 I will go ahead and introduce this wonderful pre-conference celebration by the World Health Organization together again from evidence to reality, and it gives me great joy to introduce our main moderator for this session, Frida Berg, RN, RM, MSc. Frida is a technical officer in nursing and midwifery at the Department of Maternal, Newborn Child and Adolescent Health and Aging at the World Health Organization, Geneva. Frida is by background a Swedish registered nurse, a registered midwife and is a master of philosophy in sexual, reproductive and perinatal health and educated maternal and newborn healthcare system designer. The past two years working at the World Health Organization, country office Sierra Leone and has worked closely with the Ministry of Health and Sanitation and aims to support quality of care best practice in midwifery education, nursing and midwifery leadership and practice. So let's welcome Frida to the stage. Thank you, Frida. Good morning. Good afternoon. Good evening. Good night. We at WHO are honored to present in this pre-conference. So we want to start the presentation with a welcome to the celebration of midwives by a pre-record video from our beloved WHO chief nurse officer, Dr. Amelia Lato, up to you, Mangold Tutti-Polato. Please, over to you. I am delighted to be together with you again, celebrating the international day of the midwife. You accompany us across our life cycle and our choices, through which we are brought into humanity. I applaud the extraordinary work you are doing, providing compassionate, safe and quality care and you are referred to with our nurses, the heroes of our time. One suggests that investment in midwifery care would yield important returns, including, first, more positive birth experiences. This is already impacting realities for women and newborns around the world. Second, improve health outcomes and third, inclusive and equitable economic growth. We therefore all have a duty, as we celebrate today, to continue to raise the profile and translate this grand evidence to solutions. It is time to act now to promote, support, respect and value midwifery in order to attract and retain midwives for the long term. To ensure continuous professional development is a reality. To transform midwifery education to international standards. To support equitable distribution of midwives in cities, in rural areas and outer islands. I conclude, together, let's celebrate on all grounds and at all levels to ensure that sound evidence transform midwifery care. Health systems, supporting universal health coverage, sustainable development goals, ensuring inclusive and equitable development and improved health outcomes for women, newborns and for all. Thank you so much, Amelia, for taking the offer to actually give us this wonderful speech today. And I know that you are a part in this, so if you want to, you can actually turn off your camera and we can see you live if you want to. Thank you so much, Amelia, for this welcome speech and for the effort you do to actually welcome us in this International Day of Midwifery. Thank you so much, Amelia. So let us go to the next step in our agenda. We want to do an opening remark and we're going to listen to a prerecord message from our Director General at WHO, our beloved Dr. Tedros. Dear colleagues and friends, my greetings to everyone joining today and especially to all midwives. We have come together to recognize the extraordinary work you do all over the world. Research shows the vital role midwives play in providing reproductive health and family planning services and in protecting and promoting maternal and newborn health. Yet, we still need hundreds of thousands more midwives to meet the health needs of our communities. We must improve the quality of education for midwives, increase the number of midwives in senior leadership positions and make sure they are supported and protected in their workplaces. WHO collaborates with our sister agencies UNFPA and UNICEF and the International Confederation of Midwives to advance these policy areas in the WHO global strategic directions for nursing and midwifery. I would also like to encourage you all to engage with the nursing and midwifery global community of practice which forge connections, builds the skills of nurses and midwives and amplifies their voices in global dialogue. Thank you to each and every midwife for all your efforts to safely bring new life into this world. I wish you a very happy International Day of the Midwife. Thank you so much Dr. Tedros for that wonderful speech. So now it's time to go over to the presentation that we have prepared for you all. The first presentation is called Evidence to Reality in Six-Country Study Findings and the presenters for this presentation will be Clara Fisher and Dr. Lorena Binfa. Okay, thank you Frida. I'm very happy to be here today and hopefully this will be amazing. This is a very important conference so we think that midwifery is a vital solution for many women, children and that's why it's necessary to invest in high quality education and training, invest in midwifery liberty and governance, invest in health workforce planning, management and regulation and in the work environment and of course invest in midwife-led improvements to sexual, reproductive, maternal and neonatal adolescents' health service delivery. So this is a project which is a joint collaboration from WHO, UNFPA, UNICEF and ICM taking as a base the framework for action for strengthening quality midwifery education for universal health coverage 2030 and this project which we are going to talk in this moment was implemented in six countries and included both public and private sectors. The countries include Sierra Leone, Malawi, Liberia, Bolivia, Pakistan and India. And WHO is being supported by the Merck Formatus Foundation to implement this project which is part of a wider program strengthening quality care for mothers and newborns to achieve universal health coverage. The framework is based on a seven-step action plan which will be fully described later. And the project also takes into account the WHO Global Strategic Directions for Nursing and Midwifery 2021-2025 which presents evidence-based practices and an interrelated set of policy priorities that if a doctor can help countries ensure that midwives and nurses optimally contribute to achieving universal health coverage. Another population health goal. The strategic direction for nursing and midwifery comprises four policy focus areas education, jobs, leadership and service delivery. Each focus area has a strategic direction articulating a goal for the five-year period. Enactment of the policy priorities can support advancement along the four strategic direction. This project is focused in two areas. Education, who educating enough midwives and nurses with competencies to meet population health needs and leadership by strengthening nursing and midwifery leadership throughout health and academic systems. We found through a lot of work and especially focusing gather data that it's a need for coordination and alignment. Clear and urgent needs for coordination and alignment of implementing partners and donors behind one government plan for midwifery to maximize investments. This was done in the six participating countries and how to address midwifery leadership by implementing a national midwifery