Dr James H. Cross

Research Fellow

London School of Hygiene & Tropical Medicine
Keppel Street
United Kingdom

James H. Cross is a Research Fellow of Infectious Disease Epidemiology within the NEST360 Alliance and co-leads the Healthcare-Associated Infection Interest Group at the London School of Hygiene & Tropical Medicine (LSHTM). With a background in clinical microbiology and data science, James specialises in neonatal health in low- and middle-income countries.

His research is dedicated to identifying practical strategies to decrease neonatal infections by integrating clinical, health data science, and health systems-based research. James is particularly interested in enhancing clinical bacteriology services (e.g., blood culture and point-of-care sepsis diagnostics), antibiotic stewardship in high-burden environments, and reducing neonatal hospital-acquired infections, antimicrobial resistance, and mortality.

Within his leadership positions at LSHTM, James co-directs the NEST360 Infection Workstream and the associated NEST360/UNICEF Implementation Toolkit Health System Building Block. In this capacity, he supports the improvement of infection prevention, detection, and control across 67 newborn units in Malawi, Tanzania, Kenya, and Nigeria. James has also co-led the co-design and operationalisation of the NEST360 Neonatal Inpatient Dataset within these facilities, facilitating real-time data flow and analysis from over 120,000 newborn admissions annually for the NEST360 Quality Improvement Facility Dashboard.

James holds a BSc. Hons. in Medical Microbiology with a Year in Industry (MRCG at LSHTM) from the University of Bristol (2015) and a PhD in Epidemiology & Population Health from LSHTM (2020). James' LSHTM/Bill & Melinda Gates Foundation sponsored PhD studentship, conducted over five years at MRCG in The Gambia, culminated in a thesis titled "Iron and Infection: Neonatal Iron Transition". This work explored the immunological response of hepcidin-mediate hypoferremia in the early hours of postnatal life in full-term, preterm and low birthweight newborns.


Department of Infectious Disease Epidemiology and International Health
Faculty of Epidemiology and Population Health


Centre for Maternal Adolescent Reproductive & Child Health
Antimicrobial Resistance Centre


At LSHTM, James plays a role in teaching various aspects of epidemiology and medical statistics.

One of James' key responsibilities is acting as a short course organiser, tutor, and lecturer for the Introductory Course in Epidemiology Medical Statistics (ICEMS).

In addition, James co-leads the organisation and tutoring of the MSc Summer Project Data Management Short Course. Furthermore, he actively participates in teaching practical sessions and grading assignments for several MSc modules, such as Design and Analysis of Epidemiological Studies (DANES) and Basic Epidemiology. Moreover, he serves as a personal tutor for MSc Public Health for Development (LSHTM) and as a marker for Infectious Disease Distance Learning MSc projects.

James has supervised numerous MSc students during their LSHTM MSc Summer Projects. This work has led to the development of two publications. James welcomes further MSc students interested in projects related to neonatal infections or antibiotic use to reach out for potential collaboration.

Furthermore, James has previously supervised BSc (Year in Industry), MSc, and M.D. students from the University of Cardiff (UK) and Mercer University (US)

As an educator, James has earned the Postgraduate Certificate in Learning and Teaching (PGCILT) Module 1 and achieved Associate Fellow of the Higher Education Academy (AFHEA) status. He is currently pursuing PGCILT Module 2.


James' current research centres on the NEST360 (Newborn Essential Solutions and Technologies) Alliance, a multi-partner collaboration across four African countries (Malawi, Kenya, Tanzania, and Nigeria). The alliance aims to innovate, implement, and evaluate a comprehensive package to improve hospital care for small and sick newborns in Africa.

As a Research Fellow, James supports vital components of a complex evaluation, focusing on mortality and health systems analyses to enhance care for small and sick newborns in 67 newborn units in Malawi, Tanzania, Kenya, and Nigeria.

As co-lead of the NEST360 Alliance Infection Workstream, Internal and External Groups, James' primary focus is knowledge generation and quality improvement. This encompasses the quantitative and qualitative use of neonatal blood culture (within the ward, laboratory, and interface), antibiotic stewardship, and outbreak detection (including aetiology and AMR) in all units implementing the NEST360 Alliance.

As a data scientist, James has also spearheaded the co-design and institutionalisation of a core neonatal inpatient dataset. This dataset includes essential variables for measuring impact, quality of care, and facility course correction. Utilising the NEST360 Neonatal Inpatient Dataset and its associated outputs (i.e., dashboards) enables the identification of critical system changes necessary to improve newborn health and survival. In addition, this information allows for optimising the NEST360 bundle for implementation and scale-up, as well as enhancing the NEST360 clinical and technical training programmes.

