The 5th of May was the International Midwives Day. In Zimbabwe there was very little celebration as the midwives are facing numerous challenges, especially around securing living wages. One of the publications in Zimbabwe reported that midwives are wallowing in poverty while they work under very difficult conditions. Midwives in Zimbabwe are facing many challenges which affect their delivery of work. As this is not enough, on the 20th of June, health workers — midwives included — went on a strike, demanding a salary increase.
By Edinah Masiyiwa
The challenges midwives face are contributing to the poor health outcomes for women and girls in Zimbabwe. One such poor outcome is high maternal mortality ratio which is at 462 deaths per 100,000 live births, one of the highest in the region. Zimbabwe has witnessed women delivering outside health centers without the assistance of trained midwives because of the shortage of midwives.
.There is need to understand the role of midwives for us to appreciate their importance in the health delivery system. For many people, a midwife’s role is to deliver babies but there is more than just that. The role of the midwife is very diverse. She is a highly trained expert and carries out clinical examinations, provides health and parent education and supports the mother and her family throughout the childbearing process to help them adjust to their parental role. The midwife also works in partnership with other health and social care services to meet individual mothers’ needs, for example, teenage mothers, mothers who are socially excluded, disabled mothers, and mothers from diverse ethnic backgrounds. Given all that they do, all efforts should be put into supporting the midwife to diligently deliver her duties. Simply put, “Midwifery is important as the role can sometimes be the difference between life and death”.
The year 2020 was designated The Year of the Nurse and Midwife by the World Health Organisation in order to highlight the importance of these cadres in the health delivery system. Yet, that recognition was not enough to counterbalance the shortages of midwives the world over. The 2021 State of World’s Midwifery report by UNFPA, the UN sexual and reproductive health agency, World Health Organisation, International Confederation of Midwives ICM and partners, noted the acute shortage of midwives as exerting a terrible global toll in the form of preventable deaths.
In Zimbabwe, midwives continue to leave the country for greener pastures because of the poor working conditions and some prefer to get into non midwifery employment. Thus, pregnant women in Zimbabwe have had difficult experiences delivering babies in labour wards which do not meet the expected care. Unfortunately, all the negative experiences women go through are blamed on the midwife. No one really takes time to understand the difficult situations midwives work under.
Currently midwives are working under difficult conditions with a meagre salary which cannot support their families. Just like other Zimbabweans midwives are hustling in order to put food on their tables. This was echoed by the President of the Zimbabwe Midwives Association. The President also bemoaned the fact that midwives were going abroad to work as general nurses. This is degrading the midwives who have a critical role to play in Zimbabwe in order to save lives.
The country needs to realise that midwives are important. It has been argued that, “If we ensured women had access to professional midwives everywhere in the world, we could save more than 8,000 lives every single day”. This also applies for Zimbabwe. We need trained midwives to deliver babies.
If Zimbabwe is serious about achieving Sustainable Development Goal 3 particularly Target 3.1 on reducing maternal mortality ratio to less than 70 per 100,000 live births the government should ensure that the midwife is supported fully so that they do their work effectively. Having access to a midwife should be a norm. Women should be able to access care from a midwife from the Primary Health Care clinic.
I call upon our government to allocate enough resources to the Ministry of Child Care with a focus on payment of salaries for midwives and ensuring the clinical setting in which the midwives work has enough resources. I support the requests being made by health workers in their strike. Above all I call for the midwife recognition of midwifery as a stand-alone profession. Midwives need to have a decent salary for them to be respected by the society they serve.
About The Author: Edinah Masiyiwa is the Execuite Director for the Women's Action Group in Zimbabwe (WAG)
