 Now, this is the time to welcome the speakers and please, as I said, the session is recorded. I think please have already clicked the recording, please note so. What I want to remind you, which I forgot to mention is that the session is going to run for 30 minutes presentation, 10 minutes questions and answers, and then 10 minutes to move on, change over to the next room for another presentation. So this session is going to be presented by two people. That is Tomah Ray and Arafin Happy Mim, both from Bangladesh. The topic is Young, Midwives, Leading, Quality Improvement in Bangladesh. These two people are young midwife leaders. Arafin is 23 years and Tomah is 25, and Arafin works currently in a government health facility in a research and training management institute in Bangladesh, and Tomah Ray works in the humanitarian crisis area in Rohingya at Refugee Camp. Now, they are both executive members of Midwives Association in Bangladesh, and they recently graduated from an international leadership fellowship development program with the Nothing Now Challenge in the UK. So they are, as I said, they are both executive members of the Bangladesh Midwives Society. In 2022, they were credited with using quality improvement methodology to help their midwife associations recruit and retain its members, and they also helped develop guidance on responding to various types of emergencies in Bangladesh. So we welcome Tomah Ray and Arafin Happy Mim to take us through their research to see what exactly they achieved as young midwife leaders in Bangladesh. So Tomah and Arafin, I will make you present us. So here we go. They are both members of executive Bangladesh Midwives Society. In Bangladesh, Midwives is a new profession, and they here first midwives graduated in 2016, and they are working in government sector since 2018. So 2557 midwives have been deployed in government sector, plus 400 midwives are working in the humanitarian sector. So in this regard, with aim to provide midwives with the necessary knowledge and skills, and adequate equipment to enable them to carry out their work and leadership, a Bangladesh Midwife Society was formed in 2010, as was all of the midwives in Bangladesh by nurses. So our first election was in 2018 with some midwives elected then, and in 2021 election resulted in all midwives leading the society. So all of us are young with no experience in leading an organization, and therefore the YML program and nursing now fellowship program were very, very important for us. Here you can see the diagram of ICM professional framework. It's very important to have a professional framework or a structure to support it, extend the need and guide its development. And the ICM professional framework for Midwifery X as an informative and guiding tool for ICM, its members, partners and stakeholders, and we are so, so proud that as a Midwifery Association, Bangladesh Midwifery Society is also a member of ICM. So here you can see the chain comprehensive components of ICM professional framework and association is also included. So it is very important for midwives to belong to their professional associations to have a strong collective voice, especially in a country like Bangladesh, where midwifery is tokening. Midwife associations are examples of women lead civil society organizations that can improve gender equality and access to sexual and reproductive health rights and acts and agents for the profession. So they have potential to impact its elements of the ICM's professional framework for midwifery. We are two of many young midwives in Bangladesh who are stepping up to lead our midwives association. So to advocate for midwifery services and for an enabling environment for the midwives, this is improving gender equality and access to sexual and reproductive health rights in Bangladesh, thus erasing the sustainable development goals. Here we try to give a visual look of leadership in Bangladesh, showing the different aspects and to help us lead our association, we took part in one year leadership development program with nursing now challenge fellowship program and here we learned about leading ourselves, leading others and leading organizations. We also learned how to lead quality improvement initiatives also. So this was important because across the world there is a gender gap in healthcare leadership. 75% of nurses and midwives are women but 25% leadership positions are taken by women. So also in our country in Bangladesh there is discrimination against people who are young and our culture and our health services can be hierarchical. People are giving respect here because of their age and years in service rather than competence. So we have just midwife position and some temporary positions in government sector in Bangladesh. In this regard education is also important part because without hierarchy gets much difficult. Overall as young people we have to learn how to be confident leaders and need to make any strong environment for us to show our leadership. Here you can see the whole image of education and opportunities in Bangladesh. Each of us had to identify a problem. Here we draw the leadership program and that we what we learned through the leadership program and the philosophy and methodology. The process taught through a combination of theory through lectures and practice through the implementation of the quality improvement project. The leadership theory was a theory program was run by the University of Global Health Equity in Rwanda. There were 61 participants from eight different countries in Asia and Africa. We were two or four five participants from Bangladesh and the quality improvement part of the program was led by the Uber Health Institute in Ghana. Quality improvement improvement and leadership linked was together there. So we need we