tax force. It is possible and empowering to assess national midwifery leadership capacity and identify action needed. The other important thing is gather data because government requests for a mechanism to collect, analyze and manage and have ownership of midwifery data, a country-level kind of dashboard, who also engage the private sector, which is complex and highly politically sensitive and need to know more for better integration of public and private sector collaboration. And last issues related to climate change because the midwives must be aware that changing the temperature in warm areas may be complex for healthy environments and also for their own health. So that is very important to achieve and there is just less, very a lack of information. And this is strongly needed and strong demand to be aware about this climate change for health people and for their own health among midwives. The six participating countries, as I mentioned, first starting in India, Pakistan, Malawi, later Sierra Leone and Bolivia were included and the last one is Liberia. It's up to you now, Clara. Thank you. Thank you, Lorena. Thank you so much. Yes, hello. My name is Clara. I'm a Swedish JPO and technical officer at the Family and Reproductive Health Division at the WHO country office Liberia, where I'm also joining you from today. And as Lorena has introduced you to the framework for action on strengthening the free education and leadership, let me dive into our methodology, the seven-step action plan. Rather than focusing primarily on national midwifery curricula when improving midwifery education, the seven-step action plan acts as a guide to help build sustainable midwifery education and training and doing so by systematically building partnerships around midwifery leadership and adding public engagement and advocacy. The six countries in the framework's global community are all in different stages of the circle at the moment, but after reviewing outcomes, there will always be a reason to act on new challenges. So it is supposed to be a never-ending circle. One of the first tasks for all countries when launching the framework for action was to create a country midwifery leadership profile. And I will not have time to walk you through our methodology in detail, but the aim of the leadership profiles was to map midwifery education and leadership in each country by interviewing stakeholders, partners, and midwifery practitioners. The outcome you see here on the slide summarizes the findings that were similar in all countries. A successful transition to midwifery led care can only be achieved by individuals who are willing to become leaders and visionaries in their discipline. The leadership dilemma we found on different levels but in all countries was that there seems to be a missing collective midwifery identity and the low status of women in society holding back individuals to serve as leaders. Although I know that these results cannot stand alone. One needs to have an in-depth understanding of midwifery practice in each country and that is reflected in our leadership profiles. Let me briefly present the framework's collective achievements. Although each country would have many national achievements to add, the list of achievements would be very long. But we have established, as Lorena mentioned, the national midwifery leadership task forces in all six countries in order to create a forum for midwifery stakeholders and individuals to exchange knowledge and overcome challenges in leadership. We developed tools and methodologies such as the first global midwifery leadership profile tool. Our country midwifery leadership profiles identified the levels of involvement of midwives in each country, their policy development, as well as helping and hindering forces in the participation of midwives. On the right side on the slide, you see a picture of our global midwifery conference in Sierra Leone in 2022, which was also, as we understood, the first global conference in person after the COVID pandemic. One of the framework for actions strength is the global impact that it has by collecting knowledge and connecting midwives on an international level. We were able to improve the alignment of international midwifery stakeholders and the coordination of midwifery. We support the alliance of improving midwifery education with the purpose to jointly implement the framework for action. And we see the implementation of the framework for action as a milestone in strengthening the health workforce of midwives globally and in ending the preventable maternal mortality. Before I end, I would also like to address one of the questions that was already asked to our team, to Lorena and me, about the emerging issues on climate change. And if we could explain how we expect that climate change could influence midwifery. And we discussed this in our midwifery, in our framework for action meetings, as droughts, rising temperatures and natural disasters, our threat to maternal and newborn health in general. And we believe that it will therefore impact the work of midwives as well. So we have added this to the agenda as well. And now I leave over to you. Thank you so much for your attention. Thank you. Thank you so much, Clara and Lorena, for this brilliant presentation. And for the audience, I just want to say if you have any questions, we will have a Q&A in the end of the sessions. So you can save your questions then, or just type them in the chat and we will raise them at the end of the Q&A session. So now it's time for the next presentation, Transition of Midwifery Models of Care. And the one who will present this one is Justine Lee. And so she will bring you walking through this work that WHO are doing in this stage. So please, over to you, Justine. Thank you so much, Frida and your colleagues, Estimadas Collegas, Estimadas Collegas, Schercolegs, Zoridine, Salamuali, Komunihau. My name is Justine Leles. I'm a midwife and WHO consultant. Currently working on transitioning to Midwifery Models of Care with a stage working group. And I will guide you through what is stage and what we mean by transitioning to Midwifery Models of Care. But first, let's look at what is the problem. And as I'm sure you already know, there is still a high maternal and newborn mortality and morbidity around the world. And every day, 800 women are dying during pregnancy, childbirth, postpartum period, 5,400 stillbirths, and 6,500 neonatal deaths a day. And for those who survive 27 million morbidity episodes each year due to the five most recant complications. In addition to this, we know that poor quality of care exists and is contributing to more than half of those who turn on a newborn health worldwide. The care is often described as discontinuous and provided by multiple providers with inadequate links to the community and the wider health systems. Moreover, we know that there is a global shortage of nearly 1 million midwives around the world when women want to have increased competence and better supported health workers, including midwives and nurses, to provide with sexual, dignified and non-discriminatory care. So one of the solutions is for countries to transition to midwifery models of care, and what we mean by this is the process through which countries are moving over time for no midwives at all, providing midwifery services to well functioning