This is a short reflection of four wonderful weeks spent in Nepal supporting, advocating and strengthening the existing work of the Midwifery Society of Nepal and the Global midwifery twinning project (GMTP) with the Royal College of Midwives. Although Nepal is on target to achieve reduction in its maternal mortality rate for millennium goal 5 there is still no registered protected title of 'midwife' In order to establish a strong midwifery workforce in Nepal, the three pillars that need to be highlighted are: midwifery education, midwifery regulation and professional midwifery association. The four-week programme led by GMTP volunteers helped towards building capacity in leadership, advocacy and campaigning skills in Nepal.