Petra ten Hoope-Bender

Petra ten Hoope-Bender, Director RMNCH, ICS Integrare.

June 23, 2014.

The month of June is exciting. At the start of the month, we had the launch of the State of the World Midwifery 2014 in Prague at the Triennal Congress of ICM and on Monday 23rd June 2014, the Lancet Series on Midwifery (#lancetmidwifery) launch in London. The program’s Executive Group includes the University of York, the Norwegian Agency for Development Cooperation (Norad), the United Nations Population Fund (UNFPA), the White Ribbon Alliance, ICS Integrare, the University of Southampton, Yale University, and the University of Technology, Sydney. Authors of the series will present the papers, supported by the voices of women and the global maternal and newborn health community.

This collaboration is supported by The Bill and Melinda Gates Foundation, and consists of an international team of 35 midwifery researchers who created an evidence base to inform the development of midwifery services at scale to save millions of maternal and newborn lives. The Lancet series details midwifery and quality of care, all from the perspective of women and newborns to push forward the agenda on Reproductive, Maternal, Newborn and Child Health and guide the post-2015 discussions.

The Lancet Midwifery series includes:

  • A unified quality of care framework for maternal, newborn, and child health
  • Impact of scaling up midwifery and rolling out the intervention framework on maternal and newborn survival
  • Lessons learned from countries where midwifery schemes have been scaled up
  • Mapping evidence gaps and proposing a research agenda to strengthen health systems
  • International policy brief to encourage global maternal health leaders to assess what really works for improving maternal and neonatal health
  • How to improve (?) the quality of maternal and newborn health through midwifery
  • Taking a human rights lens to maternal health care by addressing disrespect and abuse of both women and providers

In 17 Francophone African countries, the workforce only provided 44% of the essential services to all women and newborns in 2012. If no investment in family planning and midwifery workforce takes place, this figure is unlikely to change. SoWMy2014 shows that the future projections of midwifery workers are alarming and require urgent action. The Lancet series guides country-level policies relative to budgeting and health systems to meet health needs by focusing on coverage, access, and uptake of midwifery services. For instance, the four country case studies presented in the series detail ‘success stories’ of maternal and newborn survival, health and wellbeing. Maternal mortality ratio (MMR) in Burkina Faso decreased from 580 (2000) to 400 (2013) and Morocco from 200 (2000) to 120 (2013).

So how did Burkina Faso and Morocco do it?

They combined health system strengthening and staffing improvements, alongside quality of care: in short a “whole-health-systems” approach. Their long-term systems strengthening with an investment in midwifery and the removal of health-uptake financial barriers targeted what pregnant women were dying from.

Nepal: Mother and baby Nepal: Mother and Daughter

With a population growth predicted to increase by 61% to 26.6 million and a need to respond to 1.2 million pregnancies per year, 64% in rural areas in Burkina Faso. While, in Morocco a projected increase by 21% to 39.2 million respond to 0.9million pregnancies per annum by 2030, 44 % in rural settings.

We need to take action at ICM, within African regional and subregional organisations, in collaboration with Francophone midwives in Europe, North America and Africa, uniting our efforts in RMNH care and strengthening the profession to address their population needs.

You can watch the launch of the Midwifery Lancet series on the Live Stream.

The Lancet Series on Midwifery: Women should be at the heart of decisions