systems in which midwives are educated to international standards, regulators, and work within an enabling policy and health system environment. And why scaling up midwifery? Well, we know from the evidence that more than 80% of healthcare during pregnancy, childbirth, and the postpartum period can be provided by midwives when they are educated to international standards regulated within a health system and an enabling environment. We also know that by achieving universal coverage of midwives delivered interventions by 2035, we could decrease 67% of maternal deaths worldwide and 64% of newborn deaths, saving the lives of more than 4.3 million mothers and newborns around the world. But even with a 10% increased coverage, every five years up to 2035, we could avert 22% of maternal deaths, 23% of neonatal deaths, and 14%, sorry, percent of steel deaths, saving 1.3 million lives around the world. An example of a midwifery model of care is the midwife-led continuity of care model. And here on that slide, you can see the results from the Cochrane Systematic Review, which is one of the highest evidence we can have in research about the impact of having this midwifery-led continuity model of care. Okay, the midwifery community of care around the world. So as you see in this map, we have a lot of different kind of midwifery models of care. So this is actually a group that we developed in WHO, the stage and technical advice group of experts, we call it stage, and this stage group is focused on maternal newborn, child, adolescent, health and nutrition. It was developed in 2022, and it's independent group, and it was advised by our director general. For now, we have 31 members from all WHO regions, and shared by C. Homer, the midwife. The stage group should provide strategic technical advice for WHO on MNCA, HN, and to inform the WHO agents primary healthcare and universal coverage would focus on maximum countries impact in the collaboration global leadership in the field. During the first stage meeting, the outcome was three recommendations, and the recommendations involved the transition of midwifery models of care. So the first recommendation was that WHO should support countries in the transition of the collaborative midwifery models of care. We will only support the countries who actually want to do the transmission, it's not forced on to. We will give them policy advice and implement guidance. Okay, and all these models of care will be adapted to the country's context, to the country's health system and the solution for the workforce. So the second recommendation in line with the member state endowment of the state director of nursing and midwifery world health is in 2022. WHO is convened the stage working group bringing together key stakeholders ensure midwifery responsibility and develop implementation guides to support countries transition for midwifery models of care including collaboration and technical work and network and care leadership and endorsement for private and no-profit section. Over to you, Christine. Sorry about this, so thank you so much Frida for covering. So I guess you mentioned the second recommendation was a very important recommendation that in line with the member state endowment of what Lorena presented the strategic direction for nursing and midwifery at the World Health Assembly 2021. The World Health Organization convened a stage working group bringing together key stakeholders and ensuring midwifery representation to develop implementation guidance including collaborative teamwork, networks of care, leadership and engagement of private and non-profit making sector. The working group should develop the implementation guidance within a 12 month timeframe as well as an agenda for evaluation of implementation of midwifery model of care in different country health systems. And the third recommendation is about what Dr. Pedro mentioned in his speech the WHO global and nursing and midwifery community of practice that stage endorse as to establish a continued learning agenda on transitioning to midwifery model of care which links to ending presentable maternal mortality in every newborn action plan and all the global progress from proving continuity of maternal and newborn care and improving outcomes and presenting of still those. So I won't spend too much time on the theory of change but just to tell you that WHO is currently finalizing a theory of change for midwifery and soon to be published and this theory of change identified five domains of change that were endorsed by a majority of partners in two large virtual meetings with the 90 percent agreement of the domain. Showing you this to let you know how did we establish the structure of the working group. So this working group the stage midwifery working group has three subgroups from the domains of change identified in the theory of change. The first one is the subgroup the midwife. The second one is the subgroup health systems and the third one is enabling policy regulation and environment. There is a cross cutting issue which is women newborns families and communities that will be addressing all of the subgroups and is crucial in this working group in general and a monitoring and evaluation framework will be also established by the working group. All of the above is supported by what we call WHO secretariat. So who are the members of the working group? The coaches are Jane central a stage member in Sally Pairman the chief executive officer of the international consideration of midwife. Also each of the subgroups has has two colleagues and those two colleagues are members of the working group to ensure coordination. There is also three stage members among which Carol and Homer the stage chair and the midwife. Several professional organizations because this work is going to be collaborative and it's very important. So FICO the federation international federation of gynecologist and obstetrician the international pediatric association the international consideration of nurses and also the organization of neonatal nurses coin. U.N. partners so U.N.H. C.A. U.N. nation population fund and the U.N. nation children's fund U.N.S. staff. But also as I was telling you central to this is to have the women and newborns and families and communities voices you presented by W.R.A. the white ribbon alliance and my C.N. For the subgroups so far we have established the subgroups and it was key to ensure geographical distribution from all the regions and subregions of the world. So you can see here on the graph that this has been respected and the members are from different backgrounds academia and research professionalization regulation bodies government representatives our colleagues were mentioning the importance of military leadership so we have some high leadership positions from governments military health systems specialist program managers but also women newborns family and community representatives and in total out of those 45 plus members of the subgroups we have more than 60% of midwives. So very briefly to finish the next steps will be to present these updates to stage on the 16th of May 2023 finalize the standard of framework for the developing guidance and finally start the subgroup discussions that are going to be very rich just the implementation guidance and as you saw in the second recommendation present the draft