GlobalHealthAfrica

Midwives: A Key Partner in Reducing Maternal Death

In Healthcare, Maternal and Child Health, MDGs on May 3, 2014 at 3:48 pm

Midwives are key partners in reducing maternal and newborn deaths in Africa. GHA contributor, Leigh Bernstein Reardon, makes a case for increased support for midwife training programs.

A quick Google search revealed that there are dozens of trained OB-GYNs in the 0.5 square-mile zip code where I work in New York City. Comparatively, Malawi, for example, has less than 20 trained OB-GYNs in the entire county. Another quick Google search led me to this statistic: a woman’s lifetime risk of dying as a result of pregnancy or childbirth is 1 in 39 in Sub-Saharan Africa, as compared to 1 in 4,700 in industrialized countries. Leaving behind (for now) all of the obvious disparities that these facts represent, what comes to my mind first is that these figures—the number of trained health care providers and maternal deaths—are inextricably linked. Recognizing the dangerous combination of limited physician training programs and the high prevalence of brain drain the African continent faces, global health experts are calling for increased support for midwife training programs.

Midwives can provide critical care in places where no other health infrastructure exists. According to the United Nations Population Fund (UNFPA), “Midwives can help avert two thirds of all maternal deaths and half of newborn deaths, provided they are well-trained, well-equipped, well-supported and authorized.” They not only deliver care during pregnancy, labor, and postpartum, but can provide front-line access to family planning and HIV/AIDS services. Midwives can also help reduce the need for emergency care by managing complications before they become critical. Importantly, midwives can be trained in 2-3 years, as compared to the 8-9 years it can take to train doctors, meaning they can provide more immediate care to women in need.

UNFPA’s State of the World’s Midwifery Report 2011 is the first comprehensive analysis of midwifery services and issues in countries where midwives are needed the most. Based on data and information from over 50 countries, the report highlights current issues facing the midwifery profession and urges governments, the international community, regulatory bodies, and training facilities to invest in the health of its mothers. Among the report’s key findings is that the global community lacks as many as 350,000 skilled midwives in order to meet the needs of women globally. The report also notes the importance of including midwives in costed maternal and child health plans, and health care policies. State of the World’s Midwifery Report 2014 will be published in June.

One movement working to increase the number of trained midwives is Amref’s Stand Up for African Mothers Campaign. Launched in 2011, the campaign seeks to help African nations meet Millennium Development Goals 4 and 5 by training 15,000 midwives in 13 countries by 2015. According to their website, Amref has trained over 5,000 midwives using a mix of conventional and distance learning techniques. In an effort to bring to the forefront the estimated 250,000 women who die from complications of pregnancy and childbirth each year, the Stand up for African Mothers Campaign has created a petition to nominate Esther Madudu, a midwife from Uganda, for the Nobel Peace Prize. The goal of the campaign is to have the global community recognize these needless deaths and the important role that midwives play in saving the lives of mothers and children worldwide.

This week, the world will celebrate International Day of the Midwife. In honor of this day, check out a video of Edna Adam Ismail, a former midwife and UN diplomat, giving a TedX talk on the value of midwives and the notion that progress can be made in even the most seemingly desperate situations.

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