This week the State of the World’s Midwifery 2014 (SOWMY 2014) Report was launched, showing the current challenges and needs of scaling up midwifery services around the world. The report outlines the situation in 73 countries (these countries account for 92% of global maternal and newborn deaths and stillbirths), investigating whether the midwifery workforce is sufficient to meet the universal need for sexual, reproductive, maternal and newborn health.

Only four of these countries are on track, showing the great need to invest in midwives to meet global goals and targets of ending preventable maternal mortality and preventable newborn deaths.

Student midwives in Nigeria. Photo Credit: Lindsay Mgbor/Department for International Development
Student midwives in Nigeria. Photo Credit: Lindsay Mgbor/Department for International Development

How do we make the point to policy-makers?

At the International Confederation of Midwives Congress, Jim Campbell, Director at Integrare and one of the authors of the SOWMY 2014 Report, held a workshop where midwives, health professionals and academia gathered to discuss ways in which to make the case to policy-makers of the need to invest in midwives.

“You need to show the data and the numbers,” explained Campbell, as policy-makers will look at the costs and the benefits. He further encouraged the group to understand the best way to collect data. Various methods of calculating the need of midwives were investigated, including the sensitivity of the method to account for the needs: geographical distribution, fertility rates, roles of other health workers, and more.

In Afghanistan, for example, there is a good basic healthcare system, however, due to the system not taking into account variations in demand across the country, midwives are overworked, overwhelmed and burned out. An Afghani participant in the workshop explained that there is a 35% drop out rate, 12 months after a midwife has graduated. Therefore, the retention and education of the midwifery workforce must be taken into account when making policy recommendations.

The SOWMY 2014 Report is a great tool to start making recommendations based on data. For countries to plan efficiently, the report states that the following data on the midwifery workforce should be collected: headcount, percentage of time spent on key interventions within sexual, reproductive, maternal and newborn health, roles, age distribution, retirement age, length of education, enrollments into, attrition and graduation from education, and voluntary attrition from the workforce.

What are the recommendations?

There is not a one-size fits all. Instead the recommendations need to be linked to context-specific data with a needs-based approach. Countries need different kinds of investments to meet the targets, as the needs of each country is different. It is important to ensure that recommendations are grounded in the needs of each setting.

The SOWMY 2014 Report does provide some general key messages regarding the investment in midwives.

To assist with these policy recommendations, Family Care International has created a toolkit for using evidence from the State of the World’s Midwifery 2014 Report to create policy change at the country level. Download the toolkit in English, French and Spanish!

Investing in midwifery is more than human resources

To ensure that midwives are able to provide women-centered care, have access to appropriate skills, resources and support, the investment must go beyond midwifery education. To ensure that the policies are implemented and that the commitments are prioritised, women have to be included in policy-making. The rights of women must be strengthend in society as a whole and needs to be a priority throughout sectors to ensure the targets of ending preventable maternal and newborn deaths are met.

Stay tuned!


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