guidance before the end of 2023. Thank you very much. That's really interesting. Thank you so much for that. I know that you have worked hard on this and I know it's a lot to do so if you have any questions for Justine on this project and if anything was unclear and so just type in the chat or ask your questions in the Q&A in the end of the session. So now we're looking forward to hear about the midwifery toolkit. The presenter for this toolkit will be Dr. Andrew Kauru and Flores West. So over to you. The floor is yours. Thank you very much Frida. I'm really happy to be here today with Indy to present a short presentation about the WHO interprofessional toolkit that has been pilot tested in India as part of the midwifery initiative in India. I'm a midwife. I'm currently in Australia but I live in The Hague in the Netherlands and I'll let Indy introduce herself. So the interprofessional midwifery education toolkit has various resources. These include the facilitator and learner guides. It's a blended learning approach with some pre-course learning done online and then facilities and education institutes can facilitate the courses over one to five days, depending on what course they choose to implement, mainly as continuing professional development in service training. Focuses on the midwifery model of care of course, evidence-based practice and on the orange line there you can see the various courses that will be on offer. Cross-cutting themes of course always respectful care, mental health and leadership. It's grounded as our previous colleagues have said in the quality maternal newborn care framework and I think all of us are familiar with this table. I'll just talk briefly about the essential childbirth care course which is one of the toolkit courses. So this essential childbirth care course which we call the ECBC is derived from evidence in these documents as you can see on your slide. The WHO recommendations for intrapartum care positive childbirth experience, the labour care guide and the other evidence-based guidelines you can see there. So the childbirth care course ECBC contains five modules. The introduction module is currently on the WHO website and the first stage of labour, second stage immediate newborn care and third stage and referral modules will be up very shortly. I'd like to pass now to Indy who can give some evidence to reality perspective about implementing the ECBC and pilot testing it in India. Indy. Good morning everybody, my name is Indy. I'm a midwife from the UK and I'm currently based in India helping support and embed professional midwifery. Just thank you so much Florence for bringing the key in to such an important subject. You know India has made enormous strides to embed midwifery and respectful maternity care in the country. I'd just like to share our experience of testing this model. So our National Midwifery Training Institute in Fernandez has impacted 10 sites across in India. We had the privilege to pilot the ECBC course with our midwifery educator trainees and it was a pretty exciting time because we must not take for granted that India is still at the infancy and whilst trying to embed professional midwifery, a lot of the educators are also learning midwifery. So this tool toolkit proved really beneficial and we had the previous Elizabeth Iroh who endorsed this program and our trainees were really excited to meet and had a certificate. What we did was we piloted it over three days in 2020 and it was really innovative because despite the constraints our midwives enjoyed our learners enjoyed the different methodologies and a certificate was also given to them from the World Health Organization which helped because they loved their certificates as well. But the three days was packed with fun but very importantly understanding what midwifery is and using standardized WHO quality of care framework and it really helped them because as I said you know we've had the privilege of being midwives for a while for a long time and then training where else our learners had to learn both very quickly. So understanding what RM's respectful care cause and more importantly evidence-based care and having the WHO structures was very helpful. The other thing as well which is really important to say was we felt that the cause would be beneficial not just for the learners that were starting midwifery training to train the new nurse practitioner midwives but it was a good tool to use as a continuous professional development so they can use the methodologies because most of the lessons in India has been very didactic so the new innovative and quality of care approaches actually helped them. It also helped our international midwifery educators who came to India to support the nurse practitioner midwifery educators which helped standardize in the states that where we were impacting on training. We also felt that this toolkit would be very useful for healthcare professionals such as like our medical students because a lot of challenges also comes within the obstetric fatinity but the evidence could also help them and to contribute in the training and most importantly the styles that was used was innovative and what was used as well in this picture it shows healthcare professionals working as a team looking after a woman when she comes in into labour and how learners apply team work to achieve quality care for women and the newborns so that was very powerful how each and every one of us play an important part and sometimes biasness happened and being respectful to each other's profession. We had learnings from two states so facilitators and learners in Gujarat and the Telangana states in India and these educators were becoming ECBC facilitators because once they piloted it the few in the subsequent training that we had we actually used that within our curriculum before they went back to the states and these are the educators which you will hear a video on how they found it impacted on their learning as well and the next slide is we must be mindful that a lot of the learners were taught in the didactic way and hence the some of the methodologies that was used for example like roleplay simulation you know treasure hunts where evidence was seeked and solved and how you can introduce birth companions because we take for granted that a woman always has a birth companion this is one huge challenge that we face in when we are training in India so the learners could actually use these concepts and change can't happen straight away so the point of quality care tool also helped because what do you do next if you can't make a change because a lot of changes needs to be done at the higher level so so that was very useful and of course the video showing infection control and safe care for women and newborn so the group activities we have a video from from some of our learners to share how they felt it was greetings from Hyderabad I am Ruth Choshla Phillips I'm a Mercy nurse presently training to be midwife educator I'm working as a faculty in the Government College of Nursing Hyderabad I enjoyed being part of the ECBC Telangana pilot project what I like most about the project is that it has introduced me to wealth of knowledge and evidence that is available in midwifery which has woman-centered approach the program it has enabled critical thinking in me through the exercises especially the pocky