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Midwifery and Midwives: Global Situation. Della R Sherratt Senior International Midwifery Advisor and Trainer Currently UNFPA International Coordinator for Skilled Birth Attendance, Lao PDR. Global Intelligence ?. ?. Do not really know: how many, where, what production modality best

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midwifery and midwives global situation

Midwifery and Midwives:Global Situation

Della R Sherratt

Senior International Midwifery Advisor and Trainer

Currently UNFPA International Coordinator for

Skilled Birth Attendance, Lao PDR

global intelligence
Global Intelligence ?

?

Do not really know:

  • how many, where, what production modality best

We do know:

  • we do not have enough
  • quality isn’t always sufficient
  • Deployment is not always where women need
  • It is hard
we know midwives have been important part of mmr reduction in some countries
We know midwives have been important part of MMR reduction in some countries

Invest in Midwives to reach out to women and communities where they are.

Over time as confidence in service grows ....move from home to fix site for births ......... But still needed in community ANC, PNC, Linkages

consensus
Consensus?

YES

No

  • Midwives make a difference
  • Generally women like and will use midwives
  • World Needs more Midwives
  • What competencies Midwives need
  • What midwives do? –
    • Just birth? MNH?, PHC? MNCH? SRH, ????
  • Where midwives should work
  • How many needed
  • Priority
  • Funds
why is it we still have no clarity
Why is it we still have no clarity?
  • Needs of women and newborns sacrificed at the alter of ideology – throughout history
  • Gender; Midwifery = women’s work?? (volunteerism), masculinisation of childbirth
  • Protectionism/ “we know best” (Physicians, Nurses and sometimes Midwifery Associations, Agencies)
  • Health System Planning Processes (and projects)
numbers
Numbers?

For HRD Planning Midwife to Population Ratio not helpful, - Midwife to Birth (estimated births)

WHO recommended 1:175 (WHO, 2005) –but this must be set national and sub-national, based on workload plus “other duties “

dec 2006 unfpa icm who forum on midwifery in the community

How to get Midwives where women and newborns need them?

Dec 2006, UNFPA, ICM, WHO Forum on Midwifery in the Community

23 countries some with success stories, others planning, others implementing plan

lessons learnt training not enough
Lessons learnt: Training not enough

Equity Approach

To Reach All

Political Commitment towards Access

for All

Competency-based Education & Training

Competent Midwife to save lives of mothers & newborns

Monitoring & Evaluation

Enabling

Environment

Supervision

Stewardship, Resource

Mobilization & Management

specific support for midwifery 1
Specific support for Midwifery 1
  • Production of Midwives: (SBAs):Curriculum; teacher training; stipends ; T&L materials in local language
  • Advocacy and Identity: e.g. IDM, global, regional and national events, midwifery advisor in selected UNFPA Offices, uniforms (Lao PDR)
  • Supporting HRD Systems Regulations; Accreditation systems; Job descriptions; standards; Accreditation and licensing exam
  • Supply limited equipment: skills labs, for midwives working in community, community bag
  • Strengthening EmONC & FP
  • Partnership e.g. ICM MoU, others....

1.Varies in each country depending country plans

  • insert pics