Milestones

Saving Newborn Lives in Tanzania
Each year, over 3 million newborn and stillborn children are lost worldwide—many in Sub-Saharan Africa, where limited resources and preventable complications make survival difficult. In Tanzania, newborn deaths accounted for a third of all child mortality, yet many went unrecorded, hiding the true scale of the crisis.

Our aim has always been to change this narrative. Most notably, Dr. Swanson and his Tanzanian colleagues made dramatic improvements in the NICU setting at Arusha Lutheran Medical Center using evidence - based, innovative models of neonatal care appropriate from limited income settings. More than 90% of all babies including extremely premature babies weighing less than 2.2 pounds or 1,000 grams now survive in this NICU setting.

A Brief Summary

2013 - A Humble Beginning
In 2013 we had a small, under-equipped NICU with high mortality rates and few trained staff. Most care was provided by rotating junior doctors and nurses, making it hard to build the expertise needed for fragile newborns.

2014 - Transforming Care Through Teamwork

Focusing on nurses as the foundation of neonatal care. Nurse rotations ended, and experienced volunteers from abroad partnered with Tanzanian staff to build skills, trust, and teamwork. Nurses were assigned specific babies, joined daily rounds, and became key decision-makers.
Doctors received long-term mentorship focused on critical thinking, collaboration, and bedside learning. This supportive environment helped several junior physicians become pediatric specialists, with more on the way.
Parents became active participants in care—providing skin-to-skin contact (kangaroo care), learning feeding techniques, and communicating directly with the medical team. This family-centered approach built trust and improved outcomes.

These changes helped us achieve a 92% survival rate for preterm and critically ill newborns in our NICU—proof that with the right care, even the most vulnerable lives can be saved.

2021 - The first edition 'Every Breath Counts' Handbook
Swanson's team of Tanzanian doctors and NICU nurses became highly sought after as educators and healthcare workers in neonatology, demonstrating that small, premature infants weighing as little as 650 grams (1.4 pounds) could routinely survive and thrive in a low-income African NICU.

To share ICHA's expertise, Dr. Swanson and his team developed a locally published handbook titled Every Breath Counts, Manual of Neonatal Care & Drug Doses. Authored by Dr. Swanson and his team, this 400-page NICU handbook furnishes foundational protocols to conference participants, further enriching their learning experience. The handbook has gained broad recognition across Africa and is currently in its third edition.

If you would like to purchase this book or inquire further, please fill out an information request.

2021 - The inaugural Tiny Feet, Big Steps (TFBS) Neonatology Conference

The conference was developed to meet the escalating demand for evidence-based neonatology training, focusing on low-cost, low-tech interventions to enhance the survival and neurodevelopmental outcomes of premature and critically ill newborns in East Africa.
Uniquely co-training physicians and nurses, the conference has a strong emphasis on innovation, clinical proficiency, and actionable healthcare strategies.
Since the inception in 2021, 657 healthcare professionals have been trained, from 159 hospitals across 27 countries (20 in Africa).

2023 - We released the 2nd edition of our Every Breath Counts Handbook
To date, this book has been sent to nearly 250 hospitals in 25 African countries.

2024 - The fifth Tiny Feet, Big Steps Conference
In 2024, 292 healthcare individuals attended from 110 institutions across 22 countries, offering a diverse array of over 90 unique lectures and advanced skills workshops facilitated by 50 esteemed instructors hailing from academic institutions spanning 13 countries. More: Tiny Feet, Big Steps

2025 - Tiny Feet, Big Steps Conference in Ethiopia
For the first time, our Tanzanian conference will extend beyond Tanzania, with Ethiopia hosting this year’s event (December 2025). And we’re excited to share that Uganda and Ghana are planned hosts in 2026.

2024 Tiny Feet, Big Steps Conference, Arusha, Tanzania