THE world is grappling with massive shortage of midwives, exposing lives of women and newborns to the risk of death, ill health or injury, a new report by the United Nations Population Fund (UNFPA) has revealed.
By Michael Gwarisa
According to the 20201 State of Midwifrey Report by UNFPA, WHO and the International Confederation of Midwives (ICM) and partners, the world is facing a shortage of 900,000 midwives, which represents a third of the required global midwifery workforce and the COVID-19 crisis has only exacerbated these problems, with the health needs of women and newborns being overshadowed, midwifery services being disrupted and midwives being deployed to other health services.
The State of the World’s Midwifery report sounds the alarm that currently the world urgently needs 1.1 million more essential health workers to deliver sexual, reproductive, maternal, newborn and adolescent health care, and 80 per cent of these missing essential health workers are midwives.
“A capable, well-trained midwife can have an enormous impact on childbearing women and their families – an impact often passed on from one generation to the next. At UNFPA, we have spent more than a decade strengthening education, enhancing working conditions and supporting leadership roles for the midwifery profession. We have seen that these efforts work, but they need greater investment,” ” said UNFPA Executive Director, Dr Natalia Kanem.
The report added that the acute shortage of midwives was exacting a terrible global toll in the form of preventable deaths. An analysis conducted for the report, published in the Lancet last December, showed that fully resourcing midwife-delivered care by 2035 could avert 67 per cent of maternal deaths, 64 per cent of newborn deaths and 65 per cent of stillbirths. It could save an estimated 4.3 million lives per year.
Despite alarms raised in the last State of the World’s Midwifery report in 2014, which also provided a roadmap on how to remedy this deficit, progress over the past eight years has been too slow. The analysis in this year’s report shows that, at current rates of progress, the situation will have improved only slightly by 2030.
Dr. Franka Cadée, President of the International Confederation of Midwives said, “As autonomous, primary care providers, midwives are continually overlooked and ignored. It’s time for governments to acknowledge the evidence surrounding the life-promoting, life-saving impact of midwife-led care, and take action on the SoWMy report’s recommendations.
“ICM is committed to leveraging the strength of our global midwife community to carry forward these powerful findings and inspire country-level change. However, this work is not possible without commitment from decision makers and those with the resources to invest in midwives and the quality care they provide to birthing women.”
Gender inequality is an unacknowledged driver in this massive shortage. The continued under-resourcing of the midwifery workforce is a symptom of health systems not prioritizing the sexual and reproductive health needs of women and girls, and not recognizing the role of midwives – most of whom are women – to meet these needs. Women account for 93 per cent of midwives and 89 per cent of nurses.
According to Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, “Midwives play a vital role in reducing the risks of childbirth for women all over the world, but many have themselves been exposed to risk during the COVID-19 pandemic. We must learn the lessons the pandemic is teaching us, by implementing policies and making investments that deliver better support and protection for midwives and other health workers.
“This report provides the data and evidence to support WHO’s longstanding call to strengthen the midwifery workforce, which will deliver a triple dividend in contributing to better health, gender equality and inclusive economic growth.”