need strong leaders for successful quality improvement initiatives. So the whole program was a mix of theory and practice also testing. We attended lectures. We attended lectures online and had two working groups. We also formed a small group of the five YMLs in Bangladesh to encourage each other. And we were each supported by a mentor from the UK through our training partnerships with the Royal College of Midwives. So here each of us had to identify a problem and design a quality improvement program to address that problem. Here we highlighted the tools taught during the program. As we are both leaders of the Bangladesh Midwifery Society, we wanted our work to benefit the association. So we asked help from the president, staff and executive team of Bangladesh Midwifery Society to identify problem that Bangladesh Midwifery Society was facing. So one problem was that like many midwives associations around the world, Bangladesh Midwifery Society also struggles to recreate and retain its members. So we also want to have a strong link with the midwifery education institutions and recreate student midwives as members. So I focused on my quality improvement project on this issue. And our another problem was that Bangladesh is a country on emergency and humanitarian situations. So we have geographical vulnerability both of floods and cyclones. And also because of our proximity to Myanmar where there has been ethnic cleansing of Rohingya minority group. Right now Bangladesh houses almost 1 million Rohingya refugees in an area of the country called Cox's for that. And this is the world's largest refugee camp. And there are also frequent industrial accidents and fires in Bangladesh. As the Midwifery Society, we wanted to have clear guidance about how to respond to a crisis and what is our role as the professional association for midwives. This was the problem that my co-presenter choose to focus on. So under the quality improvement process, we were taught a process for quality improvement with nine steps. And these are identify a problem to work on. Second problem identification and analysis process and set a statement and then make activity plan to give result and develop change ideas to test, balance measures to the measure aim, complete PDSS cycle and describe activities with data and document. And the last one was plan for the next cycle of testing the idea to learn more about the impact of the change idea. We found it quite difficult to apply the QI methodology to our own individual projects because most people were doing clinical quality improvement in their hospitals or health centers. We were looking to improve services by the professional midwives association. And it was hard to see how the quality improvement methodology fitted with our objectives. So however, our mentors from UK helped us to see how the methodology could apply to our projects. So under my membership project, we set some activity plan with different activities. So in this regard, we needed to set some meetings and aim to achieve the goals. We set some meetings with the project manager of Bangladesh Medical Society because we had a small budget to complete the whole project. First of all, we draft a project plan and make a budget to review benefits provided by Bangladesh Medical Society. And we also set some meetings with our data consultant to have knowledge about Bangladesh Medical Society membership status. We also set some meetings with our membership subcommittee. Like in our association, we have some subcommittee individually, like membership subcommittee, funding subcommittee and the advocacy subcommittee. So with this meeting, we set some activities what to do in advocacy program and how to communicate with the students to engage them as a member of Bangladesh Medical Society. We also did some meetings with the student leaders here to help students to make a strong leadership profile in institutions also as students and help other students to enroll in Iranian platform. We also did some advocacy program under the project. We advocate teachers and students about the association that is Bangladesh Medical Society and its activities and opportunities. And we also take feedback from them about the care and quality providing by the Bangladesh Medical Society. So under membership project, in our membership project, our outcome indicators and measurements were increased in number of student members of Bangladesh Medical Society. And our target was 500 more student midwives. We compared the student numbers before and after the quality improvement project. The second one is number of institutes to engage with Bangladesh Medical Society. And due to very short budget, our target was 13 institutes, but our positive reach could be 165. The third one is a percentage of the students accessing the online platform. As Bangladesh Medical Society in collaboration with WCEA is providing all members with access to a mobile lab and online security training platform. So we have 113 courses through WCEA mobile application and 122 online courses in our learning platform. So our target was 60% of 500 students accessing the platform. That was 300 students access the platform. And the last one was to draft a mechanism to BMS can identify and support students with their specific issues. In this regard, we did one survey with some specific question. So to draw a visual face of the problems and issues that our members were facing and the result was to have a good idea about our provider services. Here you can see some picture from our membership project. As we said that we did some advocacy program in institutions. So this is a private institute called Institute of Child and Mother Health in Bangladesh advocating teachers and students to make them engage with Bangladesh Medical Society actively. And we also