This year the International Confederation of Midwives will hold its 28th Triennial Congress with a theme emphasising 'Midwifery: a worldwide commitment to women and the newborn'. (1) At the same time the World Health Organization (WHO) will celebrate both the 60th anniversary of its founding and the 30th anniversary of the Alma-Ata declaration on primary health care. The WHO Director-General, Dr Margaret Chan, has said she aims 'to focus the World Health Report 2008 on primary health care and its role in strengthening health systems.' (2)
The Alma-Ata Declaration (3) says: 'Primary health care is essential health care ... made accessible to individuals and families in the community through their full participation.... It is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work.... [it] includes at least: education concerning prevailing health problems; proper nutrition; a supply of safe water; maternal and child health care, including family planning; ... [and it] relies, at local and referral levels, on health workers, including physicians, nurses, midwives, auxiliaries and community workers'.
Midwives' commitment to families, within a functioning health system and supportive environment, is a core element of primary health care. Midwifery care is unique in the way it can influence the health of future generations through giving new parents the physical well-being, confidence and self-esteem that arise from a positive birth experience, through breastfeeding support and nutritional education, through assistance with family planning and spacing, and through encouragement of women's knowledge of their own bodies.
ICM is a confederation that depends for its skills and strengths upon its members: the 93 midwifery associations in membership around the world. Often our inspiration comes from the efforts of individual midwives within these associations and the imagery they use to describe their work. A member of the Afghan Midwives Association last year designed a beautiful poster for the International Day, representing midwives as doves 'who bring health and peace to the families of Afghanistan'; and in Haiti, midwife Katherine Goulliart wrote her Pensees...