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Dr Helenlouise Taylor, Consultant - World Health Organization

Dr. Taylor joined WHO in 2000 and has worked with WHO, UNICEF and IFRC in many countries in Asia and Africa. She has served as an advisor to the Ministries of Health of Mali, Uganda and Sierra Leone and supported the development of country level plans and budgets, strategies, roadmaps, operational guidelines and the adaptation of global guidance and materials.  
WHO guidance and training materials for all levels has been critical for training and educating healthcare personnel. Currently, Laerdal Global Health is working with the WHO on Essential Newborn Care and Small or Sick Newborns courses.  
How does the development of guidelines translate to training and competency development?  
In the past this was an enormous gap, with global guidance and trainings rarely reaching the health workers most at need, without the necessary competencies to save lives, prevent disabilities and promote healthy growth and development. 
What was the role of the WHO in the development of the ENCC Essential Newborn Care Course (2nd Edition)? 

The ENCC course was developed by WHO around 2002 and field tested in a number of countries and then implemented as a draft version. The first edition was published in 2010.This course was didactic and not linked to specific competencies. Together with partners, WHO decided with partners updated the course to include guidance which had changed since the publication of the first edition in 2010 and to integrate established courses. WHO led the update process through a technical advisory group. 
What are the key improvements and benefits of the updated version of the course?  
The new course is newborn centered, based on what newborns need. It is competency based and practical and takes place where newborn care is being provided. Emphasis has been placed on developing skills and performance, with many simple simulations These simulations all incorporate the experience of care, with respectful care and infection prevention fully integrated. Participants also work with mother and baby dyads, in the clinical setting practicing or observing care provided.  This is then directly linked to quality improvement activities.  
Another key improvement is the flexibility of the course and its availability in digital format. Organizers design the course that participants need.  Components of the course can be provided when needed and where needed in response to the current situation in a health facility. The course can be offered in blocks or in regular sessions as needed; weekly, monthly etc. No longer are long expensive trainings away from place of work, which require funding for travel, per diems and more. This flexibility supports extensive reach to health workers previously left behind in hard-to-reach fragile situations, and conflict affected areas. 
What do you see as necessary prerequisites for the effective implementation of the Essential Newborn Care Course (2nd Ed.)? For example, what do countries need to ensure the success of the program?  
Countries need to take stock of where their starting points are. This may vary in subnational locations, so careful scrutinizing of disaggregated data and documenting gaps is needed.  
Many will need to carefully review preservice curricula for all cadres caring for newborns, professional accreditation, and the content and methodologies for continuing education.  
Another critical area will be upgrading the competencies and performance of faculty and facilitators. For many, the new educational methods such as running effective simulations and effective debriefings will need support. This may also be the case for effective clinical practice and debriefing. For some, transitioning from didactic teaching will take time. As simulations and continuing practice are key, countries will need to invest in adequate materials and equipment for practice, but more importantly they need to ensure that adequate functional lifesaving equipment, such as bags and masks for resuscitation are immediately on hand when needed at each birth in health facilities. Without this investment, there is no point in starting educational activities. 
How can the implementation of ENCC be used as a model for the implementation of the upcoming Small and Sick Newborn Care course? How are they linked?  
The ENCC is the foundation for quality care for ALL small and sick newborns. The upcoming course will have benefitted from the experience of field testing of ENCC in countries and the important work that has been done with end users (health workers/students) and families from the start. The course must be practical and ensure competence and confidence for performing the more complex skills required such as safe timely and use of equipment. 

Image: Dr Taylor, pictured alongside WHO's Dr Teesta Day, on a recent trip to Laerdal Global Health head offices in Stavanger, Norway.

What is the benefit of partnership collaboration for co-designing programs that are tailored to their needs and contexts?  
The design of the programs is more likely to be effective and have lasting impact. 
How can partnership amplify impact?  
I see it like a raft and ripple effect. When we see something working with our own eyes, and having impact, we want to share and to try out in our own context. Documenting impact and using data to leverage support, collaboration and funding from public, private sector partners and foundations can further amplify impact. Specific partnerships and collaborations can fill voids, and have impact on practice, for example the development of much needed low-cost equipment for simulations, which ensure that students and health workers practice and gain confidence and bridge the “know do” gap, which means what we “know” must also be what we “do.”