Launch of State of the World’s Midwifery 2011

Ladies and Gentlemen,

Today we are launching the State of the World’s Midwifery 2011, the first report of its kind since 1976. The report is based on surveys in 58 developing countries which together account for 91 per cent of the world’s maternal deaths.

Mothers, pregnant women and newborn babies are dying because the world doesn’t have enough midwives and other skilled health workers. More than one in three women in developing countries gives birth alone -- or with only relatives to oversee what is one of the most dangerous passages they will ever undergo.

In some of the poorest countries, as few as 13 per cent of all deliveries are assisted by a midwife or health worker with midwifery skills.

This new report finds that 112,000 health workers with midwifery skills are urgently needed in 38 countries so they can meet Millennium Development Goal 5 to improve maternal health.

If all pregnant women had access to antenatal care and well-equipped basic emergency obstetric and neonatal care facilities managed by health workers with midwifery skills, we could avoid nearly two-thirds of all maternal deaths, almost half of stillbirths and 60% of newborn deaths.

So we need to strengthen health systems with skilled health workers.

We should also remember that midwives deliver more than babies. They deliver reproductive health services to families and communities. They provide counselling and services for family planning and HIV prevention, including prevention of mother-to-child transmission.

Midwives also play a crucial role in referring complications to hospitals in an emergency.

Health workers with midwifery skills play a vital role in efforts to achieve all three health-related MDGs – 4, 5 and 6—to reduce child mortality, improve maternal health and combat AIDS, tuberculosis and malaria.

The State of the World’s Midwifery report reveals that the 58 surveyed countries suffer from a triple gap – a competency gap, coverage or distribution gap, and a gap in access.

1. First let me talk about competency. The education and training for midwifery is uneven, and needs to be upgraded to meet current standards. Educational curricula need to include life-saving skills in basic emergency obstetric care. The profession requires better regulation to improve quality of care.

2. Secondly, there is a distribution or coverage gap. f the 58 countries in the report, 22 need to double their midwifery workforce by 2015; 7 need to triple or quadruple it; and 9 countries need to dramatically scale up midwifery.

3. And finally, there is a gap in access to health workers with midwifery skills. Being left behind are women living in rural and remote areas, where general infrastructure – transport, roads and electricity – is poor, and health infrastructure is inadequate.

The report finds that strong national policies on midwifery services are needed, along with regulatory and legislative frameworks. Midwifery education needs to be revisited and employment conditions made more attractive.

If health workers with midwifery skills are empowered to provide the health-care services they are trained to deliver within health systems that include the necessary infrastructure, equipment, drugs, communications and transport networks and comprehensive emergency care, up to 3.6 million deaths could be averted in the 58 countries surveyed.

Safe childbirth isn’t a luxury. It is, after all, a human right.

For our part, UNFPA, the United Nations Population Fund, is supporting midwifery as a priority. Since 2008, we’ve been working with the International Confederation of Midwives in some 30 countries in Africa, Asia and Latin America to get more midwives and others with midwifery skills to reduce maternal and newborn deaths and disabilities.

We have strengthened and equipped over 60 midwifery schools in some 23 countries and set up many new midwifery associations in Ethiopia, Bangladesh, Afghanistan, Nepal, Guyana and other countries. In short, this effort constitutes a major global partnership with UN agencies, civil society and governments to promote midwifery in a harmonized manner. These efforts are part of the Global Strategy for Women’s and Children’s Health to improve the health of every woman and child.

Today I call on governments and development partners to take further action so that every woman has access to skilled care during pregnancy and delivery.

Together we must safeguard every woman and child so they may live to their full potential.

Thank you.