"Yametimia” – a good job well done

“Yametimia” – a good job well done – this year’s various activities and national event held in Mara Region to mark the International Day of the Midwife 2015 was a resounding success.

Midwives are synonymous with life – evidence shows that given access to, availability, acceptability and quality midwifery care, more than 80% of maternal, newborn and foetal deaths could be prevented.

It’s simple: investing in midwives is investing in life.

International Day of the Midwife 2015

Crucially, a real ‘partnership’ of partners came together to raise the profile of our midwives and advocate for midwifery services to be given highest priority in our strategies, plans, budgets and actual delivery.

Under the auspices of TAMA (the Tanzania Midwives Association) – the regional leadership for Mara region; the government via the new MOH directorate for nursing and midwifery; donors led by UNFPA; and a host of civil society organisations championing maternal and newborn health, forged a determined front and compelling case for our midwives.

Impressively, both the Chief Executive for the International Confederation of Midwives participated, and the Prime Minister himself travelled across the country to grace the climax event.

Fittingly, this year’s national activities were hosted by Mara region. Mara continues to inspire with its determined leadership to transform the survival of its mothers and babies, demonstrated by a collective resolve to implement its renowned regional strategy.

With midwifery an essential foundation of all the key interventions spanning family planning and care before, during and after birth, the Mara regional leadership embraced the opportunity and honour to showcase and drive the midwifery agenda.

And a showcase it was...

Over one hundred midwives and health systems administrators from across all Mara’s councils as well as all the Sharpened One Plan priority regions from Lake and Western Zones came together to participate in Midwifery Forums held at Mara regional and national levels – with a focus on acting on the evidence of the challenges and opportunities in midwifery in Tanzania, building on the calls to action raised during the launch of the 2014 State of the World’s Midwifery Report.

Journalists were oriented at national and regional levels on the evidence for improved maternal and newborn health outcomes through investing in midwives including field visits to health facilities to get an insight into the daily life of being a midwife.

Which then all culminated in a colourful national event whereby midwives were celebrated, compelling advocacy was delivered, and the country’s highest leadership was impassioned in his recognition of the role of midwives as the bedrock for mothers and babies survival.

Concerted efforts are being made to try and close this tragic gap between midwives and mothers and babies. Enrolment of midwifery students in colleges of nursing and midwifery has increased more than threefold in the last five years – with a total of nearly 5,000 students taking certificate and diploma courses in midwifery in 2015.

The government reports having employed an unprecedented number of 8,000 skilled health workers to be posted across all regions of Tanzania this year – this is definitely great progress for which the government deserves much praise.

While we must not relax for even a moment our demands for increased and continued investment in midwives.

A recent health workforce assessment reports that across skilled health workers employed by the government, nearly a quarter failed to report to their postings, and furthermore another ten percent left their job after only the first year of employment – predictably rural areas suffering the most.

Put this in the context of rapid population growth and the demand for midwifery care is growing massively year on year – take for example the censuses of 2000 and 2012, whereby the projected number of pregnancies were approximately two million in 2012 as compared to one and a half million in 2000.

It is clear that we are facing a crisis in meeting even the minimum threshold for provision of midwifery care across our country.

A daily tragedy for which we all must take action

This is in the context of a tragic national burden of our mothers and babies losing their lives every year.

The latest evidence published in our National RMNCH Strategy points to almost 8,000 mothers and 39,000 newborns dying every year in Tanzania.

Heart breakingly, it is estimated a further 47,000 babies are born dead, with at least half of them dying during birth.If we take only the four months of 2015 to date, based on the above estimates we can project that more than 15,000 mothers and babies born alive have died during pregnancy and childbirth; and a further 15,000 babies were born dead.

Just look at the global outcry and response to the Ebola pandemic last year whose death toll over the course of the year was more like 10,000 men, women and children.

Just look at the most recent national outcry across Tanzania protesting the terrible loss of life down to road accidents with distressing images of horrific accidents happening all too frequently – the story continues to unfold as debilitating national strikes and face-offs between the government and public transport owners now dominate our news.

Put in perspective, it is reported 970 deaths took place on our roads during the four months up to mid-April 2015.Meanwhile it’s estimated that more than fifteen times that number of our mothers and babies (born alive) have died during the same period.

And a further fifteen times that number of our babies have been born dead. This is a daily tragedy unfolding for which we all individually and collectively across government, health service-providers, stakeholders, and the community at large have an irrefutable responsibility to take greater action to transform the survival of our mothers and babies.

Should anyone feel this agenda is not their own – and that they do not have a personal responsibility to take action in their own capacity – they need only look in the mirror and wonder at their navel – a universal emblem that every single one of us carries that we were born by our mothers, and we were born alive – mothers and babies are all our agenda.

Midwives: For a Better Tomorrow

Midwives: for a better tomorrow. Increasing our investment today in the access to, availability, acceptability and quality of midwifery care will transform the survival of our mothers and babies. It will have a manifold return on the incalculable costs saved across government, communities and households, economically and socially.

The only single intervention that I can think of for saving more of our mothers and babies lives would be divine intervention. Besides, what moment in our lives is more blessed than the moment of giving life? And what duty in life is more blessed that the role of delivering life?

This year’s celebrations of the International Day of the Midwife have been quite unprecedented in Tanzania to the enduring credit of everyone who made it happen. We must now build on this momentum to ensure that all our mothers and babies enjoy this fundamental human right: safe motherhood via the hands of a midwife at that most sanctified moment of bringing new life to our nation.

We need midwives more than ever before!