PMNCH Knowledge Summaries: #14 - Save lives: invest in midwives
Note: Full text and all graphs, tables and references for each Knowledge Summary are available only on the PDF version.
Each year, 350,000 women die from complications in pregnancy and childbirth, over three million newborns die, and 2.6 million babies are stillborn. Many of these deaths could be prevented by a midwife or other skilled birth attendant. However, 52 million births worldwide occur without one in attendance, while in Asia and Sub-Saharan Africa less than 50% of births are attended by someone with the right skills. Midwives save lives and provide quality care during pregnancy and childbirth. In recognition, global, regional and national initiatives increasingly focus on the training and retention of quality midwives and other skilled birth attendants.
The worldwide shortage of skilled birth attendants has been widely recognized for several years, but the problem persists. In 2010, the Global Strategy for Women’s and Children’s Health noted that an additional 3.5 million health workers were required to improve the health of women and children substantially in the 49 lowest-income countries. In 2006, the World Health Report estimated the global shortage at 4.3 million. In 2005, WHO said an additional 334,000 midwives would be needed over 10 years to achieve 72% coverage of skilled birth attendance in 75 countries. WHO recommends one skilled birth attendant for every 175 pregnant women, but countries like Rwanda have only 1 midwife per 8,600 births. The global shortage of midwives is compounded by inequitable and inefficient distribution. Although most people in developing countries live in rural areas, most of their health workers are located in urban areas.
Many maternal and child deaths could be prevented by an increase in skilled birth attendance. In addition, health personnel with midwifery skills are trained to provide a continuum of high-quality sexual and reproductive health services to mothers, helping to prevent unwanted pregnancies. Increasing investment in midwifery education, deployment and retention, regulation and oversight should be a core component of national strategies to improve women’s and children’s health.
Please read the full text of the Knowledge Summary and download the pdf version with all tables and graphs on the MNCH Knowledge Portal.
