 She's a lecturer and director at, well let me see if I get this right, yoga, kata, midwifery academy. But the responsibility is for academic planning, research and development, curriculum and strategic learning. She's also been a midwifery private midwifery clinic where she was a supervisor of midwifery services. She's developed an interesting, natural approach to midwifery care and midwife education after studying her diploma 3 and midwifery, diploma 4 in midwife teaching and last as a public house. She's focused on midwife care and capacity abilities. She's conducted extensive research over the years in a whole range of things including attitude and behaviours of midwives to breastfeeding and promoting infant formula, patterns of breastfeeding, medical error in childbirth by new graduates and family approaches as a method in community with midwifery practice. And recently she just finished a study about partnerships between midwives and family and board. And today she's joining us to talk about instilling ambition to study midwifery in team. And I'll hand it over to you now, history. I might just take us through those first few slides before history starts if that's alright. History? It's just to remind people how to use the facility here and acknowledge the help that we have from these organisations. If anyone needs to go through the audio setup wizard, just to make sure their technology is working fine, you'll find that up under the meetings tab. And most of you have been here before and you'll know how to use the chat window so please feel free to make comments and keep them relevant to the presentation if you don't mind. You can also use that icon that you can see at the very top of your screen to make some gestures or short bits of feedback. Please be aware that we will be analysing this, the chat in the window for research purposes. We won't be using anybody's names, we're just interested in how you use that facility in a conference. You do get a chance to speak at the end when we'll have some opportunity for questions. You do need to activate the microphone by pressing on the icon, but first putting up your hand so we know that you want to speak and then we'll hand the microphone to you but you need to press on the microphone to make it green so that it will be activated. Sometimes your volume is a little low and trishores was a little low then so we can adjust the microphone if you're not hearing so please let us know. The session is now being recorded and over to you. Okay thank you Deb and Trish. Hello everybody, nice to introduce myself. My name is Isri Bhartini from Chukchakarta Midwifery Academy in Indonesia. Today is a special moment and I would like to say Happy International Day of Midwifery 2016. We're proud to be a midwife and you know let's talk about midwife. Now I will share our experience about how to inspire ambitions to study Midwifery in teams. First of all, let me show you our position now. Here we are. As you are most of you have no one in Indonesia and we study at Chukchakarta Midwifery Profane, a small profane in Central Java and as we know that Indonesia has a huge number of midwives. Get out from Indonesian Midwife Association show that Midwifery of course are 353,000 and three midwives and the ratio is 49.56 bar and 100,000 people. And we have more than 700 Midwifery students for them. So many people say that Indonesia now is the surface of midwife. This condition let us to think about the opportunities and the challenges. As we know that the key message of the International Day of Midwifery 2013 is the more and the worth of the midwife now and more than ever. And the last series in 2014 articulated that Midwifery matters more than ever. And then in 2015, the WHO stated that midwife is a legal player role in decreasing maternal mortality rate. Which is 44% since 1995 to 2015. MR is the correct. It is a good change for midwife. And for Indonesia, we have had a chance to increase the quantity and quality of midwife. But something in the rest to discuss is that in our country, most team doesn't have an ambition to be a midwife. It's my interest to study midwife in Greece in three years later. Even when we were child and when we was young, if there is a question, what is your ambition or what will you become in the future? The most answer is to be a doctor. Some children maybe say to be a teacher or to be an engineer. No sound midwife here. No sound that they want to be midwife. So without that, training for a little midwife or as a community midwife is an initiative to introduce who is a midwife and build patience to study midwifery. On the other hand, we faced a problem that exclusive breastfeeding program only 52.3% implemented. So we try to involve women, families, and communities in the design and delivery quality maternal and newborn care. This study attempt to solve the advantage of little community midwife training in both this proposed twin-styling ambition as a midwife and empowerment in enhancing exclusive breastfeeding. Let's have a look to what we have done. It is a simple project. We working with our students. We have a community laboratory. It is a small village which uses practice midwifery in community setting for students. And in this village, many teams hope potentially to be encouraged to take part in health promotion activities. And in 2014, community midwifery field practice by students has found that exclusive breastfeeding in this village is just 32%, even mother not working outside. The reason is lack of information and support from other do-do exclusive breastfeeding. This problem inspired lecturers and students to create a program to empower the community with a little community midwife or little midwife. At the beginning, we do an advocacy. Some approaches to village government have done. And fortunately, the leader of this village is a woman. She is very interested and gives strong support to our project. I think it is a good suggestion that we meet the woman leader. It is easy to share vision. It is easy to make a commitment. I think if midwife has a position in a decision maker like she or her, maybe it becomes too easy to enhance