Midwifery education is a key solution to the challenge of providing universal and quality maternal and newborn care to meet our Sustainable Development Goals. While improving access to care is critical, ensuring good quality of care has an even greater impact in terms of lives saved. WHO, ICM, UNFPA and UNICEF are finalising a report and action plan for strengthening quality midwifery education to be released at the World Health Assembly, 20-28 May 2019.

WHO is working hard to provide a solution is to transform midwifery education through the first global, in-service, evidence based interprofessional Midwifery Education Tool kit.  This tool kit brings together maternal, newborn, sexual, reproductive and mental health for life-long learning in compassionate midwifery care, including during pandemics and for use in fragile and humanitarian settings.  Focused on a midwifery model of continuity of care, putting women, newborns and their families at the center, this toolkit provides midwives with all the training required to care for healthy women and their newborns,  prevent unnecessary interventions, while ensuring lifesaving actions and enable health professionals to work effectively in a multi-disciplinary team.

Midwifery education is designed to address three strategic priorities:

• All midwives should be educated to high standards and enabled to practise to their full scope
• Midwives should be involved in education policy at the highest level
• Education processes should be coordinated and aligned

Who is a skilled birth attendant?

Skilled health personnel, as referenced by SDG indicator 3.1.2, are competent maternal and newborn health (MNH) professionals educated, trained and regulated to national and international standards. They are competent to: (i) provide and promote evidence-based, human-rights based, quality, socioculturally sensitive and dignified care to women and newborns; (ii) facilitate physiological processes during labour and delivery to ensure a clean and positive childbirth experience; and (iii) identify and manage or refer women and/or newborns with complications. In addition, as part of an integrated team of MNH professionals (including midwives, nurses, obstetricians, paediatricians and anaesthetists), they perform all signal functions of emergency maternal and newborn care to optimize the health and well-being of women and newborns. Within an enabling environment, midwives trained to International Confederation of Midwives (ICM) standards can provide nearly all of the essential care needed for women and newborns. (In different countries, these competencies are held by professionals with varying occupational titles.) Reference: WHO, UNFPA, UNICEF, ICM, ICN, FIGO and IPA 2018

Midwives can provide about 90% of the SRMNAH care needed, but they account for less than 10% of the global SRMNAH workforce. The world needs 900,000 more midwives. By 2030, the midwife shortage will be smaller (750,000), but there will still be a major gap between the number required and the workforce available in midwifery.

The gap between low-income countries and high- and middle-income countries is projected to widen by 2030, increasing inequality. To close the gap by 2030, 1.3 million new DSE worker posts (mostly midwives and mostly in Africa) need to be created in the next 10 years.

WHO is working on each of the 4 priority areas to strengthen the quality and quantity of midwives globally. The most recent resolution, WHA 64.7, gives WHO the mandate to develop and strengthen strategies such as: capacity of nursing and midwifery workforce through the provision of support to Member States on developing targets, action plans and forging strong interdisciplinary health teams as well as strengthening the dataset on nursing and midwifery.

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