The State of the World's Midwifery 2014: "A Universal Pathway. A Woman's Right to Heath" launched in Hanoi by the United Nations Population Fund (UNFPA) in Vietnam, together with the Ministry of Health (MOH), reveals that having midwives at the bedside of each pregnant woman in the world can save millions of lives. However, still major shortages in the midwifery workforce in 73 countries surveyed for this report, including Vietnam, exist; countries where these services are most desperately needed. The report recommends new strategies to address these deficits and save millions of lives of women and newborns. The 73 African, Asian and Latin American countries represented in the report account for 96% of the global burden of maternal deaths, 91% of stillbirths and 93% of newborn deaths, but have only 42% of the world's midwives, nurses and doctors. The report urges countries to invest in midwifery education and training to contribute to closing the glaring gaps that exist. Investments in midwifery education and training at agreed international standards can yield – as a study from Bangladesh shows – a 16 fold return on investment. "Midwifery and midwifery practice play a crucial role in Vietnam's maternal and newborn health care system. A skilled midwifery workforce with high competencies, motivated and supported by the health care system, is key to successfully reducing maternal and newborn mortality and contributes to achieving MDGs 4, 5 and 6," said Nguyen Viet Tien, Vice Minister of Health at the launch in Hanoi. Midwives have a crucial role to play in the achievement of the Millennium Development Goals (MDGs) 4 (decrease child death) and 5 (increase maternal health and universal access to reproductive health). When educated to international standards and within a fully functional health system, they can provide about 87% of the essential care to women and newborns and can potentially reduce maternal and newborn deaths by two thirds. Despite a steady decline in maternal deaths in the 73 countries that are covered in the report – dropping yearly by 3% since 1990 – and newborn deaths – decreasing by 1.9% per year since 1990 – there is more these countries need to do to address the severe shortage of midwifery care. The report, launched at the 30th ICM Triennial Congress in Prague, Czech Republic on 3 June 2014, highlights the progress made since the inaugural 2011 report and solutions to the barriers outlined in four key areas: availability, accessibility, acceptability and quality of midwifery services: A number of countries have effectively strengthened midwifery and improved access: Nearly half (45%) of the 73 countries have implemented measures to retain midwives in remote areas and 28% are increasing the recruitment and deployment of midwives, while 20% have implemented new codes of practice and 71% have improved information collection enabling countries to address shortages and education standards. Despite progress, inequities such as lack of access to services and poverty, have increased within and among countries. There are still not enough adequately educated midwives to support the health of women and newborns, and this contributes to hundreds of thousands of preventable deaths annually. "Investing in human resources for health, especially for midwives, is one of the soundest investments a country can make. When midwives are properly trained, empowered and supported, they can contribute significantly to saving many lives of people, mothers and newborns, as well as improving the nation's economic and social productivity. This is a highly cost-effective public health strategy", emphasized Mr. Arthur Erken, UNFPA Representative in Vietnam. Today, only 22% of countries have potentially enough midwives to provide life-saving interventions to meet the needs of women and newborns, which leaves over three-fourths (78%) of the countries with severe shortages in proper care. As the population grows, so does the gap in critical resources and infrastructure, unless urgent action is taken. The 2014 report includes recommendations to close these gaps and to ensure all women have access to sexual, reproductive, maternal and newborn services. Every year, the world over, almost 300,000 women die during their pregnancy or childbirth. Implementing the recommendations come a long way to end this human tragedy, as no women should die while giving life. (Dangcongsan.vn July 10)