cycle it helped me to analyze things in a systematic way in the light of WHO recommendations COVID times have pushed us as a team to try things virtually and we as a team has proved the strength of teamwork and yes I think the module can also be used virtually I like to see the module to be more clear about the philosophy of interpersonal midwifery care because where I work right now the concept of midwifery led care is just evolving and needs clarity I look forward for the final publication of this module and also wish for anti-natal and post-natal modules I'm sure these modules are going to be great tools for every midwifery care provider not only in India but also all over the world hi I am Sheetal Samson I am a clinical midwife and educator holding a master's degree in OBGYN nursing I work at Fernandez Hospital Hyderabad India what I liked about pilot testing the ECBC course was the access to wealth of evidence-based information the point of care quality improvement exercise ignited a whole lot of critical thinking this is tremendously empowering I would like to see improvements in few area though I feel integrating learning activities related to essential skills of newborn resuscitation control core traction and handover or referral communication would enhance effective use of the related action plan checklist and records I look forward to every midwifery care provider and midwifery educator in India having access to this course together we shall achieve more thank you for sharing that so what what are the next steps it's it's very exciting that it's now out there with the changes made from the group and we're working with partners and adapting it not just in India but other countries Pakistan Malawi Sierra Leone Bolivia and other countries to follow and the resources are all available now on the WHO website and if you need any further information Frida is your person to contact and her address is there thank you so much for your time thank you Floris and Linda this is brilliant thank you so much so we're looking forward to see the next step in this project and I really looking forward to see what you think about the presentations so if you have any questions so want to see anything and say anything just end the comments in chat or ask questions in the Q&A so now we come to the next and the final presentations and I actually want Emily to put on your camera because this is my co-worker to preparing this event so Emily and I have worked almost day and night and so Emily now is your turn to shine and so over to you well thank you very much Frida and good afternoon and good evening everybody on this wonderful meeting it's a real honor to be joining you and I have to say it's been a pleasure to work on this with Frida we've had a lot of fun bringing you this and actually listening to it all ahead of ahead of the presentations you don't get a sense of the amount of work but but but hearing them just now it was really it's really inspiring to see and on a day of today I'm a nurse and a midwife and I get to celebrate both international days but I feel really proud of midwives this year it's been a hard year and I'm very very pleased to be one of you so I'm as I say my name's Emily McQuirter I work in the Chief Nursing Office in HQ in Geneva and I have two things to talk to you about that are really connected but really want to talk about what we've been doing in the Chief Nursing Office over the last few months so some of you will have heard in Dr Tedros's opening address he mentioned our global community of practice and I wanted to just bring your attention to that here there's a QR code on our screen just appeared now so if you're not a member of this fantastic global community please just put your phones on to take a picture of the QR code and it will take you straight to the site where you can join our community we set up this community about 18 months ago now and it is there for you to use it's a global network for midwives and nurses everywhere whatever level of nursing or midwifery people come from so whether you're a student or whether you're a very senior midwifery leader I do urge you to join it it's there to really strengthen our commitment to universal health coverage it works with partners all over the world you'll see comments sessions questions debates discussions news events that will really I hope support the work that you're doing in your countries we set it up because member state countries asked us to do so they said this is what we want we would like a network where nurses and midwives can talk to each other and learn the lessons that they have in their own countries and share them with other people so this is your platform your forum I do hope you will be able to use it as much as the 6 000 members that have already joined it as part of that we held a webinar several webinars last year and we talked about emergency care training and it came out very clearly from the questions and the themes that were raised during those sessions that nurses and midwives felt that they hadn't had enough training and skills in emergency care past the pandemic people had said that they had been redeployed from their normal roles to go and work on looking after patients with COVID-19 who perhaps hadn't had the skills and training at the time to do so so we've taken that on board we've listened to what you've been saying to us and delighted to say that on World Health Day the 7th of April this year just last month Dr Tedros launched our emergency care campaigns emergency care to save lives it's a 25 by 25 by 25 and our commitment in that is to say that we will support the training of nurses and midwives in emergency care in 25 countries so we will support 25 percent of nurses and midwives in 25 countries by the end of 2025 so I'm just going to talk you through this campaign so that you can hopefully understand what we're trying to achieve and this is a real ask to say please please join it please come on board and please please strengthen nursing and midwifery response to emergency care through strengthening your own skills so we know emergency care providers save lives we've got a lot of data which shows that one in two people in many countries we think die annually from an emergency situation because the people that are there do not necessarily have the skills needed to care for them immediately we know we can reduce disability from emergency situations by one in three so we we know that a lack of emergency training puts the lives of acutely ill and injured patients at risk and when I'm talking about acutely ill I'm talking about people who have hemorrhage who have sepsis who have cardiac arrest or stroke as well as patients and people who have trauma and accidents and the effects of climate change that the traumas from theirs from humanitarian disasters and through conflict generate communities that really need nurses and midwives everywhere with really strong strengthening skills in emergency care so we play as a community we play a key role in the management of emergency medical situations but we know that in many countries we don't have we haven't had the opportunity to train and the emergency care that we need to provide needs good training so what are we planning to teach eight years ago the the world health organization established a program called the basic emergency care course