Prioritise midwives to improve maternal and newborn health

If you have been keen enough and listened to most of the pregnant women and mothers in urban areas such as Kampala, majority talk about their personal gynaecologist or doctor. When you further listen critically, very few pregnant women or mothers will mention about having a personal midwife.
In Uganda, >97% of maternal and newborn health services are provided by midwives. So, this leaves one wondering if the work done by midwives majorly in urban clinical settings is not recognized.

Well, midwifery matters for all childbearing women, their babies, and their families, wherever they live in the world, and whatever their circumstances. Available evidence shows that skilled, knowledgeable, and compassionate midwifery care reduces maternal and newborn mortality and stillbirths, keeps mothers, and babies safe, and promotes health and well-being. In so doing, midwifery has a positive impact on the wider health system and the economic sustainability of communities and countries at large.

Midwifery achieves this impact by providing care for all women and babies, both with and without complications and across the continuum from pre-pregnancy, pregnancy, labour, and birth, and in the early weeks after birth. Thus, good quality midwifery care offers a combination of prevention and support, early identification and swift treatment or referral of complications, and respectful and compassionate care for women and their families at a formative time in their lives. Midwives all over the world work to strengthen women’s own capabilities and the normal processes of pregnancy, birth, postpartum, and breastfeeding.

Every year on May 5th, the International Day of the Midwife (IDM) takes place. While you would think it was an incredibly long-marked awareness day, it wasn’t made official until 1992, when it was launched formally by the International Confederation of Midwives (ICM). The theme for this year is “Together Again: From Evidence to Reality.” This time of celebration honours the efforts of midwives and their associations to action critical evidence like the State of the World’s Midwifery (SoWMy) 2021 towards meaningful change for our profession and the women and families we care for.

This year’s celebrations will take place in Soroti district, Eastern Uganda in an event that has majorly been organized by the National Midwives Association of Uganda (NMAU) in collaboration with the Ministry of Health (MoH), Uganda Private Midwives Association (UPMA), UNFPA, Seed Global Health, Uganda among others.

Prior to this day, NMAU organized a blood donation drive in the capital city, Kampala which attracted many people, and led to the collection of > 200 litres of blood. There is also an ongoing midwifery symposium at Akello Hotel, Soroti district which started on 3rd May 2023. The symposium addresses areas in clinical midwifery practice, leadership, management and policy, midwifery education and training, regulation, research and more.

Additionally, midwives from different facilities across Uganda are conducting various activities such as free cervical and breast cancer screening, provision of family planning services, free health education in nutrition, antenatal care, HPV vaccinations, free HIV testing, Hepatitis B and more. 

Over the years, midwives and all maternity support workers have met extraordinary circumstances and risked their lives to provide excellent care to women, newborns, and their families. Now is the time to not only celebrate how they’ve been there for our communities even throughout the pandemic but to show up for them in calls to the Government to put money where it counts and invest in midwives and maternal and newborn health at large. Thumbs up to all the midwives for their great efforts in promoting maternal and newborn health.

I thus recommend the Government of Uganda through the Ministry of Health and other non-government entities to comprehensively invest in the education and training of midwives, involve midwives in meaningful policy-making and decision-making platforms and positions, and provide adequate tools (supplies, equipment, accommodation) for midwives to ease their work among others.

Lilian Nuwabaine Luyima; is a BSc Nurse and MSN-Midwife & Women’s Health Specialist