Exploring Zero Separation in Tanzania and Ethiopia

Zero Separation is an emerging care practice, an approach to healthcare aimed at ensuring that mothers and newborns are not separated after birth unless absolutely necessary for medical reasons. It is rooted in evidence showing that uninterrupted physical proximity between mother and baby during the immediate postpartum period is crucial for both short-term and long-term health outcomes.

The newly renovated Neonatal Intensive Care Unit (NICU) at Hawassa Referral Hospital in the Sidama Region, Ethiopia.

What we did

From 9 to 13 December, the Institute for Healthcare Improvement (IHI) and MASS Design Group travelled to Tanzania, followed by a visit to Ethiopia from 16 to 19 December, based on a recommendation from the Gates Foundation. The purpose of these trips was to gain deeper insights into the implementation of iKMC (immediate Kangaroo Mother Care) and Zero Separation in these two country settings.

In Tanzania, the team collaborated with Newborn Essential Solutions and Technologies (NEST360)’s country office to visit four facilities across two regions—Dar es Salaam and Kilimanjaro. In Ethiopia, the team partnered with Saving Little Lives 360 (SLL360) to visit five facilities in the Oromia and Sidama regions. These visits provided a comprehensive understanding of the state of newborn care and iKMC, the progress made by the respective country offices, and potential opportunities for future improvements, including plans for piloting iKMC in Tanzania and scaling its implementation in Ethiopia.

Representatives from the Institute for Healthcare Improvement (IHI) and MASS Design Group met with the Saving Little Lives (SLL) 360 team in Addis Ababa, Ethiopia, in December 2024.

Next Steps

To support the rollout of Zero Separation, we are in the process of updating our Design Principles document to include recommendations for designing newborn care spaces that facilitate zero separation. We are excited to continue working with stakeholders to further this initiative, advocate for Zero Separation, and support its implementation.