Since the establishment of the Millennium Development Goals (MDGs) 14 years ago, global leaders, organizations, and nations have been working to reduce child mortality and to improve maternal health around the world.
Unfortunately, a major barrier in reaching the health-related MDGs is the fact that not everyone has access to quality health care services – whether at a hospital or a clinic. In sub-Saharan Africa, women are 100 times more likely to die as a result of pregnancy or childbirth than a woman in an industrialized country. Around the world, 289,000 women die from childbirth complications annually, nearly 3 million newborns die in the first month of life and 2.6 million newborns are stillbirth each year.
Enter: The midwife.
Midwife: An educated, accountable health professional who possesses the skills and experience to support mothers and babies through the pregnancy, delivery and recovery stages of birth. – UNFPA
Educated midwives have the capability to perform nearly 90 percent of the essential care for women and newborns before, during and after delivery. Midwives teach communities (men and boys included) about important family planning techniques and products and thereby help to decrease the risk of unwanted pregnancies. In fact, investing in an educated and well-trained midwifery workforce has the potential to yield a 1,600 percent (16-fold) return on investment due to the economic benefits that arise from improved maternal and newborn health. As a result, investing in an educated midwifery workforce can single-handedly help to improve gender equality, empower women and enhance economic development.
The 2014 SOWMy aims to do the following:
- Provide an evidence base on the state of the world’s midwifery to support policy dialogue between governments and their partners;
- Accelerate progress on the health MDGs;
- Identify developments in the three years since the SOWMy2011; and
- Inform negotiations for and preparation of the post-2015 agenda.
Additionally, the report highlights the importance of four key factors – the Availability, Accessibility, Acceptability, and Quality of midwifery care. It argues that countries and health systems must address each aspect of care in order to provide women and newborns with the lifesaving care they need and deserve.
Shockingly, the 73 countries profiled in the report account for 96 percent of all maternal deaths, 91 percent of all stillbirths and 93 percent of all newborn deaths, yet have only 42 percent of the world’s midwives, nurses and doctors. Even worse, no one country had a sufficient number of educated midwives and health workers to support the health of mothers and infants. The SOWMy stresses that, in order to attract others to a career in midwifery, midwives must be properly compensated for their lifesaving work.
Aligning with the United Nations Declaration of Human Rights’ assertion that “everyone has the right to life, liberty, and the security of person,” the SOWMy states that all mothers should have access to trained midwives, regardless of their ability to pay. The report urges countries to adopt a “minimum services benefits package” that guarantees a baseline of care for reproductive, maternal and newborn health.
Although maternal and newborn health centered policies accelerate progress, sustainable change comes from the bottom-up – from behavior change and societal acceptance. We must work together to dispel the myths and common preconceptions about midwives that inhibit women and girls from seeking their care.
Perhaps most importantly, the quality of midwife care and training must be addressed in order to most effectively decrease maternal mortality rates. Countries must recognize midwifery as a regulated profession in order to eliminate educational and infrastructural gaps – gaps that currently serve as huge barriers to the supply of skilled midwives.
Only 22% of the countries in the report have enough adequately educated midwives to meet the basic needs of women and newborns. #SoWMy2014
— UNFPA (@UNFPA) June 3, 2014
Progress and Next Steps
Thanks to the first SOWMy report in 2011, the world has finally realized the incredible importance of skilled midwives. In the past three years alone, serious improvements have been documented among profiled countries:
- 45 percent reported taking action to improve midwife retention in rural areas;
- 71 percent reported improvement in data collection and accountability;
- 28 percent have increased recruitment and deployment of midwives;
- 18 percent have prepared plans to establish regulatory bodies or associations; and
- 20 percent have a new code of practice and/or regulatory framework.
To ensure the availability, accessibility, acceptability and quality of maternal and newborn health care, policymakers, organizations and communities must champion all aspects of midwifery in the post-2015 agenda and let it be known that not only do midwives matter, but midwives save lives.
- Read about midwives on Girls’ Globe
- Discover the State of the World’s Midwifery report
- Like our Midwives Save Lives! Pinterest board
- Follow live updates from the 2014 International Confederation of Midwives by signing up for the Daily Delivery
- Join the conversation on Twitter using #SOWMy2014 and #ICMLive
Cover image c/o UNFPA