influence students in this regard. And we also introduced the online platform of Bangladesh Medical Society to the students and teachers. This is another picture from Dhakanar Singh College as the Dhakanar Singh College as the Central Nursing Institute. So this college is a role model to the others. In this session, leadership principles were broadly introduced with the intention of engaging more student members. Another picture from Turakathu Red Nursing Institute. And during the advocacy program, students and teachers got to know about the association and its activities, its opportunities. And they also got to know how they can use the online platform of Bangladesh Medical Society and how they can be the member of the association explained briefly. So we also explained how an association can help to grow medical profession and how they can be engaged with it. So from now, another project on emergency response has started. So I give handover to my co-presenter to Canada. Thank you. Thank you, Arifin Mem. I'm from the emergency response project. And I focus the emergency response issue. I say you can see the background of emergency response. I use the five that work who, why, where and when the problem was. And here is the emergency background and the five points question I described to my whole project. Bangladesh is an emergency prone area. So the emergency situation, including flood cyclone and influx of refugees, women, adolescent and children are particularly vulnerable in emergency situation. And at risk of gender-based and other kinds of violence, one in our four people affected by humanitarian crisis are women and girls of reproductive age who require access to and reproductive health service. And more than half of the material that occurs in emergency setting. So through a quality improvement project, Bangladesh Middle Free Society tried to help the midwives and the mother during emergencies. For that, the Bangladesh Middle Free Society must be clear about its role in emergency preparedness, response and mitigation to ensure that women and their families continue to receive high quality sexual reproductive, maternal newborn and adolescent health care during emergency situation. 2018, Bangladesh Middle Free Society commissioned a consultant to develop a strategy for its role in emergency. Since then, Middle Free has become more established in Bangladesh and it's need to update the emergency guidance law. So here is the, you can see the emergency response project and that I include my aim, methods and theme from a data collection. So as a midwifery association, Bangladesh Middle Free Society was not clear about its role in emergency situation. So what is the role of Bangladesh Middle Free Society during emergency situation? How can Bangladesh Middle Free Society help the general member during emergencies and how can the member contact with the Bangladesh Middle Free Society emergencies? These are the main motive in my project. So the aim of my project was by January 2023, the Bangladesh Middle Free Society will have an up-to-date policy on its emergency situation that will have been tested, reviewed and adopted by the Bangladesh Middle Free Society executive team and will have been disseminated to the member and the stakeholder. And you can see the main theme for my data collection that midwife and Bangladesh Middle Free Society must be involved in national and local emergency planning. Bangladesh Middle Free Society can access member needs provide support and advocate for high quality service by midwives in emergency situation. And also Bangladesh Middle Free Society can provide education for member on their role in emergencies. So this slide is including the emergency guidance draft. Now up-to-date position paper has been developed by me with the cooperation from the Royal College of Midwives and the wider Bangladesh Middle Free Team and following ACPIC stakeholders engagement. So this is through my project. Here you can see the emergency new draft guidance. So it is include the emergency preparedness, emergency response and resilience. So for emergency response, Bangladesh Middle Free Society should participate in national, divisional and local emergency preparedness network and forum to raise awareness of maternal health vulnerabilities should offer training to member on emergency response and develop rapid assessment tool for use by local teams. They should also anticipate needs of member and have supplies and funds available to enable immediate response access and reserve fund for use in an emergency. For emergency response, Bangladesh Middle Free Society should collect data from member in the emergency affected area using situation background assessment recommendation tool. Escalate SBAR finding to divisional coordination and policy level stakeholder and they also continue to collect data from member throughout the emergencies. They also engage with national and divisional response team and provide funds or equipment if available to member according to their needs also monitoring health and well-being of member in affected areas. And for resilience, Bangladesh Middle Free Society advocate for national Middle Free education program to be prepared need why for their emergencies and also follow up on action point. And this is the picture that this is the picture that I conduct a session in RTMI college in Silat that it is an emergency, Silat is an emergency prone area and every time more of the emergency situation happened there. So through the response project I meet there with some midwives who are affected during emergencies and they share their stories how they suffered with the pregnant mother during an emergency. I also shared the emergency draft guidelines with them that when they affected in emergency they can contact with BMS during