Midwives For a Better Tomorrow, For Every Woman and Every Child
By Toyin Ojora-Saraki, Founder/President, The Wellbeing Foundation Africa
[This blog originally appeared from the Huffington Post Global Motherhood Blog]
Celebrated on May 5th each year, the International Day of the Midwife recognises the invaluable role of midwives in health. As the Global Goodwill Ambassador for the International Confederation of Midwives (ICM), I would like to personally thank midwives for their inspiring work in delivering quality care to women and newborns.
Around the world, skilled midwives keep expectant mothers informed throughout their pregnancy and labour, empower all women of childbearing age to make healthy choices for their family and provide medical assistance for newborns in the fragile first days of their life. However, access to midwives varies considerably across sub-Saharan Africa, with rural communities bearing the brunt of the inequity of access. For example, in Nigeria, 14% of pregnant women give birth completely alone, and in 2013, only 40% of women gave birth with a skilled birth attendant present. And the shortage of midwives is not just a Nigerian problem. The ICM have found that if women are to receive the quality care that they need before, during, and after birth, the world needs 350 000 more midwives.
At the Wellbeing Foundation Africa (WBFA), we believe that an investment in the access to midwives and the training of midwives is crucial to the survival of mothers and babies around the world. This is why I am pleased to announce - on the International Day of the Midwife - that WBFA has forged a new partnership with Johnson & Johnson and the Liverpool School of Tropical Medicine (LSTM) to deliver an innovative global training package for local health workers in Kwara State, Nigeria, that has the potential to reduce maternal mortality by 15% and still birth rates by 20% in the state.
As First Lady of Kwara State for eight years, I have long worked to save Kwaran mothers and babies at the most vulnerable juncture of their life. To achieve this, we have instigated frontline programmes such as the Alaafia Universal Health Coverage Fund (AUHF), which draws on innovative financing mechanisms to enable Kwaran families to access affordable health insurance and supported the commissioning of the state-of-the-art Maternity Referral Centre in Eruku, Kwara. All of our frontline interventions have been designed to allow them to be scaled up and replicated in communities in Nigeria and across the African continent. Yet, progress cannot occur in silos, and we are glad to have partners to work with that can bring further global innovations back home to Kwara with us.
I am proud that this new project will bring a world-renowned 'skills and drills' training package for Emergency Obstetric Care and early Newborn Care (EmONC) from LSTM to Kwara. In 2013, a report by the African Journal of Reproductive Health found that 6 out of the 16 Local Government Areas in Kwara State did not meet UN standards for emergency obstetric and newborn care. To combat this service provision gap, LSTM's Centre for Maternal and Newborn Health (CMNH) has designed, implemented, and evaluated an innovative EmONC package to improve the quality and availability of skilled birth attendants (SBA) and provide a measurable increase in the knowledge and skills of healthcare providers.
Midwives are central to the project in Kwara, as the training programme will include support to pre-service midwifery institutions to improve the competency based EmONC training components of their curriculum. The programme will include in-service training for 80-100% of midwives, doctors and community health extension workers who provide maternity services in the state's public sector hospitals, setting up skills labs in three general hospitals, and upgrading the capacity of one skills lab in a pre-service midwifery institute. With the help of our team on the ground in Kwara, WBFA has been able to support the local operation of the project and ensure stakeholder engagement at every stage.
As we near the end of the Millennium Development Goals (MDGs) process, the International Day of the Midwife is more important than ever. Experience from the MDG process has made it abundantly clear that midwives should be placed at the very heart of the post-2015 development agenda, and access to midwives should be specifically indicated within the targets of the Sustainable Development Goals (SDGs) related to reproductive, maternal, newborn and child heath. Without this provision, the international community may fail to meet their promises to women and their families.
Therefore, we urge governments to invest in midwives now so that by 2030, birth can be safe for all, no matter where they live. Placing midwives at the heart of maternal, newborn and child health policies and programmes will ensure that there are more health professionals with midwifery skills, in the right place, at the right time, with the right education, the right support and the right pay. We know that more midwives and more access to midwives will ensure a better tomorrow, for every mother and every child. We must act now for a better tomorrow, for every mother and every child.