Coming up - First ever State of the World Midwifery Report
Find out more about the why, what, when and not least how behind this report
MARCH 2011 - Midwives and others with midwifery competencies are absolute key if we want to make all childbirths safe and achieve universal access to reproductive health. However, midwifery personnel and services are unequally distributed – between countries as well as within countries. Hence, some of the leading organizations working on midwifery, have decided to take stock and document the situation, globally and in countries, so decision makers can be equipped and inspired to action.
The result will be presented in the first ever State of the World’s Midwifery Report, which will be launched 20 June in Durban, South Africa, and hopefully also in countries around the world. The report intends to strengthen midwifery capacity around the world. It will provide new information and data from 60 countries to:
- examine the number and distribution of health professionals involved in the delivery of midwifery services;
- explore emerging issues related to education, regulation, professional associations, policies and external aid;
- analyse global issues regarding health personnel with midwifery competencies, most of whom are women, and the constraints and challenges that they face in their lives and work;
- call for accelerating investments for scaling up midwifery services, as well as improving the competencies of midwifery service providers.
VOICES spoke to the project manager behind this major undertaking UNFPA’s Senior Maternal Health Adviser, Vincent Fauveau.
Q: Vincent, why are we doing a State of the World's Midwifery Report?
A: The short answer is: The world needs more midwives now more than ever.
The deterioration of the health systems has been very much focused on the human resources, over the last couple of years. Researchers and experts have shown that one of the main reasons why health systems do not work properly is because human resources for health are deficient. There are simply not enough personnel with the required competencies. As recent as in January 2011 at the second Global Forum on Human Resources for Health, held in Bangkok, many ministers stood up and asked stakeholders to take immediate action to resolve the shortage of health workers around the world. Their message was clear: We need concrete assistance to address the needs and challenges otherwise we will not reach our health-related Millennium Development Goals.
To do this, data and analysis are critical, but not sufficiently there right now. Thus, the State of the World’s Midwifery Report aims at filling part of this data gap and give the policy makers in priority countries something to work with.
The reason why we start with midwives and others with midwifery competencies is because no country can seriously reduce maternal and newborn mortality without midwives. Yet, they remain largely invisible and unheard.
It is our hope that this report will be followed by others about other cadres of health workers, but let’s start with midwifery, the key to achieving Millennium Development Goal 5 and 4.
Q: How did the idea come up?
A: The idea was born during the Symposium on Strengthening Midwifery organized by UNFPA and nine partners just before the Women Deliver Conference in June 2010. The symposium had been so successful and put a big spotlight on midwifery and we did not want to lose the momentum. So the partners, decided to go forward at a greater scale and produce this report.
Right from the start there was big interest in the work, and we managed to raise resources for the full report in just two months with support from Sweden, Norway, United Kingdom, United States, the Netherlands and France.
Q: How is it all organized?
A: There are 17 development partners and 6 donor countries involved in this project – and more are coming by the month.
UNFPA took the lead and after a rigorous selection process, identified a private agency, Integrare, to help manage the process. They are extremely precious in ensuring the flow of information and keeping to the deadlines.
To coordinate all the joint work we have organized several workshops and meetings with all the partners. An editorial committee meets by phone weekly to track progress on the data collection and the writing of the text. The overall advisory group convenes monthly. We have also established three sub-working groups, which are working on media and communication, data analysis, and costing and economic analysis.
Sometimes, as we have different views, it can be difficult and time consuming to get consensus on the messages we want to get across. But it is also great to benefit from so many inputs and it is very gratifying to see that so many institutions are promoting midwifery. So far, everything is going according to schedule. We have assigned ourselves a very tight time line so that the main findings of the report are ready for the World Health Assembly in May and the full report is ready for the official launch in June.
Q: How are you collecting the data to be included in the report?
A: One of the key data sources is a questionnaire that all the 60 portrayed countries with high maternal and newborn mortality have received and are to fill out. It includes various aspects of midwifery, from statistics and education to regulation, association, policies and external assistance.
By end of January, we had received 40 responses and we hope to receive the remaining 20 very soon. It is a record response rate for such a survey, particularly bearing in mind that the request for data came in a very hectic period. I would like to take this opportunity to thank all those who have collected and shared the data with us. We know they deal with many deadlines and we really appreciate the effort
Apart from some global analysis and costing exercises, the plan is to have a 2-page snapshot per country with data and a short analysis, but some countries will be subject of an in-depth analysis as well. At the same time, we are planning to place additional information in ‘boxes’ with a lot of different examples of good midwifery programmes and stories of midwives.
Q: Talking about the dissemination strategy, when and how will the report and the findings be publicized and used?
A: The Ministers of Health of the 60 countries portrayed will be invited to discuss the findings of the report and the main messages in May, at the World Health Assembly in Geneva. The official launch and press conference will be held on 20 June in Durban, where more than 3,000 midwives from all over the world will gather for the Triennial Congress of the International Confederation of Midwives.
Already now we see good interest in the report, both from policy makers, global media and from the renowned medical journal, The Lancet, who will hopefully feature one of more articles based on the findings. And after the launch, the findings will feed into the global advocacy and communication in the many events and activities where MDG5 and maternal health is in focus – the G8, G20, UN General Assembly and not least the Secretary General’s Global Strategy on Women’s and Children’s Health.
However, most important is national ownership, and we encourage the countries to take the national data and analysis and use them for advocacy and media outreach in order to put a national focus on the importance of midwifery and on how to scale up midwifery services. This is very important if we want the findings and report to really echo through and be the basis of change.
Q: Why is UNFPA so involved in the development of this report?
A: Midwives and others with midwifery competencies are crucial in making pregnancies wanted and childbirths safe, which is at the heart of UNFPA’s mandate. Midwives don’t only deliver babies, they deliver a whole range of reproductive services, including family planning, ante- and post-natal care, HIV prevention services, obstetric care and counseling among others. They are key in delivering on our mandate.
Therefore this effort.