Training Midwives in Madagascar to Bridge Gap in Maternal Health

A breech birth can cause life-threatening difficulties for both mother and baby, so having an experienced midwife to assist is essential. Madagascar currently has one qualified midwife per 7,000 people - fewer than half of the WHO-recommended minimum.

Fewer than half of all deliveries are attended by skilled health personnel and 60% are home births, as many women are unable to access, or afford quality maternal health care. Every year, around 30 students are admitted for a three-year training course in midwifery at each of six public institutes in Madagascar. Although there are also more than 100 accredited private training schools for midwives, assessing the quality of training can be difficult, as their curricula are not standardised.

In an effort to have more trained midwives, the sexual and reproductive health agency of the UN, UNFPA, has since 2018, been working with the government to support training programmes for more than 800 midwifery students at three public institutions and one private school. This will ensure graduates are qualified in compliance with international standards. To date, UNFPA has supported the hiring and deployment of 157 midwives to 52 emergency obstetric and neonatal care centres and 13 primary health centres in remote and hard-to-reach areas of Madagascar.