1. Delivering low-cost, high impact neonatology services of premature and hospitalized newborns in our partner NICUs:

• Arusha Lutheran Medical Centre (ALMC) NICU.
• Kivulini Hospital / Maternity Africa NICU (providing ICHA physicians).
• Potential new hospital relationships ICHA is fostering.

 2. Providing specialty outpatient and inpatient pediatric care through the:

• Arusha Pediatric & Maternal Care Centre (APMC Centre) - a first ever dedicated specialty centre for outpatient care of infants, children, adolescents, and pregnant women.
• Arusha Lutheran Medical Centre (ALMC) pediatric ward and clinics. 

3. Mentoring doctors and nurses in pediatrics

• 7 Tanzanian doctors and 20 NICU nurses are currently supported by ICHA. 
• 4 doctors in international residency programs (Kenya, South Africa, USA) that ICHA has helped reach this stage of training.
• Teaching at Pediatric Association of Tanzania and other venues. 

4. Training NICU physicians & nurses through Tiny Feet Big Steps (TFBS) Neonatology Conferences

• Uniquely co-training physicians and nurses, with a strong emphasis on innovation, clinical proficiency, and actionable healthcare strategies. 
• Leading the largest African Neonatology Conference in Arusha, Tanzania.
• Expanded to Ethiopia, Dec. 2025.
• Exploring expansion opportunities at the request of other countries.
• Resourcing medical staff with our Every Breath Counts Manual of Neonatal Care & Drug Doses, 3rd Ed: a 440-page neonatal care handbook offering evidence-based protocols, drug dosing, and NICU procedures for low-resource settings. It’s been distributed to nearly 250 hospitals across 25 African countries, serving as a key training tool to improve newborn survival.

Learning Through Experience & Developing a Model NICU
Over more than a decade the ICHA Neonatal Intensive Care Unit (NICU) team at Arusha Lutheran Medical Centre (ALMC) transformed the hospital's NICU to offer ​amongst the highest level of care available in Tanzania, with survival rates rarely seen in East Africa:

• improving the survival rate of the babies in their NICU from 77% in 2014 to 92% in 2021. 
• survival of preterm babies weighing <1000 grams (2.2lbs) and at least 26 weeks gestation increased by 4-fold to 85%. 

A research paper was published in the journal Frontiers in Pediatrics detailing the approach and outcomes: Every breath counts: Lessons learned in developing a training NICU in Northern Tanzania

Dr. Swanson and his team found that using this approach can achieve a high survival rate among critically ill and preterm neonates in limited income environments without the use of expensive, advanced-skill technologies like mechanical ventilators. 

Sharing our NICU Practices
Our 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.

We focus on teaching our low-technology, low-cost solutions to the challenges of infant thermoregulation, respiratory support, neonatal feeding and nutrition and infection control / prevention measures.

​Dr. Swanson and/or his team have traveled to Greece, Thailand, Mongolia and across East Africa at the request of partner hospitals and institutions to train and teach other NICU physicians and nurses.

The Tiny Feet Big Steps Conference has grown to become the largest neonatology conference in Africa and expanded to Ethiopia (Dec. 2025), with plans to expand to Uganda and Ghana in 2026.