AMREF Calls on Sub-Saharan African Governments to Increase Numbers of Midwives to Address Maternal Mortality


Midwife literally translates to “With a Woman” from Latin, reflecting the practice that from time immemorial, women sought the assistance of other women close to them at the time of labour and childbirth. Midwives have therefore been part of the human experience since time immemorial.

Up until the advent of modern midwifery in approximately the 17th and 18th centuries when the first schools of midwifery training appeared in Europe, the whole world had approximately the same levels of maternal death during childbirth, roughly 20%, with the most feared causes being hemorrhage and puerperal fever, or infection after childbirth. Today, there is very low maternal mortality in the developed world, not least because of the professionalization of midwifery in those countries. However, approximately 35,000 women continue to suffer severe complications of childbirth daily, with about 900 deaths every day, most in the developing countries of Africa and Asia (The State of the World’s Midwifery 2011).

Midwife Esther Madudu, AMREF's Nobel Peace Prize Nominee for 2015

Midwife Esther Madudu, AMREF`s Nobel Peace Prize Nominee for 2015

It is no coincidence that in most of sub-Saharan Africa which has the highest burden of maternal and newborn mortality, only an average of 40% of women have access to a professional midwife at the time of childbirth, and in some countries that have been in conflict for a long time, only about 6% to 10% have access to a trained midwife. Maternal and newborn mortality is highest in such countries. There is a clear correlation between numbers of midwives and levels of maternal death and severe injury like obstetric fistula. Numerous studies show that quality midwifery services are a critical component in saving lives of women and newborns, enhancing the health of women and children in very specific ways, and therefore improving both the right of women to enjoy the highest state of health which is their birthright, and gender equity in society.

Societies that have reduced preventable maternal mortality and improved women’s access to better health and survival enjoy increased economic productivity and quality of life for all than societies that continue to experience high levels of maternal morbidity and mortality. In a recent analysis that AMREF carried out for 10 high burden countries for maternal mortality, only an average of 45% of professional midwifery posts were filled, and there was a total deficit of 30,000 midwives in just the 10 countries. It is very clear that MIDWIVES SAVE LIVES. They also provide vital care to healthy women by providing family planning, prevention and treatment of infections, nutrition counseling for pregnant women, care for newborns and ensuring that they are immunised, and help in reducing mother to child transmission of HIV, among other critical services. It is imperative that nations understand the vital connection between midwives availability and maternal and newborn survival, and focus on actions that reduce preventable maternal and newborn death, including improving their health systems. An essential element of the latter is increasing numbers of health personnel, with priority being placed on rapidly increasing numbers of midwives to ensure that women receive high quality care before, during pregnancy, during childbirth and afterwards. On the international Day of the Midwife, the African Medical and Research Foundation (AMREF) is calling on African governments and their development partners including civil society to invest urgently in training midwives, with a view to eliminate the gap of over 50% in numbers of midwives that exists today and denies African mothers life saving services.

AMREF is contributing towards this through its ‘Stand Up for African Mothers’ campaign which aims to train 15,000 midwives by 2015 and help reduce maternal mortality by 25% in sub-Saharan Africa.  AMREF is also nominating an African midwife for the 2015 Nobel Peace Prize.  This is a symbolic nomination where AMREF wants to honour all African midwives for the important role they play in saving the lives of mothers and their children. You can join AMREF’s campaign by signing up at AMREF wishes all midwives across the world a very happy International Day of the Midwife, and wishes to let them know that AMREF recognises them as heroes in our communities.

For further information, please contact:
Dr John Nduba
Technical Director, Reproductive and Child Health Programme