5 May 2018

Africa: Midwives Leading the Way With Quality Care

Photo: UNFPA
Midwifery Students in Uganda (file photo).
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Today, on the International Day of the Midwife, we not only commit to celebrating midwives as they lead the way with quality care, but to giving them a platform to inform global health policy. As frontline healthworkers at the heart of each community, midwives are best placed to advise Governments, leaders and agencies on the critical changes needed to improve health outcomes.

I am proud therefore that the International Confederation of Midwives (ICM), of which I am the Global Goodwill Ambassador, has launched a 'Midwifery Leaders Showcase.' This initiative tells the stories of midwives all over the world in a series of featured interviews. In doing so, ICM seeks to demonstrate the dynamic and diverse roles that midwives play in shaping policy, leading civil society organisations, influencing professional practice and creating a better and brighter future for women, newborns and their families. It also features the Wellbeing Foundation's own much-missed and dearly departed Felicity Ukoko.

When I advocate for midwives leading the way with quality care, I try to give an idea of the innovation that WBFA midwives bring to their role. Such innovation is often difficult to articulate in a concept note, or to narrowly define. Our antenatal and postnatal classes save lives in Nigeria and focus on helping mothers and children to survive and thrive, an approach that is well documented. Our midwives, however, together with their colleagues all over the world, go above and beyond that duty, and use developments in technology and inter-connectedness to do so. The WBFA WhatsApp group gives WBFA midwives the platform to answer questions from concerned mothers 24 hours a day, dispelling fears and reacting to emergencies. They have also become counsellors and friends, advising on topics from FGM to gender-based violence. I know that on more than one occasion they have sternly informed a husband or partner of the importance of an expectant mother of attending an antenatal class.

The holistic role of midwives makes their experiences uniquely important, but must be part of wider investment in healthcare standards and infrastructure. The publication of the UNICEF report "Every Child Alive" earlier this year provided a stark reminder of the progress that must be made. It found that five newborn babies die every minute across the world – meaning 2.6 million tragedies every year. A shocking 80% of these deaths can be prevented by access to skilled midwives, clean water, breastfeeding within the first hour and good nutrition.

Following the UN Secretary General's call to action on WASH in healthcare facilities in March, and to coincide with the WHO's 'Save Lives: Clean your Hands' campaign day and International Day of the Midwife, the WBFA has launched a worldwide campaign to improve hygiene in healthcare centres, in partnership with Global Water 2020 and others. In Nigeria, the WHO found that 29% of healthcare facilities do not have access to safe water and toilets, whilst a WaterAid survey revealed that half of primary health facilities do not have handwashing facilities in delivery rooms. Pregnant women and newborns are thereby placed in huge danger and at risk of sepsis, which is a leading cause of death in hospitals. Without adequate WASH facilities, midwives all over the world are unable to safely carry out their crucial work.

Midwives operate most effectively with a Universal Health Coverage system.  As a global UHC advocate, I believe that investment in high-quality and accessible healthcare will transform nations. The benefits go far beyond health – it allows young people to reach their potential, protects against epidemics, reduces inequality and stimulates the economy. The announcement this week from the Senate President of Nigeria that one per cent of the Consolidated Revenue Fund (CRF) is set aside in the 2018 budget to boost the provision of basic primary healthcare services across the country is a welcome step in the right direction.

On the International Day of the Midwife, I call on all Governments to invest in frontline healthworkers and the facilities they need to save lives. Midwives will always lead the way with quality care: it is time we empowered them to do so, wherever they work.

Toyin Ojora Saraki is the Global Goodwill Ambassador, International Confederation of Midwives Founder-President, Wellbeing Foundation Africa (WBFA)  ,

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