Commentary

Train, equip and motivate midwives to curb maternal, infant mortality

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By Patrick Aliganyira

Posted  Monday, May 5  2014 at  01:00
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Every day nearly 8,000 newborns and 800 mothers around the world die from causes related to pregnancy, childbirth and complications during the first month of life. In addition, more than 7,300 babies are stillborn every day. According to the World Health Organisation, a newborn infant, or neonate, is a child under 28 days of age. During these first 28 days of life, the child is at the highest risk of dying.

In Uganda, 43,230 babies die annually before they make 28 days of life. That is 3,600 per month and 118 each day. Most of these babies die at birth or within 24 hours of birth. These figures place Uganda among the five countries in Africa with the highest number of newborn deaths, yet nearly all of these deaths can be prevented.

The period of highest maternal, foetal and newborn mortality is during labour and delivery and the 24 hours thereafter. The professional workforce present with women before, during and immediately after giving birth is the midwife.
Midwives and others with midwifery skills are, therefore, the single most important cadre for preventing maternal and neonatal deaths and stillbirths. Midwives can help prevent two thirds of all maternal deaths and half of newborn deaths, provided they are well-educated, well-equipped, well-supported and authorised.

Today is the International Day of the Midwife, when we highlight and celebrate the work of midwives globally. There is a reason why the Ministry of Health, the World Health Organisation and civil society actors have been on a drive to encourage mothers to give birth under skilled medical attention.
According to the State of the World’s Midwifery 2011: Delivering Health, Saving Lives, quality midwifery services that are coordinated and integrated within communities and within the health system ensure that a continuum of essential care can be provided throughout pregnancy, birth and beyond. .

No mother should pay the ultimate price of losing a child because basic healthcare just wasn’t there. All new mothers should receive the support of a trained midwife who has basic medicines and equipment. In spite of the importance of having skilled help at delivery, today, across the world, 40 million women give birth without this help – that’s more than 100,000 women every day. Even more dramatically, two million women a year are entirely alone when giving birth.

The Uganda Demographic and Health Survey 2011 indicates that only 58 out of every 100 women in Uganda have a skilled health worker present when giving birth, with coverage twice as high among the wealthiest households, compared with the poorest. We know the problem, and with this the solution. We need to train and equip more midwives.

Last year, the Ministry of Health pointed out that Uganda requires at least an additional 2,000 midwives to enable mothers and newborns receive quality and timely antenatal, delivery and postnatal care.
The government has done a commendable job in its efforts to recruit more health workers, and we urge it to pay even more attention to cadres like midwives. In addition, it should ensure adequate availability and distribution of emergency obstetric and newborn care facilities. The professional midwifery associations should also be catalysts for change by promoting standards for in-service training and knowledge updates and advocating better working conditions.

Mr Aliganyira is a technical specialist.