Maternal, newborn, child and adolescent health

Midwives: a worldwide commitment to women and the newborn

Statement of Daisy Mafubelu
WHO Assistant Director-General, Family and Community Health

5 May 2009

Every minute a woman dies during pregnancy or childbirth. This adds up to more than half a million women's lives lost every year with hardly any improvement since 1990. Most of these deaths occur in the developing world and most of these deaths are preventable.

Today, on the International Day of the Midwife, WHO pays tribute to the work of the midwives who are key healthcare providers in facilities and communities. Midwives provide essential care before, during and after childbirth and they offer support, care and advice to mothers and their families.

Midwives can save women's and newborns' lives if they are properly trained and equipped and if a support network is available. They provide the high-quality and cost-effective package of care desperately needed by millions of women around the world: skilled care during and immediately after pregnancy and childbirth, emergency care for both mothers and their newborn and comprehensive reproductive health services.

If we want to achieve Millennium Development Goal 5 and improve maternal health, we need to invest in midwives. Worldwide, more than 330 000 additional midwives are urgently needed. If based in a facility one midwife can attend up to 220 deliveries per year.

More than thirty years ago the Alma Ata Declaration strongly confirmed that governments have a responsibility for the health of their people which can be fulfilled only by the provision of adequate health and social measures. Primary health care including maternal and child care is the key to allow all peoples of the world to lead a socially and economically productive life. In 2008, the Director-General of WHO, Dr Margaret Chan, launched a renewed call to primary health care. As pointed out in the last World Health Report, the primary health care approach continues to be the most efficient, fair, and cost-effective way to organize a health system. And midwives are an essential element of primary health care and national health systems.

WHO through its Department of Making Pregnancy Safer aims at strengthening the role of midwives and improving their education and training. Today, the Organization recognizes the contribution of midwives to the reduction of maternal and newborn mortality and renews its support to quality midwifery.