emergency situation. So these are the lessons that we learned from the quality improvement project that this quality improvement project we had we had to draft a project plan and budget and it was all about how we can utilize that short budget with different activities by making proper activity plan with the knowledge of leadership skill and learn through the classes. We are able to make a strong group of students help to engage our students as a member of Bangladesh Middle Free Society and register meet by help us to form a focus group by which we are also able to take knowledge about necessary step. We are also able to contact different stakeholders who are already engaged with emergency situation and it was also a leadership development process which we learned through our project and we did also advocacy program and face-to-face program online program. We also include leadership with the students to make their leadership best strong as a student. Please go through the next. So this is this is all from the board leadership development project that here we learn in the form of team meeting brainstorming session of forum and where a team member can discuss challenges here inside and see where key steps to systematically identify, analyze and address areas. Hello. Can you just summarize one or two and then we ask and give comments. Okay okay. So we also learn how to develop service quality in our workplace, how to use the knowledge and data collection and monitor effectiveness and to grow strongly. So this is our opinion that can help the other member who include leadership development project. Thank you. So please go through it. So this is our summary experience that we explain here that our quality improvement project taught us how to improve the system, help us to achieve predictable result and healthcare system and organization and help us to identify potential areas in improvement. So data collection and analysis monitoring the effectiveness changes also and our experience from this quality improvement project was full of knowledge. It was the first quality improvement project we did and it helped us to grow and make a strong leader. So beside the methods we learn it helps us even in our work by making our midway service quality full. Every midwife should engage themself with quality improvement project, especially where need a very proficient need and strong leader and quality full service. But for that we need to more opportunities, more platform and express our circumstances. Go to the next slide please. Are there any comments and questions? So here are our references and thank you so much. We want to thank the organizers of BITM to make this fabulous platform for this opportunity. So we can go through the questions and answer session if anyone have any question to us. And thank you so much for the comment man and the question is what advice would you give to other young midwives who want to raise their voices? How to have confidence when you are a young leader? So I think if anyone want to raise their voices I think it was quite difficult if you were individual that we learn from our quality improvement project that through an organization or teamwork you can raise your voice because in such a country where midwifery profession is totally new or needs some new opportunities or need to raise their voices in different sectors need to need to establish gender equality then you will need a strong association. So I think every midwife should be engaged with their professional association and for to have confidence as a young midwife leader you should you should involve yourself with different sectors with different stakeholders and obviously the quality improvement project as the opportunity really it will help us to grow a more as more strong leader. Okay any other comments before we wind up? Time is we have only three minutes to leave this conference to change over to conference room. So we have another question like what was your experience of older either medical or public professionals? Did you object to being too young? No we don't have any object to being too young because because as our profession is totally new in our country we are proud of that at in our age at the shortage we are representing our country and our midwifery profession in different sectors so I think it's a matter of feeling proud so thank you thank you for your question. Okay what I've learned is that for young leaders who succeed in their profession it calls for building their leadership also involving themselves in these associations and partnerships with others so that they really coming out from and again partnership is key in the success of any project for example the role of all the stakeholders have to be well highlighted each person knows the roles they have to play in in any project and Ara and Thomas I wonder how you really deal with the patriarchal issues in Bangladesh being young leaders in midwifery and you say midwifery is a recent profession I really wonder how you deal with the patriarchal societal perceptions in Bangladesh so that you can be able to move through your project. So I think some young midwifery may need to success the Trail Quality Improvement Initiative in Bangladesh that is the strong leadership and communication skill to inspire and motivation the midwives also and it is also improved analytical and problem solving skill to identify and gov's in the healthcare system and it also include it can be the knowledge of evidence based practice we can also practice it and quality improvement methodologies to develop and implement effective intervention so and that kind of decision in Bangladesh. Hi time is up thank you so much and we wish you all the best in your leadership development as you move forward. Thank you Chris do you have any comments?