International Day of the Midwife: 5 May 2014

Sub-theme: Midwives changing the world one family at a time
Date: 5 May 2014

Preamble

On the occasion of the celebration of the International Day of the Midwife, it is noted that lack of skilled attendance at birth remains a major cause of maternal mortality. This is because countries do not have adequate numbers of midwives to provide the needed skilled care.

It is estimated that Sub-Saharan Africa needs an additional 551,000 midwives by 2015 to bridge its deficit for midwifery1. It is also estimated that at the current rate of increase in numbers of midwives, it will take 29 years to reach the WHO recommended numbers of midwives and other health professionals of 2.28 per 1000 population in Africa2.

It is notable that midwives are at the heart of deliveries in Africa. More often than not, whether in the larger hospitals, or in dispensaries, midwives play a key role in ensuring safe delivery. It is imperative to have adequate numbers of midwives in all health facilities to improve skilled attendance at birth and reduce the high maternal and perinatal mortality in most African countries.

As 2015 draws near, it is noted that countries in Africa have not been able to meet the 5th MDG. This is attributed to a number of factors. By just bridging the 510,000 deficit for midwives however, maternal mortality would fall by more than one third in Africa3. It is therefore important that health systems not only employ but also retain adequate numbers of midwives.

It is in realisation of the role that midwifery plays in saving lives of women and newborns that Amref Health Africa has prioritised training of midwives in the last few years. As such, Amref Health Africa has ongoing courses for certificate, diploma, bachelors and masters degrees offered in accordance with nursing and midwifery regulations in countries where Amref Health Africa works. Through its three year campaign – Stand Up for African Mothers, Amref Health Africa aims to train 15000 midwives between 2013 and 2015. To date 5452 midwives have been trained through this campaign. This number will go a long way in meeting the current deficit for midwives across countries in Africa.

On this day of midwives, Amref Health Africa renews its commitment to work hand in hand with governments, development partners and civil society organisations to:

Amref Health Africa promises to:

  1. Assess adequacy of the health workforce with special attention to numbers of midwives in countries and its impact on maternal and child health and develop strategies for improvement.  
     
  2. Work hand in hand with midwifery regulatory bodies and training institutions to continue building skills of practicing midwives through innovative training approaches that do not take the midwives away from their work for too long.
     
  3. Using acceptable country curricular, do basic training for midwives to add numbers of midwives to the market and reduce the deficit in Africa.
     
  4. Work closely with midwifery associations and training institutions to advocate for improved coverage, equity and quality of maternal and child health services


Amref Health Africa realises that governments are solely responsible for ensuring the right to health for their citizenry. We only support the governments to meet this objective. To that extent, Amref Health Africa urges governments as well as their development partners to meet the following obligations for improving access to midwifery care:

Amref Health Africa asks governments and development agencies supporting them to:

  • Allocate adequate resources to train more midwives to reduce the current deficit.
     
  • Absorb any unemployed trained midwives into the health system
     
  • Improve working conditions for midwives as a strategy for motivating them as well as for improving quality of maternal health services
     
  • Enact policies on task sharing that ensure the application of all midwifery skills as listed by the International Confederation of Midwives (ICM)


Bibliography

    Alexander S. P., Richard M. S., Chris B. M., Brent D. F., Mario R. D., Estimates Of Health Care Professional Shortages In Sub-Saharan Africa By 2015, Accessed on 24th Feb. 2014 at http://content.healthaffairs.org/content/28/5/w849.full.pdf+html
     
    Birth Rate Plus (2014), Ratios For Midwifery Workforce Planning at National, SHA and Local Level, accessed 24th Feb. 2012 at http://www.birthrateplus.co.uk/index.php?option=com_content&task=view&id=14&Itemid=1
     
    Vincent De Brouwere and Wim Van Lerberghe (2001), Safe Motherhood Strategies, a Review of the Evidence, accessed on 24th Feb. 2014 at http://www.plan.givewell.org/files/DWDA%202009/Interventions/Maternal%20Mortality/SafeMotherhoodStrategies.pdf#page=105


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