she leads training and mentorship programs for doctors, nurses, and other healthcare professionals across Zambia.

In recognition of her exceptional service, she received the Presidential Achievement Award for her role in the successful separation of Zambia’s conjoined twins in 2017. Beyond the hospital, Jean is passionate about mentorship, research, and improving neonatal outcomes through training, evidence-based practice, and advocacy.

And I’ll add that the reason I’m in the neonatal space is because of nurses like Jean Musonda, who shared their learnings with me when I was in the NICU. I’m very excited to dive deep into Jean’s career story. Welcome to the podcast, Jean.

Jean Musonda-Chintende: Thank you very much for inviting me to this podcast. I’m really excited to share my experiences concerning neonatal care here in Zambia.

Shelly-Ann: We usually like to start by asking folks about their career path, and we’re going to get to that, but I just want to jump in because you have this wealth of experience, and I want to make sure we can go through and learn a little bit about the work that you do. So I wanted to start by asking about your role as a national trainer in advanced neonatal care with the Ministry of Health. Can you tell us a little bit about what that role entails and about the type of education that is being done for the neonatal workforce across Zambia?

Jean Musonda-Chintende: Thank you for that question. Yes, I’m a national trainer in advanced newborn care and essential newborn care. There’s another training package that we recently developed, which is the preterm baby care bundle for Zambia.

I conduct training in newborn resuscitation, stabilization, and self-transfer of the neonate. We have a standard training package that we use for the entire country. For new nurses, newly qualified nurses, and doctors (including students) we train them using the same package developed by the Ministry of Health. This training is done nationwide because most hospitals have neonatal units, and the number of babies requiring these services is significant. That’s why we ensure a standardized approach to patient care. Previously, Zambia didn’t have any formally trained neonatal nurses. Now, however, there’s specialized training for neonatal nurses. Our units used to comprise midwives, critical care nurses, pediatric nurses, and general nurses, but we now have nurses being trained specifically in neonatal nursing.

Personally, I’m a critical care nurse with vast experience in the neonatal unit. When the Ministry of Health introduced these packages, we were first trained by a team from the UK in neonatal resuscitation. Back then, we used the UK algorithm because Zambia didn’t yet have its own neonatal resuscitation protocol. After that training, we began training healthcare providers across the country. Most hospitals do have neonatal units. Some have smaller special care baby units where they stabilize infants before transferring complicated cases to higher levels of care.

Shelly-Ann: I know part of your role with the Ministry of Health also involves helping to set up neonatal units. You’ve talked a bit about the education and training for nurses and providers caring for newborns. I’m curious about your experience with setting up a NICU where one didn’t exist before. Is there a roadmap? Do you start with certain steps, or does it vary depending on the region or hospital type? Can you walk us through what that process looks like when building a special care unit in a hospital that may not have had one before?

Jean Musonda-Chintende:The first thing we did was conduct an assessment across the country to find out how many hospitals had neonatal care units. We identified several gaps. Some hospitals didn’t have a neonatal unit at all. They had postnatal units where sick babies were kept alongside their mothers, which made monitoring very difficult.

After identifying these gaps and recognizing that neonatal mortality was very high, we realized we needed to prioritize newborn care. We began planning so that every district hospital, whether rural or peri-urban, could have at least a basic neonatal or special care unit to start with something. The first step is identifying space, ideally close to the delivery room for easy transfer of newborns. Then we identify healthcare providers who will lead the neonatal unit and train them in advanced newborn care.

We have two training packages: Essential Newborn Care, for well babies, and Advanced Newborn Care, for sick or preterm infants. We also noticed that transfers weren’t being done properly, so we emphasized training in safe neonatal transport.

We established a policy for every hospital and health facility to have both a neonatal unit and a kangaroo mother care (KMC) unit. Once we identified a suitable space, we worked with hospital management to plan and prepare the unit. Our team (comprising nurses, doctors, and an anesthetist) would travel to the site for about seven days to help set up and operationalize the unit. We would rearrange equipment, align procedures with national neonatal protocols, train staff, and admit the first few babies together with the team to demonstrate hands-on care. We also identified a key person to oversee the unit after we left.

