Midwives in Liberian yesterday joined millions of their counterparts around the world to observe International Day of Midwives, with the United Nations Populations Fund (UNFPA) calling on the Government of Liberia to urgently address the shortage of midwives in the country.
The UNFPA Resident Representative to Liberia, Ms Esperance Fundira, said women in Liberia continue to die every day due to pregnancy related complications.
“The maternal mortality ratio is at 994 per 100,000 live births. Skilled birth attendance is at only 46 percent and antenatal coverage at 79 percent. Liberian women also suffer from the long debilitating problem of obstetric fistula,” Ms. Fundira, serving as keynote speaker for the occasion, said.
The Theme of this year’s International Day of Midwives was “The World Needs Midwives Now More Than Ever”, same as last year’s, which the UNFPA boss localized as “Liberia Needs More Midwives Now More than Ever” as topic of her statement.
At least 250 midwives and other health practitioners paraded through the principal streets of Monrovia, before converging in the Auditorium of the University of Liberia — to present a position statement to the government through the Ministry of Health and Social Welfare — where the UNFPA Chief addressed them.
“Midwifery is the labor of love and that is why we are all gathered here to honor our midwives on behalf of UNFPA and the United Nations in Liberia,” Ms. Fundira said.
She said the numbers highlighted above make grim reading, but the real scandal is that the medical technologies and knowledge to save the lives of women are available. “This situation is unacceptable and needs urgent attention. We need to put our efforts together to scale up provision of emergency obstetric care and save the lives of Liberian Women.”
She said UNFPA was fully prepared to help the government to address critical issues such as human resource to improve the country’s reproductive health service.
Said Ms. Fundira: “We are proud to announce that UNFPA has just approved a special fund called “Maternal Health Thematic Trust Fund” to Support the Ministry of Health to strengthen institutional and human resource capacity to deliver quality reproductive health services.”
This she said include family planning, emergency obstetric and neonatal care, sexually transmitted infections, and HIV & AIDS prevention. “The Ministry of Health has already started the implementation of this program,” she said.
She described midwives as key healthcare providers to reverse the situation highlighted above and in achieving MDG5 (to reduce maternal mortality).
In 2008, UNFPA and International Confederation of Midwives launched a new initiative to tackle the severe shortage of midwives in developing countries. The program aims at building the national capacity to increase skilled attendance at birth by equipping midwives with skills, knowledge and attitudes to provide quality basic emergency obstetric care including other sexual and reproductive health services.
This initiative focuses on developing the foundation for a sustainable midwifery workforce by training midwives and strengthening midwifery education, developing standards, and developing and strengthening midwifery associations.
“There is a general agreement that strengthening health systems and addressing the shortage of human resources for health can make great contribution to reduce the number of maternal deaths,” the UNFPA Country Rep stated.
Weak health system, more especially human resources, she indicated, has been a persistent challenge in the Liberia health sector. The human resource crisis is characterized by lack of doctors in rural areas, shortage of key professionals such as midwives, high attrition and low motivation of skilled health workers, she said. “Therefore, supporting midwifery program will improve women’s reproductive health in Liberia,” he said.
“We need midwives because the presence of a midwife at birth can mean the difference between life and death. Midwives understand that every child bearing woman deserves to give birth within a safe and supported environment for herself and her baby,” Madam Fundira noted.
The UNFPA Liberian boss indicated that midwives also provide skilled newborn care to achieve MDG 4 (reducing child mortality). Liberia, she stated, has made a lot of progress and reduced neonatal mortality rate to 32 per 1,000 live births, but noted that “Most of the children die within their first 24 hours of life due to lack of adequate health services including midwifery care,” adding, “The presence of a midwife at birth can mean life or death for the neonate.”
Ms. Fundira: “Today, on the International Day of the Midwife, the International Confederation of Midwives and UNFPA…are calling on the governments of the world to urgently address the shortage of 350,000 midwives worldwide including the shortages here in Liberia.”
Commending the Liberian midwives for their resilience in the face of many challenges, Ms. Fundira said “I am also joining the UNFPA Executive Director and ICM In calling on the Ministries of Health and Education to invest more resources in midwives.”
“If we want more women to deliver in our health institutions, we need to work more on the supply side of the health care delivery system and produce competent midwives who are able to manage complications and refer as soon as possible those complications that they cannot handle,” Ms. Fundira said in her speech published on page 5.
In a position statement, the Midwifery Association of Liberian called on the government of Liberia to increase salary and incentives for them and also upgrade the Midwifery School to a bachelor degree level.
Each year, their statement presented to Health Minister Walter Gwenagale noted, hundreds of thousands of women die and three millions newborns do not survive the first week of life because they lack access to maternity health services and skilled midwifery care.
“For every tragic maternal death another 20 women face serious or long-lasting illnesses or disability such as obstetric fistula,” they said.
They said in Liberia, too many women are dying in pregnancy labor and child birth. Less than half (46 percent) of births are assisted by a skilled; a major contributing factor to the country’s unacceptable high maternal mortality rate which stands at 994/100,000 live births.
“Liberia needs more midwives, in order to fully fulfill its Poverty Reduction Strategy (PRS) and achieve the Millennium Development Goals 4 (Reducing child mortality), 5 (Improving maternal health), and 6 (Combat HIV/AIDS, malaria and other diseases),” the statement read.
The Liberia Midwifery Association, Like the UNFPA Boss, called on the government to urgently address the shortage of midwives in the country by prioritizing midwives in its health program, policies and budgets.
“We in this light appeal to the Government to revise the national training curricula for midwives, marking it a Bsc. level program,” they pleaded, adding, “We also urge the Government to raise the level of remuneration for midwives in the country on par with other paramedicals in the country to avoid midwife leaving the practice.”
The Midwifery Association then pledged “to reaffirm their commitment to help save the lives of pregnant women and their newborns.”
Meanwhile, Health Minister Gwanegale has lauded the sacrifices of midwives in the country and noted that the Liberian government was committed to improving their welfare.
He said their concern about salary increment would be addressed as the government annual budget swells.
The Minister disclosed that he has already held discussion with the Civil Service agency put midwives in special category of salary because their job is risky.
He however warned against the establishment of quack midwifery institutions in the country, bent on producing unqualified individuals in the profession.