The World Health Organization honored the 200th anniversary of the birth of Florence Nightingale and the significant contributions of nurses and midwives by designating the year 2020 The International Year of Nurses and Midwives. It is estimated that 42% of maternal and newborn care can safely be provided by nurses and midwives.

Global partnerships can provide educational initiatives for birth attendants that are cost effective. For example, the American Academy of Pediatrics works with the John Hopkins Program for International Education in Gynecology and Obstetrics on Helping Babies and Mothers Survive (Ersdal et al., 2017; West & Bokosi, 2020). The International Confederation of Midwives partners with national midwives' associations in Happy Birthday projects (Laerdal, 2020). The 10,000 Happy Birthday project in Malawi and Zambia was able to enhance the life saving clinical skills of 10,000 birth attendants. Additional partners include Latter-day Saint Charities and others, providing training in Malawi, Zambia, Ethiopia, Tanzania, and Rwanda (West & Bokosi). I have personally observed the training being given in Armenia by the Latter-day Saint Charities. Training in the Russian Federation has been facilitated in a hospital skills laboratory and accompanying institutions where nurses, midwives, and physicians are educated. National midwifery associations are given resources such as simulators. International training teams focus on train-the-trainer workshops. Midwives are provided with equipment and supplies for their clinical practice. Outcomes evaluations are being conducted, with positive results of the training documented. In Rwanda there was a 52% reduction in neonatal death and 12% reduction in stillbirth after educational initiatives (Novametrics, 2020). In addition to reductions in maternal and newborn mortality, researchers found that midwives, nurses, and physicians collaborated more often as they learned evidence-based practices together and applied them in their clinical practice after being in the safe environment of a simulation laboratory. Midwives were viewed more positively by other members of health care team as they built their confidence and skill levels. A comprehensive review of barriers and facilitators of quality midwifery care in India found lack of competence was a significant barrier, whereas the provision of hands-on education an essential facilitator (McFadden et al., 2020).

Collaborating with national midwives' associations is being found to be an effective way to foster long-standing partnerships that are becoming long-standing. Constant quality improvement evaluation is conducted, as midwives being trained are surveyed, answering questions such as "What went well?" and "What could you have done better?" (West & Bokosi, 2020, p. S224). Professional relationships established and sustained over time are essential for success. The Latter-day Saint Charities (2019) has been providing these types of educational initiatives in 94 countries since 2003, with training provided to 83,555 providers (nurses, midwives, physicians) up to and including 2019. That is 16 years of long-standing collaboration. Their Maternal and Newborn Care initiative has helped over 80,000 children and mothers in 27 countries and territories in collaborative efforts. Best practice for maternal and newborn care is facilitated by global partners committed to improving the health and well-being of mothers and newborns through educational initiatives and partnerships. Nurses are leaders in maternal and newborn education and care around the world and thus vital to optimal outcomes.

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