James is also a member of the Maternal and Newborn Health Group, Surveillance and Epidemiology of Drug-resistant Infections Consortium (SEDRIC), FIND Neonatal Sepsis Diagnostics Group, co-lead of the LSHTM REDCap User Group, and a previous PhD student representative (2016-2019) for the Antimicrobial Resistance Centre (LSHTM).
Research Area
Clinical care
Clinical databases
Drug resistance
Global Health
Innate immunity
Neonatal health
Perinatal health
Molecular biology
Complex interventions
Health outcomes
Public health
Electronic health records
Disease and Health Conditions
Hospital acquired infection
Infectious diseases
Sub-Saharan Africa (all income levels)
Sub-Saharan Africa (developing only)

Selected Publications

Quantifying health facility service readiness for small and sick newborn care: comparing standards-based and WHO level-2 + scoring for 64 hospitals implementing with NEST360 in Kenya, Malawi, Nigeria, and Tanzania.
PENZIAS, RE; Bohne, C; Gicheha, E; Molyneux, EM; Gathara, D; Ngwala, SK; Zimba, E; Rashid, E; Odedere, O; Dosunmu, O; Tillya, R; Shabani, J; CROSS, JH; Ochieng, C; Webster, HH; Chiume, M; Dube, Q; Wainaina, J; Kassim, I; Irimu, G; Adudans, S; James, F; Tongo, O; Ezeaka, VC; Salim, N; ... With the Health Facility Assessment Data Collectio,
BMC pediatrics
Health facility assessment of small and sick newborn care in low- and middle-income countries: systematic tool development and operationalisation with NEST360 and UNICEF.
PENZIAS, RE; Bohne, C; Ngwala, SK; Zimba, E; Lufesi, N; Rashid, E; Gicheha, E; Odedere, O; Dosunmu, O; Tillya, R; Shabani, J; CROSS, JH; Liaghati-Mobarhan, S; Chiume, M; Banda, G; Chalira, A; Wainaina, J; Gathara, D; Irimu, G; Adudans, S; James, F; Tongo, O; Ezeaka, VC; Msemo, G; Salim, N; ... With the Health Facility Assessment Technical Cont,
BMC pediatrics
Neonatal inpatient dataset for small and sick newborn care in low- and middle-income countries: systematic development and multi-country operationalisation with NEST360.
CROSS, JH; Bohne, C; Ngwala, SK; Shabani, J; Wainaina, J; Dosunmu, O; Kassim, I; PENZIAS, RE; Tillya, R; GATHARA, D; Zimba, E; Ezeaka, VC; Odedere, O; Chiume, M; Salim, N; Kawaza, K; Lufesi, N; Irimu, G; Tongo, OO; Malla, L; Paton, C; DAY, LT; Oden, M; Richards-Kortum, R; Molyneux, EM; ... With NEST360 Neonatal Inpatient Dataset Learning G,
BMC pediatrics
Blood culture versus antibiotic use for neonatal inpatients in 61 hospitals implementing with the NEST360 Alliance in Kenya, Malawi, Nigeria, and Tanzania: a cross-sectional study.
Murless-Collins, S; Kawaza, K; Salim, N; Molyneux, EM; Chiume, M; Aluvaala, J; Macharia, WM; Ezeaka, VC; Odedere, O; Shamba, D; Tillya, R; PENZIAS, RE; Ezenwa, BN; OHUMA, EO; CROSS, JH; LAWN, JE; NEST360 Infection Group,;
BMC pediatrics
Infection detection gap: barriers and enablers to performing blood culture for neonatal inpatients in Kenya, Malawi, Tanzania, and Nigeria
Royal College of Paediatrics and Child Health Conference 2023, Glasgow, UK
Iron homeostasis in full-term, normal birthweight Gambian neonates over the first week of life.
CROSS, JH; Jarjou, O; MOHAMMED, NI; Gomez, SR; Touray, BJ B; Kessler, NJ; PRENTICE, AM; CERAMI, C;
Scientific reports
Correction: Genetic variations in human ATP2B4 gene alter Plasmodium falciparum in vitro growth in RBCs from Gambian adults.
Joof, F; Hartmann, E; Jarvis, A; Colley, A; CROSS, JH; Avril, M; PRENTICE, AM; CERAMI, C;
Malaria journal
Culture gap: antibiotic versus blood culture use for 61 facilities with NEST360 in Kenya, Malawi, Nigeria, and Tanzania
Measuring care for small and sick newborns: co-design of a minimal neonatal inpatient dataset and multi-country learning to inform tracking of Every Newborn targets
Evaluating service readiness for small and sick newborns to inform tracking of the ENAP coverage target: Baseline results of a health facility assessment from 65 facilities in four African countries
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