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Midwives on frontline for women, girls, newborns

EXPECTANT mothers must be attended to by qualified midwives. PICTURE: UNFPA

ZAMBIA has recorded significant progress in reducing maternal mortality rates, from 726 per 100,000 live births in 2002 to 398 per 100,000 live births in 2014.
One of the key drivers for achieving this reduction has been the growing number of skilled midwives within the country’s health delivery system.
Current national data indicates that Zambia has increased the number of births assisted by a skilled attendant from 50 percent in 1992 to 64 percent in 2014. If deployed in even larger numbers, trained midwives could avert approximately two thirds of infant deaths that occur during childbirth or as a result of it.
The gains attained so far, however, need to be sustained. For this reason, the United Nations Population Fund (UNFPA) in Zambia has committed itself to stepping up its partnership with the government, other national and international partners to address the challenges related to midwifery within a supportive health system.
This partnership is seeking to work on multiple fronts. Key among them is capacity enhancement and skills development. This effort will involve the development of a Bachelor of science midwifery curriculum to improve the quality and skills of midwifery personnel in the country and review of existing midwifery curricula to ensure consistency with international standards.
It will also involve sponsoring the education and training of midwives including providing educational materials, supplies and equipment, building the capacity of the Midwives Association of Zambia, and recruiting retired midwives to provide services in rural and most underserved areas.
Such efforts will deliver on women’s rights to health and ensure that women and newborn infants obtain the care they need and contribute to the global and national shared vision of ending preventable maternal and newborn deaths by 2030.
Midwives in Zambia have also gone a step further by creating a framework within which their professional development, both as individual practitioners and as a group of professional health personnel, can be advanced.
In 2012, they established the Midwives Association of Zambia whose vision is to have an empowered midwifery profession that is dedicated to the provision of quality health care services to prevent maternal and neonatal deaths so as to promote safe motherhood in Zambia.
The association’s strategies, amongst others, include exploring innovative ways of improving the provision of quality care, capacity building among its members, professionalism and advocacy.
As the association held an inaugural indaba yesterday, October 11, 2016, this event was a culmination of many other activities which demonstrate the midwives’ evolving role in preventing maternal morbidity and mortality by emphasising, among other things, the need for expectant mothers to expeditiously seek care, as well as the need for health practitioners to provide the needed care without delay and to effect referrals when they are needed.
Therefore, the indaba focused on the critical role that midwives play in reducing maternal mortality and morbidity. Participants re-examined the place of midwifery in the current medical context and saw how they can make an impact in the light of prevailing high poverty levels, high unemployment, high cost of living as well as the numerous challenge facing the health sector.
Midwives should challenge themselves whether they can or should continue to be placid observers or if they should instead be taking up the challenge and be the drivers of maternal health.
During the indaba and beyond, midwives must find answers to these questions. In addition, they must shade more light on how they can enhance community midwifery as a strategy for instance.
This will entail their stepping up to use opportunities that are available for midwives to get back to communities and provide community midwifery services where they are needed in the villages, townships, cities, markets and streets where the women and children are.
To do this, it can perhaps be argued that there is need for a policy shift in the public sector so that midwives should be employed in all ministries which deal with women, girls and children.
These ministries would include the Ministry of Local Government and Housing, Ministry of Youth, Sport and Child Development, Ministry of Community Development and Social Welfare, Ministry of Chiefs and Traditional Affairs and others which deal with women and children.
The right to survive pregnancy and childbirth is a fundamental human right and midwives as professionals can make this right a reality.
Finally, it should also be advocated that retired midwives be utilised within the communities where they reside as a way of creating increased access to care for women who need it.
The author is a media and advocacy consultant for UNFPA.

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