Zero Separation workshop in Senegal during MSF Paediatric Days

Zero Separation helps us to create the best possible conditions for mothers and babies to receive care together, starting from birth. While ensuring zero separation comes with many challenges, the concept offers MSF ample opportunity to improve the quality of care we provide to some of our most vulnerable patients. 

On November 29th and 30th, MSF Sweden Innovation Unit (SIU) organized a two-half-days' workshop focused on designing and exploring innovative solutions on the topic of Zero Separation in Dakar, Senegal. In this article, we share insights into the event and look at some of the early outcomes.  

What is Zero Separation?  

The current gold standard of neonatal care leads to the separation of mother and baby if the newborn is sick. The infant is taken from their mother, and brought to an intensive care unit where they receive high-quality and life-saving care.  

However, there is mounting evidence that shows the significant, positive effects of ensuring close contact between babies and their parents including decreased neonatal mortality, increased bonding, decreased maternal stress and anxiety and increased rates of breastfeeding.  

MSF is interested in implementing new strategies where the mother and baby dyad are cared for together from birth to discharge from hospitalization. These new strategies fall under the framework of Zero Separation and will aim to ensure that the moments where babies and their mothers (fathers/caretakers) are separated are kept to a minimum. 

MSF sees this as a person-centered approach to care which will eventually reduce newborn death and promote breastfeeding. 

Zero Separation Workshop in Dakar, Senegal 

During this year’s MSF Paediatric Days, the MSF SIU team organized a workshop on the topic of Zero Separation, which was validated by the MSF Pediatric working group. Over the course of two sessions, 16 people from both MSF projects and HQs came together to dive into the topic. Participants brought with them a wealth of experience in medicine, paediatrics, nursing, training, health promotion and maternal and child health care.    

Prior to the workshop, the MSF SIU team conducted 12 stakeholder interviews to learn about the history of Zero Separation and how it fits into MSF strategic vision for neonatal and maternal and child health care. The SIU spoke with people from different backgrounds in MSF to gain different perspectives about the benefits and the challenges of implementing Zero Separation strategies in MSF project locations. 

Participants for the workshop were selected based on their interest, field of work and their physical presence in Dakar for this in person workshop. 

Together with an external design firm, a workshop methodology was created to lead participants through eight hours of activities to brainstorm around the current challenges faced in this space and to consider potential implementation strategies 

A first step Zero Separation in MSF  

Participants were encouraged to think outside the box and be creative in their solutions and that further development of ideas would come later, and our team repeatedly made it clear that the workshop only constituted the first of many steps required to address challenges related to Zero Separation.  

The entire process brought many new learnings on this topic – as well as confirmed already identified insights and areas of priority. Initial stakeholder interviews highlighted clear barriers to implementing Zero Separation strategies including the lack of awareness of the topic, cultural barriers in many of the communities where MSF works as well as within our own medical teams, the need for new medical management processes, construction, and logistics to allow for babies and mothers to be kept together and an overall need for training of all those impacted by a change in the model of care. 

With these barriers in mind, participants considered potential solutions, including community training packages, such as a community radio station, skits and shows highlighting the need for this type of care. Furthermore, participants explore the creation of mother-baby care packages starting already from pre-natal care to discharge planning and discussed the ideal infrastructure requirements to achieve this goal. 

What’s next? 

We are just days after the workshop, so the current priority is to synthesize all the work done and to share the final output with all the participants. Ideally, we will be able to highlight several potential solutions that could be further explored together with key stakeholders and/or project teams. We aim to share more insights from this workshop together with a short video about the event on the SIU website in early 2023, along with a conceptual road map. Our aim is to help raise awareness and continue to build momentum within and beyond MSF so that we can approach the topic more systematically and ensure the implementation of practices promoting and enabling Zero Separation. 

The MSF SIU wishes to send a big thank you to all collaborators and participants who made this event possible, the wide range of creative solutions developed during the event show the power of bringing people with diverse expertise together to work on shared solutions for the benefit of our patients, their families, and their communities.