it's a five day face-to-face program that delivers training through skills stations hands-on practice into supporting care for people when they have an emergency in many countries this is delivered already but there is a very low uptake in this training from nurses and even lower uptake in this training from midwives and the purpose of this campaign is really to address that violence and to strengthen the skills by training 25 percent of all nurses in midwives in countries where they need the training most so just to introduce you to this campaign 25 by 25 by 25 and you'll hear me say that many times I expect over the next few months as we scale up this campaign and seek help from organizations who will really become what we hope will become partners in and what we think will be really valuable to saving lives we're absolutely determined that this is a member state led program we recognize that emergency care emergency training is different emergency needs are different in different countries so we want to work with countries to make sure that the program meets the needs of the individual countries and is run by the countries within which we train we want to make sure there is a sustainable program which has educational accreditation and is really useful for nurses as part of their CPD it's not an expensive course to train we've calculated that to train one midwife costs approximately 120 dollars so we're working with global partners to support the funding of this so that we can deliver it obviously some of the numbers in countries are large so the budget to be able to support this needs to needs to reflect that so as I said before the director general launched this campaign in the beginning of April and you can see from this slide here we have a plan to scale up this course over the course of the next three years so over the next few months we're planning how we will roll this out what the rollout team needs to include what are the countries that would be they like to be part of this as early adopters of the training and then in phase two we explore how we train our trainers so so our plans are to ensure that within our communities nurses and midwives not only trained in the program but a percentage of those people who are trained in the program will become the trainers of it so there is a sustainable model that can continue to grow throughout the countries and increase the numbers of people who have can have access to this training and as I said before in phase three we will ensure that the course is delivered in accordance with the national context so making sure that it's relevant to the countries that want to take this program forward phase four which will be a huge scale up many courses delivered all over the world and this is where we rely on support from our partners to help us to do that and that will take place in 2024 and 25 and then as we come to the end of the program we want to make sure that we've built in a sustainable model and through our community of practice we will then be able to provide refresher training support and resources to make sure that if you've had your training maybe a year two years before there's an opportunities to update your skills through the work and the sessions and the and the live learning that we host through our community of practice that I talked about just earlier on so we hope to make a great impact on emergency care through this through this program um depending on the countries that will adopt this it's unclear yet who they all who they all will be um but we estimate that we will be able to train 250 000 nurses but that really depends on the countries that choose to adopt the campaign some some countries have smaller numbers of nurses and midwives as you know and others have huge numbers of nurses and midwives so we want to make sure that we can scale this up to meet all the needs of the countries that want to take this program first so why now I've mentioned that just a little bit at the beginning but it's really important that we use this as a tool to scale up our response to emergency care we know that we have to learn lessons from the global pandemic and we're listening to what nurses and midwives have been telling us over the last few months about how they need to strengthen their own skills we know this is to be an accelerated program three years is a tight timeline to be able to treat uh to teach so many numbers great numbers of of nurses and midwives but we really know that we have to accelerate this program in order to reach reach the sustainable development goals so we will be seeking funding from our public and from donors we're creating some innovative ways of finding donor money hoping that we'll be able to have campaigns to sponsor a midwife sponsor a nurse sponsor a program sponsor a country and and hoping that this will attract support and funds from people worldwide who can really support the the development and strengthening of emergency care nursing and the group free there's information on our community of practice about all of this now so do have a look if you you'll find it very easily in the community there's lots of resources that talk about the program what the course involves within it we are going to be supporting a research program an educational program to make sure this fits with competency-based learning and additionally we're going to be able to we're building a mentorship and supporting program around this too so that the trainers of the program and the nurses and midwives who take the program and become trainers of it will seek will have mentorship support from people who've been delivering this and their experienced trainers already so we're trying to make sure that the infrastructure around this course is is solid and strong so that it isn't just a case of doing a five-day training and then we we leave people to then continue by themselves we intend to make sure that the systems around will strengthen the entire healthcare system to provide better support for emergency care for people who need it most and I think you had the opportunity to hear from our wonderful chief nursing officer Dr Amelia earlier on who is the real front face of this campaign and really does and I'm speaking for here but does believe that the way we will do this is by doing this together and this is a huge a huge project it's an ambitious targets but I think I would you will hear more about this you will hear more from Dr Amelia about this and we know that with your support we can close these gaps to strengthen our emergency care services and ultimately make a massive impact on on life-safe I just wanted to add this slide it was launched on the start of the World Health Organization's 75th anniversary you'll see this beautiful logo in many of our presentations and on our slides over the next few months but I think what we're trying to do is really set the bar high for providing really great strong support to development and education of midwifery I thank you very much for listening to that I really do hope that you'll join our community that you'll become involved with this and I really hope that you'll find some inspiration from being able to do a course and use the skills that you'll gain from it to help the people that you serve in your community so I think there's so much to gain from all of this and thank you very much indeed