In northern Namibia, the realities of maternal and newborn care unfold far from the infrastructure of large urban hospitals. This autumn, Rohan D’Souza spent a week in the region, invited by the Namibian Obstetric Survey System (NamOSS) team to observe their work and contribute to ongoing discussions on collaborative approaches to reduce maternal and neonatal mortality and morbidity.

The visit offered a rare opportunity to see, first-hand, how smaller hospitals and birthing units deliver care in some of the country’s most remote settings – and to understand the distinct challenges each site faces. At Onandjokwe State Hospital and Rundu Intermediate Hospital, D’Souza joined clinical teams, local researchers, and health administrators in reviewing cases, visiting neonatal units, and discussing the infrastructure, staffing, and outreach needs that vary sharply from one facility to another. “Seeing the work happening in these settings changes your perspective entirely,” D’Souza reflected. “You begin to appreciate how much dedication it takes to provide consistent, high-quality care in places where geography alone can make everything harder – from data collection to the most basic logistics of transport and follow-up.”

At Rundu State Hospital, the focus turned to neonatal mortality review, site visits, and educational initiatives that engaged staff across multiple levels of the health system. Discussions explored how to strengthen mobile clinic capacity and how future partnerships might help expand access to outreach care in underserved areas.

The week also carried a collaborative dimension closer to home. Bronte Johnston, a research assistant with the FLOURISH Research Group, is currently based in Namibia, supporting research and educational capacity-building through NamOSS. Her work, like D’Souza’s visit, is part of a growing partnership aimed at strengthening local systems through mutual learning and long-term collaboration.

“NamOSS represents a model of what national audit systems can look like when they’re both deeply local and globally connected,” D’Souza noted. “Their ability to translate review into action – even in resource-constrained settings – is remarkable, and there’s much we can learn from how they sustain that momentum.”

The exchange reflects FLOURISH’s broader commitment to international collaboration – connecting research and clinical practice across countries to better understand how surveillance, review, and community-based care can together reduce maternal and newborn deaths.