Scaling up midwifery-reaching out to women 1st Forum on Midwifery in the Community: Karen Odberg Petterson, Della Sherratt and Nester T Moyo report on the 1st International Forum on midwifery in the community, held in Hammamet, Tunisia, 11-15 December 2006.

• Auteur: Pettersson, Karen Odberg
• Tenlastelegging: Conference news

Half of the World's Pregnant Women Still Lack Access to Skilled Care at Childbirth

HAMMAMET, Tunisia, 11 December 2006: Half of the world's pregnant women still have no access to skilled care at childbirth. This contributes to a persistently high number of mothers and babies who continue to die every day for want of skilled attendance at birth. To ensure that every pregnant woman and newborn has access to a skilled birth attendant, ICM, the International Confederation of Midwives; UNFPA, the United Nations Population Fund: WHO, the World Health Organization; and their partners are calling on governments to invest in developing and scaling-up of "Midwifery in the Community".

Evidence shows that the health and well-being of mothers and their babies have improved in several countries, such as Costa Rica, Egypt, Malaysia, South Africa, Sri Lanka, Thailand and Tunisia, because of their investment in midwives' and others' training through national midwifery programme development.

"Midwives form the bridge between communities and facilities. They transcend the levels of care within health systems, and are essential to the continuum of care during the childbearing cycle," said Kathy Herschderfer, the Secretary-General of the ICM.

Access to skilled care during pregnancy and childbirth is a woman's basic human right. Investment in the training and supporting of midwives is urgently needed worldwide. An estimated 334,000 more midwives are required to reduce maternal and newborn death and disability, according to the 2005 WHO World Health Report. "A strong midwifery profession is key to achieving safer childbirth, and all pregnant women should have access to a midwife," said UNFPA Executive Director Thoraya Ahmed Obaid.

Extract from ICM/UNFPA/WHO press release, 11 December 2006

The organisers

The 1st International Forum on 'Midwifery in the Community' was organised by the International Confederation of Midwives (ICM), the United Nations Population Fund (UNFPA) and the World Health Organization (WHO), with the support of the Swedish International Development Agency (Sida), the Government of Luxembourg, the global research initiative IMMPACT, Family Care International (FCI), Averting Maternal Death and Disability (AMDD) and the Partnership for Maternal Newborn and Child Health (PMNCH).

The Forum brought together multi-disciplinary experts from 22 low- and middle-income countries in four regions of the world (Africa, Asia, Latin America and the Caribbean, and the Middle East) to consider how midwifery care in the community can be scaled-up.

The organisers of the Forum recognise that efforts to date under the umbrella of the Safe Motherhood Initiative have always prioritised the need for skilled care at birth. However, the issue of strengthening quality midwifery care in the community has not received due attention, as compared to the focus on expandng--or 'scaling up'--emergency obstetric and neonatal care (EmONC). Yet without skilled midwifery providers working closely with women and their families, the knowledge of when and how to access such care, even the willingness to do so, is limited.

The background

The international community's involvement in the scaling-up of the work of midwives and others with midwifery skills took a different dimension and pace with the publication of the World Health Report 2006 on ' Working together for Health'. The recognition of the magnitude of human resource shortages, coupled with the Lancet Series on Maternal Survival published later in 2006, triggered debate about the most effective strategies for reaching MDG5.

As a result, attention is currently focused on how best to invest in the human resource dimension. It is recognised that there is an urgent need to review the characteristics of the current programmes for...