maternal and child health. Another effort is to have a meeting and disseminate the project to help cattle group. The main purpose is to empower the community in their health. A little community midwife is a part of community that will contribute for health programs at the village. The next step is training. A little community midwife training held in October 2014. And then we continue on March 2015 and October 2015. We invite 33 teens from seven villages and all of them are girls. They are nine up to 12 years old. And we prepare the material. There are healthy pregnancy and exclusive breastfeeding. And the training activities. We do some activities that we give a theory class in two day first. And then we continue to workshop for two guys. And we continue to sympathetic action. And then the last week do a competition and evaluation. The picture of class of theory. The material are about healthy pregnancy and exclusive breastfeeding. And the theory are provided by midwifery students. Our midwifery students. We do a class theory two hours in every afternoon. And our students use a method like lecture and sometimes they do it again. The class theory is to know the improvement of knowledge. So at the beginning, little community midwife training was doing a pre-test. After they finished the theory, little community midwifery have a reflect the information in their class theory into a creative handmade. And little community midwife have three days to finish handmade. And their handmade was used as a media to promote exclusive breastfeeding. And the picture, some activities that the little midwife makes a creation to make a media to promote the exclusive breastfeeding. And the best experience is the sympathetic promotion to pregnant women. The LCM applied in 11 group. They treat in per group. And they visit pregnant women in their village to promote exclusive breastfeeding with the media they meet. When they visit mother, the mother, student midwife, assist the little midwife during activity. And pregnant women give a sticker to appreciate the LCM. Activities, we have to know the effectiveness of the project and to endorse the LCM. So we make a competition in evaluations. Post-test has done to evaluate their knowledge. And then the winner selected from the highest point in post-test and most number of staff ticker they got. An independent view has done to seven little community midwifery and also for five pregnant women. This is the picture that we documented in our activity. And the scoring in pre and post-test analyzes with the priority test and the data showed us the statistically significant difference between the main pre and post-test with the B-value 0.00. And if they're naturally building for positive data for their teens or little midwives have positive interpretation for midwives. You can see what they say in the yellow writing. And pregnant women also gave an appreciation that a sympathetic with creative handmade by little midwife became a fun reminder to prepare exclusive breastfeeding. This study besides that learning midwifery by practicing is an effective method. What little midwife done with mother is a valuable learning experience. And I think that a deep impression in it when they were seen come up likely subconscious mind. They will remember for their future. It might be influenced to make decision making study midwifery. It's time to get the patience. It's very important. And from this study patient to study midwifery will be found when someone do a midwifery practice. Study 2015 they see the bottom at all. Said that as students progress through the program growing commitment and interest in midwifery and stronger sense of vocational direction strengthen it. They did the determination to complete what I have started. And stuff at 2010 also said a decision to be a midwife sometimes in spite after someone meet pregnant woman. And became to think about the amazing of the process of pregnancy and crazy creations of a whole person. Or maybe come up become see all this because see all this love of baby. Other study of all that effective practice for children, boring woman and infant is how education and support to promote this feeling. And I'm agree with Professor Corleane writing in 2015 that in a real where are in sufficient of midwifery. Other providers with a midwifery skill can be can provide some or many of the effective interventions. So the conclusion is that a little community community midwife. Build an ambitions and patients to become a midwife. It's very important, particularly for teacher or for faculty or for midwifery itself. And this initiative should be continuously held to strengthen midwife and community empowerment, particularly in exclusive best feeling program. This is the reference that I have read to support this study. And I think it's enough. Again, I would like to thank you for the committee, FIA EDM conference and I hope we'll continue participating in the next year. And thank you for all participants and trees and gaps. Many thank you. And again, happy international day of midwifery 2016. Thank you for that. That was so wonderful. If anybody got any questions or comments that they'd like to put into the chat box or would like to jump on the microphone, pop your hand up. So we've got Tesla saying here, a very interesting program. I love an experience like this when I was younger, beautiful. Deborah is asking, what are some of the barriers to girls becoming a midwife in Indonesia? I think for girls becoming a midwife in Indonesia, some barrier is, I think it's policy. Because, you know, in Indonesia, people prefer to get high education. And unfortunately in Indonesia, although we have a large of midwifery school in diploma midwifery, but there is a very, very little, a very, very, I think just two universities that held this large degree of midwifery. So people now think that they have to continue education and unfortunately the government is not really now. So yeah, that's the policy level. We've got some more questions just coming through now. So yeah, a big thank you from Deborah. Has anybody else got any questions for history? You can jump on the microphone as