Guyana is among 38 countries that could miss the fifth Millennium Development Goal target if it does not train more midwives, a new report by the United Nations Population Fund (UNFPA) and partners has found.
A maternal health-care giver views some of the exhibits at a safe motherhood photographic exhibition at the National Library on June 20
The report said that 38 of 58 countries surveyed during the study could miss their MDG target to achieve 95 per cent coverage of births by skilled attendants by 2015 without a total of 112,000 more midwives. Globally, 350,000 midwives are still lacking.
The study, released on Monday by the local UNFPA office, revealed that up to 3.6 million deaths could be avoided each year in 58 developing countries, which together account for just under 60 per cent of all births worldwide but 91 per cent of all maternal deaths, if midwifery services are upgraded by 2015.
The State of the World’s Midwifery 2011 was launched at the Triennial Congress of the International Confederation of Midwives (ICM) underway in Durban, South Africa.
“Ensuring that every woman and her newborn have access to quality midwifery services demands that we take bold steps to build on what we have achieved so far across communities, countries, regions and the world,” said United Nations Secretary General Ban Ki-moon in his foreword to the report.
Each year, 358,000 women die while pregnant or giving birth, some two million newborns die within the first 24 hours of life, and there are 2.6 million stillbirths, all because of inadequate or insufficient health care. If adequate facilities were accessible to deal with complications at their onset, many deaths could be averted – 61 per cent or nearly two thirds of all maternal deaths, 49 per cent or almost half of stillbirths, and 60 per cent or three in five newborn deaths. The report adds that if midwives are in place and can refer the most severe complications to specialised care, up to 90 per cent of maternal deaths could be prevented.
The State of the World’s Midwifery 2011 is the result of collaboration among 30 partners whose collective aim is to strengthen midwifery practices to prevent maternal deaths and disability, and improve the health of newborns, families, and entire communities. Among the 38 countries most desperately in need of midwives, 22 need to double the workforce by 2015, seven need to triple or quadruple it; and nine (Cameroon, Chad, Ethiopia, Guinea, Haiti, Niger, Sierra Leone, Somalia and Sudan) need to dramatically scale up midwifery by a factor of 6 to 15.
“In addition, ICM’s new global standards for midwifery education and regulation will assist governments and policy makers to address the report’s recommendations,” said Bridget Lynch, President of the International Confederation of Midwives.
Increasing women’s access to quality midwifery has become a focus of global efforts to realise the right of every woman to the best possible health care during pregnancy and childbirth. It is also at the heart of three health-related Millennium Development Goals – to reduce child death (MDG 4); improve maternal health (MDG 5); and fight AIDS, malaria and other diseases (MDG 6). In addition to inadequate numbers of midwives, the report reveals that coverage within countries is unequal, as is quality. There is a short-age of training institutions and employment opportunities for midwives.
In addition, poor regulation, weak professional associations, an incomplete policy environment, and the omission of midwifery from human resource costing plans for maternal and neonatal health are significant challenges. Several recommendations were made to help remedy these problems.
In Guyana, the year 2010 was described as a setback by Health Minister Dr Leslie Ramsammy, as several mothers and babies died during labour. “It is always a painful experience when we fail to achieve the only result that matters to us – delivering a healthy child all the time, without complications,” Ramsammy said, adding that the health workers of Guyana have worked hard and have improved the situation.
He noted that, in 1991, the maternal mortality ratio was 32 deaths per 10, 000 deliveries. Since then, significant strides have been made and the rate was 8.01 per 10, 000 deliveries in 2009. To date, there have been only two maternal deaths for this year.
