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Florence West RNM, MIPH, PhD candidate University of Technology Sydney.

BACKGROUND
Papua New Guinea (PNG) has some of the poorest health and education outcomes in the Asia-Pacific region. Maternal mortality is estimated to be as high as 733 per 100 000 live births. The World Health Organization (WHO) PNG Maternal and Child Health Initiative (MCHI) commenced in 2011 and is funded by the Australian Government.

AIM OF PAPER
The aim of the MCHI is to build midwifery capacity to reduce maternal and child deaths and improve health outcomes. In this paper I will present my professional reflections on my involvement in the MCHI and describe how collaborations between midwives can help to build much needed capacity for the next generation of midwives in PNG.

METHODS USED/RECOMMENDATIONS FOR PRACTICE
I was a Clinical Midwifery Facilitator (CMF) in the MCHI from 2012 to 2013. The role of CMF is to work alongside PNG midwifery educators as mentor and advisor to improve clinical and tutoring skills. The cultural exchange, professional development and personal growth that occurred was extremely valuable for both myself and my counterparts. In a low-resource, culturally diverse country like PNG, there are many challenges for the expatriate midwife. Language, culture, the ‘way things are done around here’ were all different. English, for many staff and students, is their third or fourth language and consequently face to face communication was more effective than email or telephone. There were inequities in housing conditions, salary and leave entitlements that also affected relationship building.

RESULTS/CONCLUSIONS
Capacity building requires more effective methods of culturally appropriate communication. Sharing details of my family life and my experiences working in other countries were received well as knowledge is traditionally transferred through story-telling. My ‘direct’ approach to get straight to the point was not culturally appropriate. The emphasis was more on the process of communication, rather than the outcome of the discussion. The responsibility for having cultural competence becomes more relevant today as increasing numbers of midwives migrate around the globe to support capacity development initiatives, seek professional development opportunities or fill rural and remote area vacancies.

ETHICAL/CONSENT CONSIDERATIONS
No personal identifying information will be provided. I have permission from UTS for this presentation.