After the initial setup, we continued mentorship remotely and through follow-up visits. We also invited nurses from those facilities to spend time in our tertiary neonatal unit so they could gain experience caring for critically ill newborns. All the units we’ve helped establish are functional, and we’ve seen real improvements with better quality of care and a reduction in neonatal mortality.

Mbozu: Thank you, Jean, for giving us that roadmap to setting up neonatal units through your training and leadership. It's very motivating and inspiring to hear about the work that you're doing. I wanted to dive deeper into the mentorship that you give to the sites you’ve set up. Could you explain how you do that? I can imagine that many of the sites are rural and far from where you’re based. So how do you sustain that mentorship? And could you give an example of sites that you’ve continued to mentor after setting up their NICUs or neonatal units?

Jean Musonda-Chintende: We have partners that support the UN programs, such as UNICEF and the Clinton Health Access Initiative (CHAI). They fund these programs, covering logistics and supporting the sites. For example, in Eastern Province, Chipata Central Hospital originally had only a small room for neonatal care, but now they have a larger, well-equipped unit. These partners supported them with essential equipment such as bassinets, resuscitaires, infusion pumps, and other items needed for the unit to function. That’s a very important component, because when we assess a unit, we look not only at staff skills but also at available equipment. You can train someone well, but without the right tools, they can’t perform effectively.

After equipment support, we conduct a five-day training in advanced newborn care, which includes both theory and hands-on practical sessions. Once trainees are confident, the training is followed up with mentorship. This is an on-site mentorship, where experienced mentors go and work alongside nurses and doctors in their own units to ensure the standard of care is consistent across the country.

Mentorship isn’t a one-time event, it’s ongoing. After each mentorship visit, we identify remaining gaps, make recommendations, and plan the next steps. In some cases, we bring nurses from these hospitals to the Women and Newborn Hospital in Lusaka, which is a tertiary facility, so they can gain more experience through observation and practice.

We also make sure they have learning resources, including the presentations we use in training, so they can continue reviewing material afterward. We stay available for questions even when we’re not on-site, leaving them with our contact information so they can reach out for guidance when needed.

Shelly-Ann: That’s huge, because being able to go into a place for such a short period of time and get everything set up and educate staff is remarkable, but having that ongoing mentorship afterward makes such a difference. To be successful, you need not only knowledge and skills, but also a sense of connection and knowing who you can call when you have a question. That kind of support helps build momentum rather than letting things drop after a training visit. Thank you for sharing that. It’s pretty remarkable, and I’m sure some of our listeners might be getting ideas from your process.

I wanted to ask a little about your main NICU in Lusaka. Could you tell us about that NICU and the kind of care provided there?

Jean Musonda-Chintende: I work at the Women and Newborn Hospital Neonatal Intensive Care Unit, which is a tertiary hospital. This means that all complicated cases from across the country are referred there. We have three labor wards, so even mothers with high-risk pregnancies deliver at our facility, and many of their babies are admitted to the NICU, often with asphyxia or other complications.

We have a very high patient turnover. On average, we care for between 80 and 100 babies each day, most of whom are critically ill. Around 60% of them are preterm neonates, often due to maternal complications like preeclampsia and eclampsia. We also manage many asphyxiated babies for the same reason. In terms of care, we provide full neonatal resuscitation and respiratory support. We currently use bubble CPAP systems for continuous positive airway pressure because we lack mechanical ventilators. Equipment shortages are one of our biggest challenges. However, we do provide mechanical ventilation where possible.

For preterm babies, we implement the preterm care bundle, which includes skin-to-skin care, early feeding, surfactant administration, caffeine citrate for apnea, and developmental supportive care. For babies with jaundice, we provide phototherapy.

