Delays in transferring sick neonates born in primary healthcare centres to hospitals with specialised care facilities are a significant contributor to preventable neonatal mortality. Yet they are notoriously difficult to address because they are fundamentally a systems problem, involving multiple stakeholders across facilities, transport services, and health authorities who must coordinate seamlessly under time pressure. 

In partnership with Airlangga University and the Surabaya City Health Office, we undertook a two-phase initiative to understand and address critical gaps in the neonatal referral system. The first phase applied a structured bottleneck analysis methodology to map barriers across the referral chain, spanning recognition of a sick neonate at the referring facility, through transport coordination, to reception at the receiving hospital. 

This evidence base informed the second phase, which is currently in progress: a Lean Six Sigma quality improvement programme engaging stakeholders across the full healthcare system, from frontline workers to health administrators. Using the DMAIC framework, the team is co-designing solutions targeting communication delays, data gaps, standardisation of the referral process, and coordination failures to ensure that sick babies are transported safely and efficiently. 

The project exemplifies our commitment to locally-owned, evidence-driven health systems strengthening, translating research into actionable improvement to build lasting institutional capacity. 

Allied health professionals play a critical role in delivering comprehensive healthcare services, yet many low and middle income countries face significant challenges in developing and sustaining an adequately trained workforce. In Cambodia, limited data on current workforce capacity and future service needs have constrained efforts to plan for the education, deployment and retention of allied health professionals. 

In partnership with the University of Health Sciences, Cambodia, this project seeks to strengthen national health workforce planning through a systems-based assessment of allied health services and workforce capacity. By examining current service provision, identifying workforce gaps, and modelling future workforce requirements, the study aims to generate evidence to support strategic investment in allied health development. 

The project combines stakeholder engagement, workforce mapping and projection modelling to understand how allied health services can better meet the evolving healthcare needs of Cambodia’s population. Working closely with academic institutions, healthcare providers and policymakers, the study will provide insights into workforce distribution, training needs and long-term capacity requirements across the health system. 

Currently in its preparatory phase, the project has focused on research coordination, stakeholder engagement and planning for in-country data collection scheduled for mid-2026. Findings will inform national strategies for allied health workforce development, supporting evidence-based decision-making and contributing to a more resilient and sustainable health system in Cambodia.