2014 State of the World’s Midwifery

The UN General Assembly week and advocacy events held by partners such as “Every Woman Every Child” have brought the 2014 State of the World’s Midwifery (SoWMy) Report back into the spotlight, as donors and policymakers are encouraged to provide the resources needed to strengthen maternal and newborn health services. Fistula Care Plus has been involved with global midwifery action throughout 2014.

The International Confederation of Midwives hosted its 30th Triennial Congress in Prague. Over 3,700 participants, including midwives and allied medical and public health professionals participated in the June 2014 Congress. Recognizing the crucial role of midwives as front line providers of safe motherhood services and emergency obstetric care, Fistula Care Plus was honored to participate in two events at the Congress.

FC+-hosted a workshop on the role of midwives in the prevention and management of obstetric fistula through catheterization. At the catheterization workshop, panelists presented research findings regarding this intervention, identified barriers and challenges to the wider use of this intervention, and generated action items to facilitate the use of catheterization and address identified barriers. A report on catheterization for prevention and management of obstetric fistula is available here.

A side meeting on future research, education, and practice priorities related to the partograph, co-hosted by WHO, USAID’s maternal and Child Health Integrated Program (MCHIP), EngenderHealth, and the University of Manchester presented results from an EngenderHealth and University of Manchester realist review of the partograph along with the results of a global survey of midwives on their knowledge, attitudes, and practices related to the partograph. The report of this meeting is available here.

Building on this exciting momentum, The State of the World’s Midwifery (SoWMy) report was launched at the ICM Congress. This report is a collaboration between UNFPA, International Confederation of Midwives, and the World Health Organization and examines the landscape for midwives in 73 low and middle income countries. The countries described in the report account for 96% of global maternal deaths, 91% of stillbirths, and 93% of newborn deaths. Yet, they only have 42% of the world’s doctors, midwives, and nurses.

The report calls for immediate action to be taken to prevent two-thirds of all maternal and newborn deaths by investing in quality midwifery. Currently, it is believed that only one-fifth of countries have enough adequately educated midwives to meet the basic needs of women and newborns. Strategic investments in midwives are needed in four key areas: availability, accessibility, acceptability and quality. SoWMy 2014 notesthat investing in midwives is a “best buy” and could yield a 16-fold return on investment in terms of lives saved and procedural costs (like caesarian sections and even fistula repair surgeries) avoided.

SoWMy 2014 also introduces Midwifery2030 – an action pathway for policy and planning around midwifery. The 2030 plan is a push towards achieving the Millennium Development Goals (MDGs) by their end date of 2015, and looking beyond them to the creation of the next generation of sustainable development goals. Midwifery2030 aims to increase coverage, increase services, and increase financial protection by involving stakeholders and addressing the four key domains of effective health system coverage (availability, accessibility, acceptability and quality) key stakeholders. The action plan begins before women become pregnant and continues until after the birth.

The Fistula Care Plus (FC+) project at EngenderHealth is excited about SoWMy 2014 and the Midwifery 2030 vision. Obstructed labor is the leading cause of obstetric fistula and midwives are the front-line providers in recognizing and managing obstructed labor and preventing adverse outcomes, such as fistula.  Additionally, the Midwifery 2030 vision recognizes the crucial role of family planning, which FC+ recognizes to be a key component for fistula prevention, and a cornerstone of maternal health. Midwifery 2030 provides a pathway for promoting women’s health and preventing fistula and are excited to see this important issue highlighted as an area of focus for both ICM and the global agencies that have developed and endorsed the SoWMy 2014 report.