Advancing Neonatal Care in Northern Pakistan: A Sustainable, Scalable, and Resilient Approach – Ismaili Health Professionals Association USA

In Northern Pakistan, where access to neonatal intensive care is critically limited, a dedicated team has supported the development of a Level II-III Neonatal ICU. This initiative is designed to reduce neonatal mortality and enhance care quality, addressing staggering global statistics—premature birth complications remain the leading cause of death among children under five.

Building a Sustainable Neonatal Microsystem

The project began with the admission of its first NICU patient in January 2022. Since then, a multi-pronged evaluation and planning approach has laid the foundation for a self-sustaining and scalable microsystem, ensuring lasting improvements in neonatal health. Through a collaborative partnership between AKHB USA, IHPA NICU Team, and AKH Gilgit a rigorous 5P Microsystem Assessment was conducted — first remotely, then validated in person in July 2023.

Implementation Highlights and Achievements

Remote Support: Case reviews, procurement of advanced NICU equipment, and establishment of neonatal care scope of practices, policies, and guidelines.
Comprehensive Training Programs: Breastfeeding education, neonatal resuscitation, S.T.A.B.L.E., Early Warning Signs in Newborns and Postpartum Mothers, Bubble CPAP management, and Neonatal Respiratory Therapy Training.
Capacity Building Site Visits: Strengthening healthcare team expertise and fostering public-private partnerships for establishment of quality standards.
Quality Improvement Initiatives: Multi-site projects improving breastfeeding education, antenatal counseling, family-centered care, respiratory therapy proficiency training, and Kangaroo Mother Care affordability strategies.
NICU Development & Scalability: Built for scalability, with an initial 8-bed design, the neonatal ICU is actively operating as a 6-bed NICU, including 4 high-dependency neonatal ICU beds to ensure specialized treatment for critically ill infants, adhering to global ICU standards.
Empowering Healthcare Team to Provide Innovative and Affordable Care: The team championed two transformative neonatal care practices:
- Introducing oral immune therapy using early maternal breast milk to strengthen preterm infants’ immunity.
- Establishing a Kangaroo Mother Care Unit to support continuous skin-to-skin contact, promoting infant growth, early discharge, and affordability.
Global Collaboration & Lasting Impact: 17 clinicians and other members of the team from AKHB USA remotely support the AKH Gilgit NICU, contributing expertise to advance neonatal ICU care.

Today, the IHPA NICU Team remains actively engaged, ensuring access to affordable, high-quality neonatal care. Beyond medical advancements, this initiative fosters a community-driven, patient-centered approach that will transform neonatal health across the region for years to come. Both personally and professionally, this experience has been giving us far more than we have contributed. Professionally, it has challenged us to refine the timing of diagnostic evaluations, balancing affordability with clinical precision. This approach has enabled the development of a standardized yet individualized treatment model for vulnerable preterm infants while easing financial strain on families.

On a personal level, we are profoundly touched by the heartfelt generosity of people we had never met before. Their kindness—offered in countless ways—continues to strengthen our sense of unity and belonging. Through this journey, we have felt the deep, enduring connection of the global jamat—a priceless gift from our imams.