for letting me have the chance to talk to you about it well thank you thank you so much Emily and and Frida and I are going to start with the you're going to do the thanks then we'll go to the Q&A so thanks Frida thank you Jane so actually I want to to actually hand over to you because now we are starting the session that I'm actually looking forward to the most and that is the question and answer session so I will actually to introduce the moderator for that session that is Jane Houston and she will be supported by Lea and Becker so you can actually turn on your camera Jane again so I will hand up the session for you and I know that you want all the presenters to have the camera on too so over to you Jane well thank you so much Frida and to everybody we've just been getting some fantastic chats so as our our amazing who team rolls in I just like to say Billy Hunter wrote thank you Indian Florence this is a positive experience of piloting the ECBC it's so wonderful to hear come on in don't be shy come on into the room um Seal Jevitt wrote this project has had huge accomplishments Lorraine Mockford wrote looking forward to hearing more from Indy at session eight and Susanna wrote that in session 17 later on we'll be describing a project of the College of Midwives of Lima Peru on midwifery first response team so please please don't be shy I know you're you're all with the pandemic we've all got very comfortable in virtual rooms so come on back for the Q&A and we've got a few questions so please if you've got questions and I will be monitoring the chat but we've actually got a couple of couple of questions here so I'd love to go ahead and and ask and particularly for the this will be for justine if yeah yeah you are you you were really great there saving the day you just swerved right back in there without missing a beat we did hear a lot about the role of midwives in the amazing uh stage work transitioning but we were there was a question actually I received from Nepal about um what part do you think um OBGNs play in this transitioning and about being included in the process and what are our our collaborative uh physician OBGNs thinking about this topic so over to you justine thank you thank you very much that is uh maybe a tricky question Jane to start with the question no I'm just I'm just giving thank you very much well if you remember um stage recommendation it was about transitioning to a collaborative major free model of care and collaborative means that um midway free model of care is not just for midwives it's also about contributing with other patches of course and in this but this was very important so in the members of the working group the international federation of gynecologist and obstetricians are part of the working group and so our other professional associations and within the subgroups as well we have a pediatrician nurses obstetricians I can't speak for them on what they think about the work but the obstetricians that are joining the working group in subgroups are very eager to work in collaboration um on this important work and are very thrilled about working together thank you thank you um I'm actually based in the USA so I uh I appreciate your candor on that and there is actually if anyone out there wants to ask a question in Spanish we do have many members on our committee um that are Spanish speakers so we'd love to have we can we can um do that as well so the next question up is for the toolkit and the ECPC and it's from the Netherlands for Ms Indycar and Dr Florence West um so I we were all very taken with this toolkit and the ECBC and do you have any comments or top or pro tips if there's a country or specific hospital university would like to implement one of the courses um how how would that how would that look if somebody wanted to contact you about that Indy do you want to take this yeah um it's been really interesting because we've the ECBC is there to contextualize it to country context so for example the modules are there um and when you go to another country you can actually change the names and make it more country context and we will be more than happy to share our experiences with the universities or whoever that's keen to adopt the toolkit more than happy I'll leave my email id and I'm sure Florence would be too because she was heavily involved at that as well Florence anything else that I may have missed no that's perfect um it really is a like a a package that you can take up and and go with there's a a really detailed facilitated guide for every course and learn a guide as well and as Indy said we're both very happy to be contacted for more information and if Frida receives any inquiry she can pass them on to us as well wonderful that's great and we can also take questions all for all say if we need to also so this is great having all these wonderful international midwives and healthcare providers right here in this room and I just like to announce I mean we had a fantastic attendance we had over 19 countries in the room so I think that's that's pretty outstanding for our pre-conference so I've got a probably maybe a final question I don't see any more questions in the chat I have a question um Susanna's going to have a question actually would you like to ask a question Susanna yes actually it's hard to I want to do in Spanish I think it's a little difficult to ask the questions in Spanish because the session has been in English so there's not much to ask when the session is in English there's not much to ask sometimes in Spanish because the session was in English so yet to make the questions in Spanish will be a bit difficult but I want to make a summary of what the presentation is today if she has done this introduction of the work in education and the work of emergency response of the obstetrician career and of how the work of obstetrician departure and matronery is seen from a collaboration lens more than power and from a professional career domination lens from my position as an obstetrics that works in latin america that and in countries in this case peru and with other chilean or bolivian colleagues that I know are here present I would like to know what is the way in which the World Health Organization is going to make sure that the voices of the latin americans or the spanish speakers can access these sessions I was asking how the World Health Organization is going to make sure that latin american countries or spanish speaking countries are going to access all these amazing opportunities where usually the conferences for example today most of the information is given in english so even asking questions is difficult for for our counterparts thank you i would generally like to make a response to susana our amazing partera amiga right justine y yo podría contestar en bueno al menos para el trabajo de stage cuando tuvimos que elegir a los miembros de los grupos de trabajo y de los suburbos grupos de trabajo en tuvimos bueno hemos reflexionado muchísimo sobre la representación de las regiones del mundo y de las publicaciones del mundo y entonces en los sub grupos de trabajo si tenemos a persona de latino america es verdad que el el programa del idioma es siempre un programa porque las reuniones más bien los correos electrónicos todos hacen mucho en inglés pero también hacemos lo máximo para poder colaborar con personas de todo el mundo y eso es