Our vision is to answer questions of immediate translational importance, focusing on inpatient care (i.e. “the sick child”) and subsequent development (i.e. “the developing child”). Our clinical research approach has gradually evolved from smaller scale work centred around Kilifi Hospital to multi-centre international work with significant work now led from our collaboration in Uganda and the Programme in Nairobi. Work in Nairobi includes a network spanning 14 hospitals where clinical information systems have been established as part of health systems research. This network supports monitoring case burdens, management practices and outcomes, and will form the basis for pragmatic randomized clinical trials and implementation studies. We also lead a network of sites working on malnutrition (the CHAIN network) which includes work on pathophysiology and epidemiology and will also form the basis of multi-centre international trials.