access to quality midwifery care for women and newborns: findings from the state of the world’s...
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Access to quality midwifery care for women and newborns: findings from the State of the World’s Midwifery 2011.
Track 4: Global access to care for women and children.
7th European Congress on Tropical Medicine and International HealthWednesday 5th October 2011.
Jim CampbellDirectorICS Integrare, Barcelona, [email protected]
June 2010
• Concept (Women Deliver)
Novemb
er 2010
• NORAD/UNFPA commission
Dec 2010
– Feb
2011
• Country survey
Mar –
June 2011
• Report and launch
MIDWIFERY – the INTERVENTION MIDWIFERY - the PROFESSION
• intervention is practised not only by “midwives”. – ‘skilled birth attendants’ – ‘community health workers’ – ‘traditional birth attendants’
• respective cadres have (some) competencies
COMPETENCIES in the COMMUNITY
Summary messages
1. Practising workforce (and quality) not known
2. Inadequate numbers – inequitable coverage
3. ‘Triple gap’ – competencies, coverage, access
4. Education, regulation, professional association – weak
5. Policy coherence – missing
“Failed to reach” NOT “Hard to reach”
MDG5.2 – 95% births assisted by a SBA
• Estimates for ‘practising’ collated by WHO
• 38 countries – 112,000 more midwives needed
• 20 countries – volume, but distribution, utilisation, quality etc remain barriers (still low % SBA)
9 countries: x 6 to 157 countries: x 3 to 422 countries: x 2
Conditions for achieving quality
1. Education, Regulation and Professional association development
2. Access to facilities and referral mechanisms
3. Human resource management based on ‘Strategic Intelligence’
4. National health plans and policies integrating human resources for maternal health
LiST - Impact of increased coverage of midwifery (Bartlett L, Sikder S, Friberg I. - JHSPH)
• Double the current access to practising midwives => 21% reduction of maternal, foetal and newborn deaths
• Add universal coverage of all births in a BEmONC facility with midwives => 56 % reduction
• Total: 3.6 million lives saved in 2015 – 61% of maternal deaths, – 49% of foetal deaths, and – 60% of newborn deaths
“Ensuring that every woman and her newborn have access to quality midwifery services demands that we take bold steps”
Ban Ki-moon, Secretary-General of the United Nations
Sept 2011
• UNGA / EWEC
2011-12
• Country studies (x 7)
Sept 2012
• EWEC Progress report
Sept 2012
• The Lancet Special Series on Midwifery
Special Series on Midwifery
September 2012
Report (EN, FR, SP)
www.stateoftheworldsmidwifery.org
Further information:
Jim CampbellICS Integrare
C. Diputacio 26208007 Barcelona