The Nursing & Midwifery Development Center (NMDC) is a non-governmental organization based in Erbil, Kurdistan Region of Iraq. It provides continuing professional development (CPD) courses for nurses, midwives, and other healthcare professionals through a purpose-built, 36,000 square-foot simulation and training facility.

With 11 high-fidelity simulation laboratories and capacity to train up to 7,000 professionals annually, the NMDC is designed to strengthen the clinical skills of the existing healthcare workforce—particularly those working in maternal and newborn care.

Iraq has achieved high levels of childbirth within facilities, with approximately 96% of births attended by skilled health personnel. However, maternal and neonatal mortality remain elevated:

• Neonatal mortality rates in Iraq: ~21 deaths per 1,000 births - more than triple that of the U.S. (World Bank)

• Maternal mortality rates in Iraq: 66 women die per 100,000 live births due to pregnancy-related causes in Iraq (World Bank)

• The absence  of  trained attendants  who  provide  the necessary  care  for  babies  is  the  leading cause of newborn death in low- and middle-income  countries, such as Iraq.

Iraq's healthcare system, once among the region's strongest, has been severely impacted by decades of conflict, sanctions, and underinvestment. Many facilities lack basic equipment and experience frequent supply shortages. The country faces critical healthcare workforce challenges, with an estimated 70% of doctors having left since 2003. Security concerns continue to limit access to antenatal care in some regions, with women reducing facility visits to minimize travel risks. (Quoted from the Healthy Newborn Network)

This indicates that the primary challenge is not access to care, but quality, consistency, and emergency readiness at the point of care.

NMDC focuses on upgrading frontline providers through high-fidelity simulation (HFS) and evidence-based training programs.

High-fidelity simulation recreates real clinical emergencies using advanced, robotic mannequins with lifelike skin and internal sensors. The mannequins:

• Breathe, bleed, and respond physiologically to treatment

• Deteriorate or stabilize based on clinical decisions

• Allow full-team practice of emergencies such as:

  • Neonatal resuscitation

  • Postpartum hemorrhage

  • Shoulder dystocia

  • Maternal cardiac arrest

HFS enables clinicians to practice rare, high-risk scenarios repeatedly in a zero-risk environment, allowing nurses and midwives to master life-saving skills before ever working with a real patient.

Simulation-based training is widely used in obstetrics and emergency medicine because it improves both provider performance and patient outcomes.

• Reduction in adverse outcomes: Simulation-based obstetric training has been associated with reductions in composite adverse maternal outcomes (such as postpartum hemorrhage requiring transfusion) from 6.9% to 3.8% (Source).

• Reduction in Neonatal Injury: Large-scale trials have shown that simulation training for obstetric emergencies (like shoulder dystocia or neonatal resuscitation) can reduce permanent neonatal injury rates by 50% (Source)(Source2).

• Improved clinical performance: Research shows that simulation-based training can drop clinical error rates from 30.9% down to just 4.4% in high-stakes environments (Brown).

NMDC provides hands-on simulation programs for nurses and midwives, including:

• Helping Babies Breathe (HBB): An evidence-based program from the American Academy of Pediatrics (AAP) that teaches essential newborn resuscitation skills to reduce neonatal deaths, especially in low-resource settings (Source).

• Essential Care for Every Baby (ECEB): Another AAP program that focuses on immediate newborn care practices such as keeping babies warm, skin-to-skin contact, early breastfeeding, and infection prevention (Source).

Both programs use realistic, practice-based simulations to ensure that trainees can apply life-saving skills in real clinical settings.

The World Health Organization (WHO) estimates that over 80% of maternal deaths, stillbirths, and neonatal deaths are preventable with high-quality midwifery care delivered to international standards. (WHO Midwifery Ed Framework; WHO Maternal Health; The Lancet)

Some outcomes of courses offered at the NMDC:

• Helping Babies Breathe (HBB)

  • ~56% reduction in infant mortality rate in the first 24 hours after birth

  • ~57% reduction in stillbirths 

  • Proven impact in Nepal and other low-resource settings (LDS Study in Nepal; HBB)

• Essential Care for Every Baby (ECEB)

  • Only 2.5% of nurses had mastery of ECEB skills before training

  • 85% of nurses achieved mastery after completing the course at NMDC (Study of NMDC)

NMDC strengthens healthcare across the region, not just for mothers and babies. As a certified American Heart Association training center, we offer Basic and Advanced Life Support programs, equipping nurses, midwives, and emergency responders—including the Peshmerga—with essential life-saving skills. We are also expanding into additional areas of nursing and healthcare, multiplying the impact of every trained professional.

It costs just $29 to train one nurse or midwife in NMDC simulation-based programs, equipping them with skills to improve maternal and newborn care.

• $60 trains 2 nurses or midwives

• $600 trains 20 nurses or midwives

• $1000 trains equips 35 nurses or midwives

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