MIDWIFERY, MATERNAL MORTALITY REDUCTION, AND MDG 5

Wednesday, 6th of July 2011

This UNFPA report, the result of collaborative efforts by 30 partners, shows the links between midwifery and reductions in maternal mortality.

Full text, http://www.unfpa.org/sowmy/report/home.html#

From the Executive Summary, The State of the World’s Midwifery 2011

It is a responsibility of governments and their political leaders and an investment that is key to

reducing maternal and newborn mortality and morbidity. In addition to saving lives and preventing disability, the benefits of quality midwifery services extend to all members of society in farreaching ways, including contributing to a country’s human and economic development.

There is much that needs to be done. Every year approximately 350,000 women die while pregnant or giving birth, up to 2 million newborns die within the first 24 hours of life, and there are 2.6 million stillbirths. The overwhelming majority of these deaths occur in low-income countries and most of them could have been prevented. They happen because women — usually the poor and marginalized — have no access to functioning health facilities or to qualified health professionals.

Quality midwifery services that are coordinated and integrated within communities and within

the health system ensure that a continuum of essential care can be provided throughout pregnancy, birth and beyond. Midwifery services also facilitate referrals of mothers and newborns from the home or health centre to the hospital and to the care of obstetricians, paediatricians and other specialists when required.

The State of the World’s Midwifery 2011: Delivering Health, Saving Lives, coordinated by the United Nations Population Fund (UNFPA), is the result of the collaborative efforts of 30 agencies and organizations and hundreds of individuals working at national, subnational, regional and global levels.

It responds to the ‘Global Call to Action’ issued at the Symposium on Strengthening Midwifery. Increasing women’s access to quality midwifery services has become a focus of global efforts to realize the right of every woman to the best possible health care during pregnancy and childbirth.

The diversity of responses confirms that there are significant gaps in data and strategic intelligence. However, three key points have emerged from a synthesis of the available evidence relating to the status of the profession and the many challenges and barriers that affect the midwifery workforce, its development and its effectiveness.

There is a triple gap, consisting of competencies, coverage and access. In most countries

there are not enough fully-qualified midwives and others with midwifery competencies to

manage the estimated number of pregnancies, the subsequent number of births, and the 15 percent of births that generally result in obstetric complications. WHO estimates that 38 countries have severe shortages. A few countries will need more than a 10-fold increase in the number of midwives, with most needing to either double, triple or qadruple their midwifery workforce to improve quality and coverage. Second, coverage of emergency obstetric and newborn care facilities is low; and existing facilities are often insufficiently staffed and poorly equipped. This is most acute in rural and/or remote communities. Third, access issues from women’s perspectives are often not addressed.

[complete executive summary at http://www.unfpa.org/sowmy/resources/docs/main_report/en_SOWMR_ExecSum.pdf ]