Due to our high patient numbers, we also have an extended unit: a Kangaroo Mother Care (KMC) Unit with 35 beds, which is always full. So, at any time, we might have 35 babies in the KMC unit plus around 100 in the NICU. If a baby’s condition changes, they are moved back to the intensive unit for closer monitoring.

Staffing, however, is a major challenge. Sometimes we have only eight nurses caring for over 100 babies, which is very difficult. To help with this, we’ve set up KMC satellite units at nearby first-level hospitals that refer patients to us. Once we stabilize babies, we can transfer them back to these satellite units, helping to decongest the NICU.

Mbozu: Thank you, Jean, for that tour of your NICU. You’ve brought back memories of my own time there! It truly is a very busy unit, and caring for over 100 babies with only eight nurses and limited doctors is incredibly demanding. I’d like to explore the topic of the neonatal workforce. Can you tell us more about the workforce in your NICU? We know there’s a challenge in retaining skilled nurses and encouraging them to stay in neonatal care. As someone who’s also part of the Nursing Council in Zambia, could you share your thoughts on how to empower, motivate, and retain neonatal nurses?

Jean Musonda-Chintende: Thank you for that. Yes, it’s a huge challenge managing so many patients with so few staff. As I mentioned earlier, our team includes pediatric nurses, critical care nurses, midwives, and general nurses.

For the general nurses, when they first join the unit, we provide extensive orientation and continuous mentorship so they can function confidently. We have a shortage of midwives because most are assigned to labor wards, so we rely heavily on mentoring general nurses in neonatal care.

When new nurses join the hospital, they’re asked where they’d like to work—whether with neonates or adults—so it starts with interest. If they choose to work with babies, we bring them into the NICU and mentor them thoroughly.

Retention is very important because training and mentoring NICU nurses is expensive and time-consuming. In many hospitals, nurses rotate between wards every three to six months, which disrupts care. Each time a new team comes in, mortality and sepsis rates rise, because they’re inexperienced. At the Women and Newborn Hospital, we’ve stopped nurse rotations in the NICU. Once a nurse is trained for neonatal care, they stay in that unit. In other facilities, we advocate to the Ministry of Health that trained neonatal nurses should not be transferred out of the NICU.

Motivation is also key. Even with long hours and heavy workloads, you’ll often see nurses smiling. Simple recognition—just saying “well done” or giving a pat on the back—goes a long way. What truly keeps us going, though, is seeing the impact of our work.

When we treat critically ill babies—sometimes 800-gram or 1-kilogram preterm infants, twins, triplets, or even quadruplets—and later see them healthy and thriving, it’s incredibly rewarding. Parents come back to visit or send us photos, and it’s especially touching when it’s a “miracle baby” after years of infertility. That joy keeps us motivated.

Ongoing mentorship also plays a big role in keeping nurses confident and supported. When nurses feel they have knowledge, skills, and backing from mentors, they’re much less likely to feel isolated or demotivated.

Shelly-Ann: We had one guest who said, “We have the privilege of taking care of these babies,” and that is so true. It’s really an honor to be part of these families’ lives during such a short but intense time. It’s a joy to see them go home and to see those happy families.

You mentioned, as you were talking about the NICU and the care you provide, that it made me think of the award you received for being part of the team that successfully separated conjoined twins in 2017. I feel like this might be a good spot to talk about that. Can you tell us a little about your role in that case, whatever details you’re able to share?

Jean Musonda-Chintende: When you mentioned the award, yes, I received a Presidential Award for Meritorious Achievement from the President of Zambia. This was after we cared for conjoined twins who were admitted to our unit when they were just two days old. We looked after them for an entire year before they were discharged.

Before the surgery, we held numerous multidisciplinary planning meetings to prepare for their care. My role was to ensure that nursing care was well-coordinated and that the most experienced nurses were assigned to the twins. I led the nursing team for their care.

