The State
of the
World’s Midwifery 2021

Dedicated to all health workers who have lost their lives to COVID-19
Building a health workforce to meet the needs of women, newborns and adolescents everywhere.
© Gates Archive/Nelson Owoicho
© Felicity Copeland

Why midwives?

Midwives can meet about 90 per cent of the need for essential sexual, reproductive, maternal, newborn and adolescent health interventions.

The world is still lacking one-third of the midwives needed.

© Felicity Copeland

The impact of midwives

Midwives strengthen the health and well-being of women, adolescents and newborns and put safe and effective care within the reach of more people.

Midwives would save a projected 4.3 million per year by 2035.

The global shortage of midwives

There is a global shortage of 1.1 million sexual, reproductive, maternal, newborn and adolescent health-care providers - 900,000 are midwives.

The shortage is most severe in low-income countries and in Africa with a potential shortage of 750,000 midwives by 2030.

Why the shortage?

There is insufficient investment in the health workforce as a whole and midwives in particular, despite recent Lancet Global Health data showing that midwives have an enormous impact on improving health and preventing death.

© Amorim Flavia

Global shortage of midwives

The State of the World’s Midwifery 2021 estimates a global shortage of 900,000 midwives, projected to fall to 750,000 by 2030 if all countries continue on their current trajectory. The following visualization shows how this evolution is projected to vary by region. Most of the global improvement is projected to occur in the Asia and Pacific region.

Size of midwife shortage

Arab States
80000
Asia and the Pacific
200000
Eastern Europe and Central Asia
3500
East and Southern Africa
330000
Latin America and the Carribean
110000
West and Central Africa
150000
Other
65000
0 100,000 200,000 300,000
Arab States
65000
Asia and the Pacific
100000
Eastern Europe and Central Asia
1500
East and Southern Africa
330000
Latin America and the Carribean
100000
West and Central Africa
100000
Other
70000
0 100,000 200,000 300,000
Arab States
60000
Asia and the Pacific
70000
Eastern Europe and Central Asia
1000
East and Southern Africa
330000
Latin America and the Carribean
100000
West and Central Africa
90000
Other
75000
0 100,000 200,000 300,000

Source: Projections on the global midwives shortage from SoWMy 2021

Number of deaths averted with midwife shortage covered

Maternal deaths averted per year
Neonatal deaths averted per year
Stillbirths averted per year
Maternal deaths averted per year
Neonatal deaths averted per year
Stillbirths averted per year

Source: Projections on percentage deaths averted from The Lancet impact of midwives paper

Why invest in midwives?

A larger, fully enabled midwifery workforce can increase women’s, children’s and adolescents’ access to health care. And a healthier population can build a stronger economy.

Investing in midwives will strengthen the primary health-care system and provide a pathway to universal health coverage.

Investing in midwives will foster a more equitable world for all

An equitable health system lacks constraints to receiving care. With more trained midwives available, there is a greater percentage of care providers available to provide care.

Improving sexual, reproductive, maternal, newborn and adolescent health requires increased commitment to and investment in midwives.

© UNFPA/Geeta Lal
© Natasha Objava

The road to 2035

The State of the World’s Midwifery 2021 calls for a strong focus on universal access to essential sexual, reproductive, maternal, newborn and adolescent health services, addressing equity at all levels and leaving no one behind.

These investments should be considered at country, regional and global levels by governments, policymakers, regulatory authorities, educational institutions, professional associations, international organizations, global partnerships, donor agencies, civil society organizations and researchers.

Four Areas of Investment

For midwives to achieve their potential, greater investment is needed in four key areas

Health workforce

Strengthen health workforce data systems for more effective decision making

Focus on primary health care that allows midwives to provide the full scope of SRMNAH interventions

Education and training

Ensure that midwife educators are fully equipped with both knowledge and skills for teaching

Design curricula that include interdisciplinary modules and encourage teamwork and respectful care in all settings

Midwife-led service delivery

Treat midwives as equal and respected partners at all levels

Encourage an enabling work environment where midwife-led continuity of care can flourish and recognise midwives’ capacity to contribute to a wide range of SRMNAH services along the life-course

Midwifery leadership and governance

Engage midwives in policy and planning decisions at all levels of the health system

Improve institutional capacity to help midwives be leaders and advocates for high quality respectful maternity care

Impact of investing in midwives

Puts safe and effective sexual and reproductive health care within the reach of more people

Midwives contribute to positive birth experiences and by delivering about 90 per cent of essential sexual, reproductive, maternal, newborn and adolescent health interventions, improve health outcomes

© Elena Heatherwick

Impact of investing in midwives

It could save millions of lives each year

An estimated 4.2 million lives can be saved annually by 2035 through quality midwifery care and midwifery support for safe, comprehensive abortion services

© Kim Carter

Impact of investing in midwives

It contributes to national and local economies

Investing in midwives can boost the willingness of governments and others to pay for health care, thus increasing employment of health workers and stimulating economic growth

© Gates Archive/Nelson Owoicho

Impact of investing in midwives

It contributes to women’s empowerment and gender equality

More midwife-led interventions contributes to healthier families, productive communities and a health system that can deliver comprehensive services for all

© Action for development
© Anushree Surin

Impact of COVID-19

The COVID-19 pandemic has highlighted the importance of investing in midwives as essential parts of the primary health-care system. Midwives were able to provide a wide range of clinical interventions and contribute to broader health goals.

Unfortunately, in the midst of the pandemic, midwifery learning was disrupted, midwives were denied personal protective equipment, lost their salaries and some, their lives, yet they continue to provide care to women giving birth.

Midwives per 10,000 population

Colour indicates the number of midwives per 10,000 population. "Midwives" includes midwifery professionals, midwifery associate professionals, midwives not further defined, nursing professionals with midwifery training and nursing associate professionals with midwifery training Click on a country to view key data and access the SoWMy 2021 country profile
  • 10+
  • 4 - 9.99
  • 3 - 3.99
  • 2 - 2.99
  • 1 - 1.99
  • 0 - 0.99
  • not reported

Explore Country Data

You can search countries here. Please click a country on the list of results to zoom the map into that country.

Resources

The Report

Executive Summary

Fast Facts

Webappendices

Supplements

The designations employed and the presentation of material on the map do not imply the expression of any opinion whatsoever on the part of UNFPA concerning the legal status of any country, territory, city or area or its authorities, or concerning the delimitation of its frontiers or boundaries. The dotted line represents approximately the Line of Control in Jammu and Kashmir agreed upon by India and Pakistan. The final status of Jammu and Kashmir has not yet been agreed upon by the parties.

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