 My name is Sharon Browney and I'm the Professor and Dean of the School of Nursing and Midwifery at Aga Khan University for East Africa. First of all, I'm a registered nurse and a midwife and I've built on that basic foundation over the years and I now lead three schools of nursing across East Africa, one in Nairobi, one in Kampala and one in Dar es Salaam, so that's Tanzania, Uganda and Kenya. And we specialise in providing upgrade programmes for working nurses from enrolled nurse to diploma and diploma to Bachelor of Nursing or Bachelor of Midwifery. Globally the health workforce is challenged by insufficient numbers and inequitable distribution of the workforce so currently there's almost a billion people who don't have access to affordable healthcare and so most of that is due to health workforce shortage and health workforce maldistribution. That is exacerbated in East Africa and in Kenya in particular where there might be a significantly less percentage of nurses per thousand population than it is recommended. The challenge of how that relates within healthcare sectors and inpatient units, not neonatal units, there are simply insufficient hands quite often to be able to provide the quality and level of care. Sometimes nurses are looking up to 10, 12, 13, 14, 15 babies each alone and there's insufficient resource to provide the care that's needed. The recent large-scale research project has been important and welcomed. It's important from the point of view that Kenya still has statistics that show that far too many newborns die and don't reach that first month of life and their first five years of life. So this research is important because it's really helped focus what are the issues, what is the quality of care, what care is provided, what care is missed, what resources might be needed and so the reason that this is unique is that rather than rushing to a suggested or recommended solution, first of all the research has been done to actually understand what the issues are and where the gaps are and that's what can be then help build solutions into the future. The most important things for improving nursing relates to several well-known documented pillars of nursing. There needs to be the right enabling legislation. So there needs to be legislation that allows under a Nurses Act for advanced and specialty practice. Another pillar is that there needs to be sufficient resourcing so that there's sufficient numbers of nurses and then the third pillar is that there needs to be access to education and the right kind of programs for nurses to develop specialty and advanced skills in areas like neonatal nursing, midwifery, or cadre's and all areas of nursing practice. Kenya, like many East African countries, has limited numbers of nurses with specialist qualifications. So if we're talking neonatal nursing it's important for there to be legislation and enabling conditions for specialty and advanced nursing practice including the right education. And then of course there is the issue of there needs to be sufficient nurses and resourcing through the health system to be able to provide and meet the level of demand and need that exists. Further research is needed to understand and to delve more into the major causes of death. The strategies that work the best in helping mothers and families care for new newborns, the amount of resourcing that's required, those combinations of factors will help ensure that the right solutions are put in place. More generally it's important for research priorities. It's important to look at the particular needs of a population and the health trends. Kenya, like the other East African countries, has alarming rates of non-communicable disease, diabetes, cancers, cardiovascular disease, diseases of lifestyle, diseases of urbanisation. And there needs to be a lot more research in those areas. There's also needs to be more research that will assist in health literacy. The levels of cancer are rising and people tend to come very late because they don't necessarily have the information to have understood early signs of cancer. So research into areas of what the population does know, what kind of health education, health promotion and how to halt some of those things earlier.