When the time came for the operation, I was in the theater as well, and I stayed at their bedside throughout the first night after surgery, monitoring them closely. Once they stabilized, we continued to care for them in the unit until they were ready to return home to the northern part of the country, and I was part of the team that accompanied them for repatriation. The surgery was a huge event. It drew attention from the public, the media, and the government. The Ministry of Health was very supportive and provided everything needed for the procedure.

It was a total surprise when I received a letter saying I was to go to State House to receive an award. The selection was done independently, not by our hospital. I didn’t do it for recognition; we were deeply bonded with those babies and just wanted them to survive. It was an incredible moment of teamwork and history-making for Zambia.

Mbozu: Thank you, Jean, for sharing that milestone and the story behind your award for the separation of those twins. I can imagine it was your critical care nursing expertise that brought you into that room to care for those babies. I’m curious, what made you decide that critical care nursing was your calling? Why did you choose that as your area of focus within neonatal and other intensive care spaces?

Jean Musonda-Chintende: After completing my general nursing training, I had a personal experience that changed my path. Someone close to me fell ill and was taken to the hospital. During their examination, the healthcare provider was writing notes and taking history but hadn’t actually touched the patient. Another provider walked by and noticed that the patient wasn’t breathing, and that’s how my relative died, right there in the chair.

That moment stayed with me. I thought, I wish I had the knowledge or skills to intervene. I was just a general nurse then, but I knew I needed to learn more—how to assess, act quickly, and save lives. That’s when I decided to specialize in critical care nursing.

During my training, I learned advanced life support, anesthesia, intubation, and mechanical ventilation. During my training I had to decide which anesthesia to give, I intubated over 50 patients, and monitored and resuscitated critically ill patients. I wanted to be hands-on and confident with life-saving equipment.

That training made neonatal care much easier for me. If I could intubate an adult, managing an infant airway or giving surfactant to a preterm baby came naturally. I wanted to go beyond routine nursing—assessing, identifying problems, and intervening decisively.

For me, every patient matters. I’ve always said: no patient should die under my care if there’s something preventable I can do. If I’ve done everything possible and the patient still doesn’t make it, then at least I know I gave my best.

Shelly-Ann: It sounds like that heartbreaking experience really pushed you to develop the skills to make a difference, and now, you’re doing just that. Working with the Ministry of Health and improving neonatal care across Zambia is such inspiring work. Thank you for sharing that personal story and for reminding us that each of us can make a difference in our own way.

Do you have any advice for someone who wants to improve neonatal care in their own setting, maybe at their hospital or in their region, but doesn’t know where to start?

Jean Musonda-Chintende: First, to work in a neonatal unit, you must have the interest to serve. You need to understand what you want to achieve and have compassion. Parents come to us desperate to save their babies. When we act swiftly and do the right thing, we make a real difference in their lives.

Let me give an example: if you don’t resuscitate a baby properly, that baby could end up with cerebral palsy. Sometimes families break apart because of the challenges that follow. But if you act quickly and save that baby, you’re also saving that family.

You want to send parents home with smiles—with both their baby and their suitcase full of clothes. Not just the clothes. That’s the difference we strive to make every day.

We also aim to make a difference at the national level. Our neonatal mortality rate used to be around 24 per 1,000 live births in 2020–2021, then rose to 27. But through training, mentorship, and strengthening neonatal systems, we’ve now reduced it to around 17 per 1,000. That’s real progress. It’s all about making a difference: one baby, one family, one country at a time.

Mbozu: On that lovely note, thank you so much, Jean, for sharing your story and your insights. We usually like to ask our guests how listeners can connect with you. Do you have a LinkedIn or email?

Jean Musonda-Chintende: Yes, they can connect with me on Facebook—just search for my name, Jean Chintende. You can also reach me on Messenger or find me on LinkedIn under the same name.

Mbozu: Thank you so much, and thank you to our listeners for joining us for another episode of the Global Neonatal Podcast. We hope you’ll share this interview within your networks as we continue working together to advance newborn care. See you in our next episode.