Good Midwives Promote Healthier Families, Communities and Nations

National Yemen

Asma al-Mohattwari

Jennifer Ikokole, 49, started working as a midwife 24 years ago in her home country, Uganda. When she joined UNFPA’s midwifery program in South Sudan two years ago, and she knew her work was cut out for her. South Sudan, the world’s youngest country, has one of the highest maternal death rates in the world. Health facilities are poorly equipped and understaffed, making the country ground zero in the battle against maternal deaths.

Although she was working under harsh conditions in the midst of a humanitarian emergency that has gripped the country, nothing could stop her from working to save the lives of the women and children in her care. “When I was told to come and work at the displacement camp, nobody said it would be easy. The conditions are not good, but helping mothers is a calling I must heed, and I get satisfaction from that. It is good to know I’m saving lives by helping mothers deliver safely,” she says.

Midwives are the first contact many expectant women have with health personnel, bringing hope to women who have no access to doctors or clinics, especially during the current humanitarian crisis. When delivery complications occur, trained health personnel are crucial to saving the lives of women and their babies.

On August 25, the Population Sector and the National Midwife Association, in partnership with United Nation Population Fund (UNFPA), WHO, and USAID MCHIP held a workshop to launch the State of the World’s Midwifery Report 2014 (SoWMy).

The State of the World’s Midwifery Report 2014, which examines the global midwifery landscape across 73 low and middle income countries, calls for urgent investment in high quality midwifery to prevent about two thirds of all maternal and newborn deaths, saving millions of lives every year. The 73 African, Asian, and Latin American countries represented in the report account for 96% of global maternal deaths, 91% of stillbirths, and 93% of newborn deaths. Yet they have only 42% of the world’s doctors, midwives and nurses. Investment in quality midwifery could help bridge this gap and prevent some two thirds of maternal and newborn deaths.

The 2013 Survey showed a significant decline of maternal mortality in Yemen, from 365 to 148 per 100,000 live births – more than halved. It also showed as an improvement in the use of antenatal services from skilled providers, the increase of births delivered by a health professional and of deliveries in health facilities.

In Yemen, four components are needed for effective midwifery coverage to enable women and newborns to get the services: availability, accessibility, acceptability, and quality. Suad al-Qasem, the Head of National Yemeni Midwife Association, said that the barriers to effective midwifery coverage are not enough planning and investment in education and deployment of MNH workers, midwifery being considered an unattractive profession, and the assignment of too many non-clinical tasks.

Lene K. Christiansen, UNFPA Representative to Yemen, said that access to quality health care is without a doubt a basic human right. Yet, nearly 40 million women globally give birth without skilled care, increasing the risk of death and disability for both the mother and newborn.

Globally, in the past two decades, maternal death has declined by nearly half. In the same period, skilled birth attendance has increased by 15 per cent, with two out of three deliveries worldwide now attended by a skilled health professional.

“Yemen still has a way to go when it comes to availability of qualified health staff in this area. Estimates show that between 2012 and 2030, in Yemen, 15 million births will take place, which should be accompanied by 93 million antenatal visits and 60 million postnatal visits to qualified health staff. That is a big challenge for the Yemeni health system in terms of deploying the right staff and ensuring the quality of their service delivery,” Christiansen added.

The hard and dedicated work of midwives in Yemen is one of the key reasons behind the impressive improvement. Midwives are there, in the communities, helping women and girls care for their reproductive health during their cycle of life, from family planning all the way through the postpartum period.

“Believing in the critical role of midwives, UNFPA in partnership with the National Yemeni Midwives Association has made strong efforts towards improving the status of midwifery in Yemen over several years,” she said, “The good work of midwives will promote healthier families, healthier communities and healthier nations.  The good work of midwives is an indispensable ingredient as we work towards the goal of ensuring that every pregnancy is safe and that universal access to sexual and reproductive health services is a reality for all.”

Dr. Najeebeh AbdulGhani, Deputy Minister of Health and Population Ministry, said, “to ensure safe social life, we need to apply the law of free birth, family planning services, and mother and child services. There must be a list of disciplinary actions for those who don’t apply mother services. We must also set a budget for all hospitals for the commitment of free services.”