well or pop it in the chat box. I was just going to make a comment and I wondered what people in other countries think about what are the draw cards for young people to be midwives. And I don't know if it was popular in Indonesia, but the television program called The Midwife is a TV program, a fiction about midwifery in the 40s and 50s. And I think that's been very influential in highlighting the role of midwives even though it's different now. So yeah, I'm interested in other people in the audience. What do they think of things that are attractive for younger people about being midwives? I think that it is true that technology and information give up a lot of information about midwife and they can access everywhere and anywhere. But you know, in Indonesia, I think medicalization is fairly dominant. So the most popular health worker is a doctor. And maybe they just know about midwife who person to assist the delivery. They didn't know what midwife is like. And maybe because most of us or most of midwife Indonesia is a woman. So sometimes we have an art unit. So yes, I think that the prior problem is that medicalization is very, very dominant in here. I bet anyone else has any experiences to share? I'll put them in the chat. I've also got another question here for you, Istri, asking, what are some of the topics that the girls found most interesting during the program? For this study, we can see that all the topic is interest for the girls or for the midwife, because we can see the participation during class, in workshop, and same but they did action. No one of them given negative or doesn't understand. I think because they can discuss with our students and also make a creative. So I think the two topics that are healthy pregnancy and breastfeeding is an interesting topic for the girls because our students say with approach, it's like a kid approach, not like a lecture in a campus, but it's very funny and very simple to easy to understand for young girls. Wonderful. We've got someone with their hand raised here. So I'll just pop you on the microphone and welcome to the call, Andrea. You should be able to speak now, Andrea, maybe. You might need to enable your audio settings to speak. You've got to activate the microphone, Andrea, so I've enabled the microphone. You might have to activate it. You can use some icon at the top tab and make sure the microphone is green and then it activates it, Andrea. Okay, so is anybody else got any questions like a pop in the text books? I see that Olga's typing. I think it's very important to lecture our teacher, midwife with teacher because our students have a surprise to some students in four years that when they ask about the motivation to study midwifery, they say that 40%, they go to study midwifery just to make parents happy. It's not true from their feeling or their ambitions because at first they're not the ambition to be a midwife. So it's important to teacher when they have a coming to midwifery program to ensure the patient, to ensure the motivation to study midwifery. Yeah, so Olga's just saying here that promotion of midwifery would be greatly improved by the support of the medical community. Lack of acknowledgement of the value of midwives as a respected professional is a barrier to many. Did you want to talk to that at all? Any other questions or comments? Yes, I have to promote that midwife is a provision given effective care in mother and child rather than a medical care. So it's a challenge to us to ensure to convince the community, the mother, the females and particularly lorry for midwifery that actually we have found that midwives tend to medicalization action. So it's like a humble for us to think about how to improve, how to promote midwifery to a good service in our community. Maybe make a peer study between midwife and midwife. The activity with the community midwife is a simple way when student midwife study with the young girls or teenagers and the younger or teenager is interested to study midwife and then they can share what is midwife. Having a good idea to improve and we have a plan to continue this activity in every year because we have a community laboratory that every year our students do an activity in this village. I just wanted to make a comment, you made some really interesting points about midwifery being really a primary healthcare with the family and the woman and the baby. The idea of high-tech hospital is very romantic to a lot of midwives and sometimes we've had young people turn up who can't wait to wear the scrubs and the stethoscope around them and then they see on TV what happens in a big acute hospital. So I think that's interesting that that is such a romantic idea that some people really want to have that medicalised view of themselves when we try to promote midwifery as not being centred in the hospital but more as a primary health intervention which may be not so much romantic and attractive to young people. Yes, that's right. And the people sometimes think that medical or when they go to the hospital it's more better than they do at the primary healthcare because they think that at the hospital there's more than equipment but it's not true I think. And from this study I think that we have to concern about the community how we can approach to the community. One of the ways is that we have done to create a project, create an activity that involves the community. At least they can join with our program sometimes like better group and we can improve what we can do to scale up the maternal and heart health in the village. Community empowerment is one of the important things that we have to think about community also make something like, what is it, maybe something the community will give us or protect from some protected midwife face problem. For example, when midwives understand the needs of the community and they can learn in the community activity and the community accept the midwife so it became a cultural safety I think. What we have done to approach with elements, with the part of the community there is teenagers in the community. It's so ineffective methods to introduce midwife, the importance of midwives.