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Transforming the obstetric nursing workforce in NE Brazil through international collaboration

Girot, Elizabeth A.; Enders, Bertha Cruz; Wright, Joyce


Elizabeth A. Girot

Bertha Cruz Enders

Joyce Wright


Aims. This paper seeks to analyse the content, people and process of transformational change to introduce new ways of working for specialized obstetric nurses in northeast Brazil, and identify the lessons learned. Background. Countries across the globe are beginning to focus on improving the nursing workforce through new ways of working. High numbers of caesarean sections coupled with high indices of maternal mortality in northeast Brazil prompted the introduction of a British Council Higher Education Links scheme to work collaboratively to transform the role of the specialist obstetric nurse and introduce the principles of Safe Motherhood. The concept of a normal birth had not been widely accepted, with the birth process viewed as a medical condition requiring pharmacotherapeutic interventions rather than as a natural process. Method. Between 2000 and 2003, a more woman-centred approach to childbirth was introduced through the local delivery of two in-house education programmes and the qualification of 38 nurse-midwives. Discussion. In spite of its slow progress, the success of the Higher Education collaboration has been recognized nationally, a new philosophy is guiding practice and new ways of working have been established. Conclusion. Lessons learned include the need to set achievable goals (content), respond to the emotional needs of those involved in the change (people) and make best use of reciprocal visits to rally the teams and sustain the focus for change (process). Although the Higher Education link is complete, funds are being sought for formal evaluation and dissemination. Overall, the process and outcomes of this collaboration suggest that to embrace such an opportunity to learn from each other can lead to real improvements in service and the lives of women. © 2005 Blackwell Publishing Ltd.


Girot, E. A., Enders, B. C., & Wright, J. (2005). Transforming the obstetric nursing workforce in NE Brazil through international collaboration. Journal of Advanced Nursing, 50(6), 651-660.

Journal Article Type Article
Publication Date Jun 1, 2005
Journal Journal of Advanced Nursing
Print ISSN 0309-2402
Publisher Wiley
Peer Reviewed Not Peer Reviewed
Volume 50
Issue 6
Pages 651-660
Keywords collaboration, international health, practice development, rural midwifery, transcultural nursing, workforce issues
Public URL
Publisher URL
Additional Information Additional Information : This paper evaluates the outcomes of a British Council and Brazilian government funded 3 year academic link between the University of Rio Grande do Norte, Natal, Brazil and the UWE, Bristol. Girot took forward work developed through an earlier British Council funded project led by Pollock (UWE) and Emond (CCAH).

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