The State of the World’s Midwifery 2014

The State of the World’s Midwifery finds that midwives, when educated and supported to do so, can provide 90% of the essential care needed by women and infants in the 73 countries where progress in maternal and newborn survival is most urgently needed. In the report, the midwifery workforce also includes doctors and nurses who care for women and infants as part of their work. Insufficient numbers of workers, or inadequate skill mix, is pervasive, with only 4 countries out of the 73 profiled reporting an adequate number of midwifery professionals.Lack of key information about the midwifery workforce, such as rates of exit from the workforce, future graduates, or age distribution, prevent countries from planning their midwifery workforce in line with current and future needs.Many families cannot afford midwifery care, despite commitments to universal health coverage, and many live too far from the closest maternity service. Misperceptions of midwives pose a challenge to the acceptability of care, as their profession is less well known and they are often seen as less skilled than doctors or nurses in some countries. Countries reported many efforts to improve the enabling environment for quality midwifery care, including education, regulation and the development of associations. However progress is still needed to ensure that all midwifery care is as life-saving as it can be. So what should countries do? Firstly, invest in midwives – a panel by the World Bank shows that midwives are a “best buy” for maternal and newborn survival, yielding a 16-fold return on investment when taking into account the cost of their education compared to the cost of c-sections avoided throughout their 30-year careers. The report also talks us through the key steps to achieve Midwifery2030, a policy and planning vision for midwifery. These include:

• Redesigning models of practice to support, listen and respond to women and families;
• Strengthening education, regulation and professional associations to improve quality of care and support individual health workers;
• Changing health systems to support midwifery professionals’ daily work, particularly referral networks and human resource management;

Fostering genuine collaboration and teamwork between different types of health workers as they all have an important role to play in midwifery care.To read the report, click here.To compare progress with 2011, click here.To see a toolkit for using evidence from the State of the World’s Midwifery 2014 report to create policy change at the country level, click here.UNFPA. (2014). The State of the World’s Midwifery 2014: A Universal Pathway. A Woman’s Right to Health. New York: United Nations Population Fund.