United Nations Population Fund
This programme, jointly executed by United Nations Population Fund (UNFPA) and the International Confederation of Midwives (ICM) and jointly funded by Sweden, The Netherlands and UNFPA, aims at building national capacity in low-resource countries to increase skilled attendance at all births by scaling up the capacity of midwives. It will contribute to the achievement of two of the Millennium Development Goals (MDGs): improving maternal health (MDG 5) and reducing neonatal mortality (MDG 4). It is also in line with the ICPD and the international community of donors' call for investing in sexual and reproductive health and rights. The programme has two areas of work: at the Country level and the Global/Regional level.
The Goal of the Programme
The overall goal of the proposed programme is to increase and improve skilled attendance at birth in low-income countries through the creation of a "critical mass" of advisors who will work both nationally and regionally to promote and enhance the role and impact of midwives and others with midwifery skills.
- strengthening regulatory mechanisms,
- developing and strengthening education and accrediation mechanisms, and
- promoting the development and role of midwives associations.
Given the specific gender issues around midwifery, women's empowerment and gender equity will strongly influence the choice of advocacy methods, working practices and interventions for the work in each country.
Read the September 2011 update on the ICM-UNFPA programme:
Read the September 2010 update on the ICM-UNFPA programme:
In English en français en español.
World Bank Strategy for Health, Nutrition and Population Results
MDG 5: "Improve Maternal Health"
- In sub-Saharan Africa, a 15 year old female faces a 1 in 20 risk of dying in pregnancy or childbirth during her lifetime, compared to a 1 in 7300 risk for a 15 year old female living in developed regions (and 1 in 30 000 in the richest parts).
- An estimated half a million women die each year from complications of pregnancy and childbirth, which mostly occur between the third trimester of pregnancy and the first week after birth. Almost all of these complications can be managed successfully in an appropriate setting with a skilled attendant. Most are not predictable.
- The World Bank estimates that maternal deaths would decrease by 73% if coverage of key interventions, including the prevention of unwanted births, rose to 99%.
The internationally agreed optimal strategy to reach the MDG5 is to ensure that all pregnancies are wanted, all births are attended by professional and skilled attendants operating in teams in health centres, and all complications have access to emergency obstetric care.
Why Focus on Midwives?
- The 2005 World Health Report: Making Every Mother and Child Count identified midwives as the essential human resource in health systems to reach the MDGs 4 and 5.
- The 2006 World Health Report:Working Together for Health initiated a decade of efforts to improve the health workforce, including the midwifery workforce.
- Midwifery is a the only healthcare profession with a fundamental focus on the care of the new mother and her infant together.
- Midwives provide antenatal, intrapartum and postpartum care as a "point of entry" into all levels of the health system.
- Their competencies also include delivery of essential sexual and reproductive health (SRH) services, allowing women to make informed choices regarding family planning, testing and treatment of sexually transmitted infections and choosing safe delivery practices.
- The midwifery competencies emphasise the importance of cultural sensitivity and require that midwives have knowledge of the cultural norms about childbearing practices of the women and communities they serve.