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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 pharmaco-therapeutic 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.

Background: To enhance healthcare globally, successful academic partnerships between institutes of higher education are crucial to strengthen collaboration between countries and identify new ways of working. The desire to reduce maternal mortality and morbidity among childbearing women in north-east Brazil urged professional nurses to seek new ways of working through such a partnership. Reflections on the success of the link identify the key qualities uniting the partnership., Aims: This paper explores the key qualities of a higher education partnership between the United Kingdom and north-east Brazil. These qualities can act as a guide to other faculties engaged in such links to facilitate successful collaborative working for gains on both sides., Results: Critical reflections from both partners revealed that the key qualities identified are effective communication, deep commitment and the need for both partners to understand each other's context of care., Conclusions: Examination of each of these qualities illustrates that the shared perspectives, mutual respect and enriched educational experience are valuable and essential to successful partnership working. This critical reflection illustrates the process of success and how others can benefit from the lessons learned, whatever the nature of partnership. Understanding the nature of collaborative working has strengthened each education and practice community, encouraged them to take risks, and remain committed to collective success.