PURPOSE:
This abstract shares practical insights from India on how strategic communication, trust-building, perception-shaping, shared language, and alignment strategies have served as critical enablers when introducing a new intervention in the public health system.

DISCUSSION:
In 2018, India took a bold step of introducing the Nurse Practitioner in Midwifery (NPM) as a separate cadre in the public health system. Since then, multiple development partners have worked to support the vision of the Government of India. While global midwifery scale-up often centres on education, regulation, and infrastructure, India’s experience highlights the importance of people-centred implementation enablers such as stakeholder trust, professional identity, and system ownership to ensure that new cadres are understood, accepted, and sustained. It was recognised that information and guidelines alone were not sufficient for integration. In systems where professional boundaries and decision-making structures are deeply embedded, mechanisms were needed to shift how midwifery was perceived and positioned within the broader health system. Aligning midwifery with existing cadres through strategic enablers helped build clarity and confidence, showing their roles to be distinct yet complementary. This abstract reflects on lessons from: • Sensitisation meetings that facilitated shared understanding and system buy-in • Consistent use of standardized terminology to ensure clarity and coherence • Bootcamps and exposure visits that supported inter-professional engagement and confidence • Commemorative events that normalized and affirmed midwives’ roles and presence in public health systems • Adaptive course corrections to maintain alignment and momentum

EVIDENCE WHERE RELEVANT:
Based on multi-year efforts across four Indian states, this abstract draws insights from meetings, bootcamps, exposure visits, campaigns, and success stories. Qualitative insights suggest improved clarity on midwifery roles and stronger collaboration. Implementation continues, with encouraging results to be shared during the presentation.

KEY MESSAGE:
Strategic communication and alignment are essential for creating environments where midwifery can be accepted, integrated, and sustained as part of public health systems. French - professional identity