Investment in midwives could prevent two-thirds of deaths among mothers and newborns and save millions in health expenses, according to the United Nations Population Fund's (UNFPA) State of the World's Midwifery 2014 report released last week.
Although the 2014 report emphasizes progress since its first edition in 2011, a shortage of midwives across the 73 low- and middle-income countries the agency surveyed led to an estimated 289,000 maternal and 2.9 million newborn deaths in 2013.
The 73 African, Asian, and Latin American nations are home to more than 96 percent of maternal deaths and 93 percent of newborn deaths globally, but only employ 42 percent of the world's doctors, nurses, and midwives. Midwives can provide nine tenths of the care pregnant women and newborns require, but deeply rooted economic, social, and geographic barriers impede the accessibility, education, and retention of qualified midwives.
"The biggest challenge to midwives in these countries is that many don't have an education that's up to international standards," Dr. Laura Laski, chief of the Sexual and Reproductive Health Branch in Technical Division at UNFPA, told MediaGlobal News. "Complications can't be identified by people who haven't been taught the skills they need. Most also don't have a support team of health experts, and work in isolation."
According to the UNFPA report, training midwives can yield a 16-fold return on investment. However, the lack of education and support are far from the only hurdles to developing a strong network of practitioners across the developing world - a high rate of midwife turnover rate is one of the most overwhelming challenges, according to Dr. Genevieve Reid, Executive Director of the Global Midwife Foundation.
"Women are sent to geographically isolated communities where they don't know anybody - far away from their families, friends and neighbors - so they don't end up staying," Reid told MediaGlobal News. "Only people who come from families with resources can afford to move to city centers and receive an education, so the women who are sent to these communities are used to having running water, electricity, flush toilets, and cell phones. They're not happy in these poor communities with very little social engagement."
Reid has worked in remote, rural communities in Morocco, Pakistan, Nicaragua, and Bolivia, where she's experienced the difficulty of retaining midwifes firsthand.
"If I wanted to provide training for all the births, I would have to train every single husband out there," said Reid.