The global call for attention to midwifery as a profession and as a solution to preventing unnecessary maternal and neonatal mortaility has been building momentum over the past decade. The conversation that started among global and national midwifery associations was supported and echoed in academic literature and by global development agencies.
In recent years countries including Cambodia, Indonesia and Morocco have taken policy action to invest more in midwives. The results have seen significant improvement in their maternal and newborn indices.
Well trained, qualified midwives are a crucial low-investment, low-risk, high-yield resource that prevent maternal and newborn morbidity and mortality. Midwives can, if supported to task, play a unique role within their communities as part of the integrated health system, providing 87% of the essential care needed by women and newborns – potentially preventing two thirds of all maternal and newborn deaths.
Tanzania is a large country with 70% of its 53 million population residing in rural areas. Access to fully equipped health facilities remains a challenge and many women still experience complications as a result of not being able to give birth under the qualified supervision of a competent health practitioner. It is estimated that 8,000 women currently die every year and more than 1 million births take place in the absence of a qualified midwife.
We have spent the past 18 months understanding the current, interlinking complexities that are at play which have contributed to the current increase in maternal and newborn deaths in Tanzania. Training and recruitment, access, affordability, availability of medical supplies, cultural practices and quality of care each play a critical role and thus a collective effort is in order to achieve sustainable change for mothers and newborns.
Working closely with The Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDEC) there is without doubt, a strong political will to accelerate progress in reducing maternal mortality. Within the framework of the National Road Map 2016-2020, The Government is making strides to improve emergency and obstetric care facilities and distribute critical commodities such as surgical gloves and magnesium sulphate to health facilities country-wide. The MoHCDEC’s request for a budget increase was approved to specifically focus on strengthening maternal and newborn health services and on The International Day of the Midwife 2017, The Vice President of Tanzania, Honourable Samia Suluhu with The Minister of Health (MoHCDEC), Dr. Ummy Mwalimu announced that the government would review the nurse-midwife curriculum and explore the notion of making midwifery a stand alone profession. All of which reflect the Lancet report urging policy makers to improve effective coverage of reproductive, maternal and newborn health care while simultaneously improving the quality of care.
The growing commitment to this health priority has been further re-inforced by the highly respected advocate, The 4th President of Tanzania, Dr. Jakaya Mrisho Kikwete who has announced that The Jakaka Mrisho Kikwete Foundation will focus on strengthening midwifery in Tanzania and collaborate with the government and health partners in achieving sustainable gains.
At a time where political will is fully charged and with the count down to 2030 upon us, it is also a critical time for the international donor community to come together in support of the government’s aspirations to amplify the demand and number of midwives in Tanzania so that every pregnant woman has access to this cadre.