PURPOSE:
To share the program strategic approach of introducing and integrating a culture of translational simulation as a part of maternal and newborn care related quality improvement (QI) initiatives in Nepal.

DISCUSSION:
Despite 80% of births being attended by skilled health providers, the high Maternal Mortality Ratio of 142/100,000 and Neonatal Mortality Rate of 16.6/1000, indicate quality care issues, particularly in intrapartum and small/sick newborn care. This necessitates urgent efforts to strengthen competencies and quality of care along with integration of midwifery models. Under the leadership of Family Welfare Division, in collaboration with provincial stakeholders and supported by UNICEF Nepal, Laerdal Global Health and Simulation Society of Nepal launched an initiative in 10 facilities, targeting areas with highest maternal and newborn mortality, benefiting over 30,000 births annually. I. Strengthening competencies of the interdisciplinary healthcare teams including midwives using onsite responsive low-dose high-frequency skills and simulation sessions II. Strengthening low-cost, efficient set-up for simulation-based capacity building at the health facilities. III. Strengthening linkages for technical support by engaging pool of mentors/ experts IV. Strengthening the implementation of QI processes in maternal and newborn care including Maternal and Perinatal Death Surveillance (MPDSR), innovations like Safer Births Bundle of Care (SBBC), [i] Labor care Guide (LCG), Respectful Maternity Care (RMC), Thermal watch and SNCU orientation. V. Community engagement using Human-Centred Design to increase service utilization.

EVIDENCE WHERE RELEVANT:
This program includes scalable, sustainable approach based on global learnings around translational simulation [i] to create culture change in strengthening competencies, QI initiatives like MPDSR, SBBC, LCG, RMC and community engagement. [i]Nickson, C.P., Petrosoniak, A., Barwick, S. et al. Translational simulation: from description to action. Adv Simul 6, 6 (2021). https://doi.org/10.1186/s41077-021-00160-

KEY MESSAGE:
Comprehensive, collaborative simulation-based interventions strengthening government-led QI initiatives translate to improved maternal and newborn care quality while ensuring midwifery models of care. Education - competency development 3 (including three-minute presentation competition)