parte del mandato de la organización también así que al menos tenemos varias personas de su región y muy orgulloso de tenerlo con nosotros i was saying that um in stage at least we made sure that we were ensuring the representation from all regions and we have members from latin and american and the caribbean as well but uh if i know i want this special um person who are speaking Spanish yeah thank you wonderful thank you so much yeah we're we're very much engaged at vi dm and including as many languages as we can to make it equitable and available so thank you so much is there any further questions for this outstanding panel of experts all right well i think it's time to say oh sorry Emily go ahead oh i was i was just going to say that our community of practice um can be accessed in Spanish um in fact there's several languages there and you just click on the choice of language that you have and um all our global webinars are translated into the six un languages so anything that is there um from our global live learning center uh you'll find you'll be able to listen to it in Spanish if you don't even if you don't get to listen to it live on the day the recordings with the interpretation is there included as well just sort of add to that to say we do we do really recognize the language issues are huge and we must you know we try as much as we can to make sure that they're accessible to as many people as possible yeah more importanty that's so such a great point so um thank you so much so if we just uh like to uh thank uh this outstanding panel once again and you can go ahead and put your applause uh on for all our wonderful uh colleagues in in the health care and midwifery thank you so much and uh chris woodhouse has raised his hand and he's put his hand down again all right i guess he's giving us applause all right so if y'all want to go ahead and probably get well earned sleep because i think some of you it's the middle of the night so uh thank you again uh uh from us at vidm to all of you and please reach out and support um international day of the midwife with the world health organization and do register it was super easy i registered um for um your registration very simply using the qr code and i'm old so and i could do it so just get your get your um registration in there so thank you thank you to everyone again so i'm going to um say thank you and i'm going to um hand over to dr uh freda berg again to introduce dr and shoo banerjee and we're going to keep on this slide as we close out the session thank you thank you so much jane so uh now we are going to this is the end of this webinar and we want to end uh to hear what dr and shoo banerjee director of of the department of maternal newborn child adonis and health and ages at who actually my my boss he said like that so forward to you to give your closing remarks thank you very much freda and what an amazing session that was uh and all the evidence that was presented um i think we started with kind of problem statement first for that we have 800 women dying of maternal mortality every day um and how do we address that and the critical role that midwives play within that but also of course we have around 2.3 million newborns dying every year and um essential newborn care is also provided by midwives so um i think the evidence really high right highlights the role that midwives play in providing services so we looked at a couple of issues first for planning and we know that we have a gap of 900 000 midwives in order to be able to provide globally the kind of arm and cah services that are required and so how do we ensure that um we fill these positions and how do we move countries forward in in providing that kind of support and thinking through how to do that we looked at leadership and i think we looked at the midwifery model of care and how can midwives actually move that issue forward and how can we have midwifery led continuity of care that improve services for mothers and newborns so for example from Liberia we heard on how to improve leadership is taken forward by a national midwifery leadership task force uh we looked at education and of course we want that all midwives are trained according to international standards according to the ICM standards and for that WHO has been working on the interprofessional midwifery education toolkit and has also introduced an innovative kind of teaching methodology that has been highlighted as part of the essential child birth care uh course we also heard about the new initiative the 25 times 25 times 25 campaign for basic emergency care and how WHO would like to take that forward and train up to 250 000 health professionals to strengthen their basic skills and again a lesson from Liberia was to establish an alliance at the country level to really strengthen education looking at service delivery all of this planning scaling up the number of midwives that are going to be recruited the leadership led the leadership for midwives as well as education of course all is going to support the service delivery and we heard that about 80% of services for this population group mothers and newborns it can be provided through through through midwives or by midwives and again therefore it's so crucial that we take this forward I think what we also wanted to highlight was the importance of the experience of care and that's why this continuity of care model is very important in the WHO guidelines both for antenatal care interpartum care and postnatal care as part of our quality of care standards we are really highlighting the importance of the experience of care not only provision of care the supply side but also the demand side and the experience of care and one issue that really stands out there is the issue of respectful care and finally I think we heard about how WHO wants to support this through the stage working group the issues that they're looking at and really we as WHO are ready to support any country that would like to move towards a continuity model of care that wants to move from let's say systems where there are no professional midwives to systems where we have continuity led care by midwives so that is our commitment and I want to thank everyone for joining today and thank you very much this is the story of health no it's not just about eating your vegetables and growing taller it's about how the world's people came together to help us all live long and healthy lives making amazing discoveries like new medicines and vaccines guiding us to grow up healthy strong and happy keeping us safe from nasty diseases painful ones and deadly ones and some horrible ones you've never heard of because they were completely wiped out the end of smallpox the magnificent chapter in international collaboration has finally been declared free of wild polio virus it was really a story of human perseverance innovation commitment bringing communities together towards one unified goal this is a story about all of us because we all played a role and if we can keep working together we'll make more discoveries have more victories over diseases and help even more people be healthy and happy in the future just really remains for me to say a happy a such a happy day to be a midwife and say happy international day of the midwife especially to our wonderful World Health Organization team let's give them a big round of applause again