By Princess-Ekwi Ajide -Abuja
The 2021 State of the World’s Midwifery report, by the WHO, the ICM and the United Nations Population Fund (UNFPA), say the global shortage of midwives stands at 900 000, and is particularly acute in Africa with estimates that 75% of essential needs for maternal and reproductive health care are met by midwives, it is however worrisome that the comparative figure for the WHO African Region is 41%.
International Day of the Midwife is celebrated annually on 5 May, providing an opportunity to honour the work of midwives, and promote awareness of the crucial care that midwives provide to mothers and their newborns.
This year marks 100 years of the establishment of the International Confederation of Midwives (ICM) and there are currently 143 Midwives’ Associations representing 124 countries worldwide, including the Confederation of African Midwives Associations (CONAMA), which was inaugurated in 2013.
Midwives, are the front-line caregivers and backbone of maternal and child health care on the continent and have been an integral part of African medicine for centuries. They support women through pregnancy and childbirth, providing antenatal, intrapartum and post-natal care, and family planning services, as well as breast and cervical cancer screenings. In emergencies, they can also perform basic emergency obstetric care.
According to the WHO Regional Director for Africa, Dr Matshidiso Moeti, Midwives are central to the prevention of maternal and newborn deaths, and stillbirths and 4.3 million lives could be saved annually by 2035 if there is adequate investment in midwifery, with particular relevance for the WHO African Region, which records about 196 000 maternal deaths each year, along with the deaths of one million babies younger than one month.
She lamented that if current trends persist, only 300 000 midwifery jobs are likely to be created in low-income countries, with the shortage of midwives set to increase to 1 million by 2030 and this has serious implications for the Sustainable Development Goal target of reducing the global maternal mortality ratio to less than 70 per 100 000 live deaths before 2030.
Dr. Moeti, said that contributions of midwives towards achieving the Sustainable Development Goals and Universal Health Coverage cannot be overemphasised as midwives have been strengthening Primary Health Care for decades, acting as a critical link between women and the health system, and making pregnancy and childbirth safer and more secure.
According to her, if fully integrated into the health care system, and with the necessary enabling support, midwives have the capacity to provide a wide range of clinical interventions, thereby, contributing to broader health goals including advancing Primary Health Care, addressing sexual and reproductive rights, promoting self-care interventions, and empowering women.
She noted that African Region’s tragic record of maternal and infant deaths demands urgent interventions to expand the coverage of emergency obstetric and newborn services, with a revision of the scope of practice to allow more task-sharing and task-shifting to mitigate the shortage of midwives as WHO in the Region, are working closely with Member States to improve the quality of maternal and reproductive care, supporting the development and implementation of national strategies to accelerate the reduction of preventable maternal and newborn illness and death, and to improve every mother’s experience of care, by 2030.
Dr. Moeti, counted the interruption of services due to the COVID-19 response as one of the several challenges despite significant progress in Africa to reduce preventable deaths related to pregnancy, childbirth, and the postpartum period, saying that governments and partners must substantially increase investment in the education, recruitment, deployment, retention and protection of midwives which is essential if African countries are to be capacitated to increase coverage and quality of mate
