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State of the World's Midwifery 2021

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State of the World's Midwifery 2021 Building a health workforce to meet the needs of women, newborns and adolescents everywhere THE STATE OF THE THE STATE World’s OF THE Midwifery World’s 2021 Midwifery Dedicated to all health workers who have lost 2021their lives to Covid-19 Scan this code for a link to the full SOWMY 2021 report at www.unfpa.org/sowmy. United Nations Population Fund 605 Third Avenue New York, NY 10158 ISBN 9789211295092 Tel. +1 212 297 5000 eISBN 9789214030935 @UNFPA Sales No. E.21.III.H.3 CHAPTER 1: INTRODUCTION i *** ADJUST POSITION LEFT/RIGHT OF THE ART ON THIS PAGE AS NEEDED TO GET GOOD CROSSOVER WITH TEXT, DEPENDING ON TYPE OF BINDING *** CONTRIBUTORS AND ACKNOWLEDGEMENTS WRITING TEAM: Sarah Bar-Zeev, Luc de Bernis, Martin Boyce, Manju Emily McWhirter, Garth Manning, Viviana Martinez-Bianchi, Olga Chhugani, Caroline Homer, Kirsty Hughes, Joanne McManus, Zoë Maslovskaya, Andrea Mateos Orbegoso, Federica Maurizio, Hedieh Matthews, Million Mekuria, Andrea Nove, Petra ten Hoope-Bender. Mehrtash, Ann-Beth Moller, Sopha Muong, Maria Najjemba, Manjulaa Narasimhan, Pros Nguon, Marianne Nieuwenhuijze, Danielle Okoro, Muna Abdullah, Mohamed Afi fi , Zalha Assoumana, CORE GROUP:MIDWIFERY2030 Olufemi Oladapo, Paulina Ospina, Charlemagne Ouedraogo, Sally Pairman, Sarah Bar-Zeev, Luc de Bernis, Mathieu Boniol, Martin Boyce, Alma Francesa Palestra, Christina Pallitto, Ann Phoya, Laura Pitson, Marina Virginia Camacho-Hübner,A PATHWAY Caroline Homer, Kirsty Hughes, TO Catherine HEALTH Plesons, Bob Radder, Anna Rayne, Charlotte Renard, Cori Ruktanonchai, Breen Kamkong, Tamar Khomasuridze, Anneka Knutsson, Geeta Lal, Jihan Salad, Martin Schmidt, Andrew Schroeder, Meroji Sebany, Teymur Sandra Land, Carey McCarthy, Fran McConville, Joanne McManus, Zoë Seyidov, Mehr Shah, Pragati Sharma, Tekla Shiindi-Mbidi, Callie Simon, Matthews, Million Mekuria, Allisyn Moran, Andrea Nove, Sally Pairman, Luseshelo Simwinga, Amani Siyam, Laura Sochas, Sokun Sok, Karin SUPPORTING A SAFE BEGINNING Charlotte Renard, Shible Sahbani, Petra ten Hoope-Bender, Pulane Stenberg, Tigest Tamrat, Ai Tanimizu, Joyce Thompson, Patricia Titulaer, • safely accessing midwifery services with the partner of your choice Tlebere, Sally Tracy, Joseph Vyankandondera. Sally Tracy, Elena Triantafyllou, Özge Tunçalp, Samson Udho, Victoria when labour starts STEERING GROUP: Core Group + Olajumoke Adebayo, Elena Ateva, Anshu Vivilaki, Andrea Vogt, Amanda Weidner, Florence West, Jessica White, Banerjee, Amy Boldosser-Bausch, James Campbell, Howard Catton, Manju Teodora Wi, Elspeth Williams, Christiane Wiskow, Helen Witte, Julie • fi nding respectful, supportive and preventive care, provided by Chhugani, Sheena Currie, Atf Ghérissi, Kristy Kade, Afsana Karim, Holly Woods, Ann Yates, Catherine Yevseyev, Masahiro Zakoji, Willibald Zeck, competent midwives who have access to the equipment and supplies Pascal Zurn. Kennedy, Bashi Kumar-Hazard, Barbara Levy, Vivian Lopez, Lastina Lwatula, PLANNING AND PREPARING they need and receiving emergency obstetric care if required Lori McDougall, Martha Murdock, Josephine Murekezi, Anwar Nassar, We acknowledge the vital data collection work done by National Health • participating in decisions about how you and your baby are cared for Luseshelo Simwinga, Naveen Thacker, Veronic Verlyk, Jessica White. • delaying marriage Workforce Accounts (NHWA) focal points and International Confederation • having the privacy and space to experience birth without unnecessary of• Midwivescompleting (ICM) secondary member associations, education with support from United PARTNERS’ GROUP: Steering Group + Sultana Afdhal, Darcy Allen, disturbance and interventions Deborah Armbruster, Maria Helena Bastos, John Borrazzo, Louisa Nations• providing Population comprehensive Fund (UNFPA) and sexual World education Health Organization for boys (WHO) and girls • being supported by a collaborative midwifery team in the event that Cabal, Franka Cadée, Doris Chou, Giorgio Cometto, Helga Fogstad, Lynn regional• protecting and country yourself offi ces, against and Direct HIV Relief. you do need emergency obstetric care Freedman, Howard Friedman, Carlos Füchtner, Meena Ghandi, Lars COMMUNICATIONS• maintaining a good AND healthMEDIA: and Rachel nutritional Firth, Molly status Karp, Geeta Lal, Grønseth, Kathleen Hill, Elizabeth Iro, Annette Kennedy, Étienne Langlois, Veronique• planning Lozano, pregnancies Lori McDougall, using Hanno modern Ranck, contraceptive Sonali Reddy, Irum methods Taqi, Chunmei Li, Betsy McCallon, Alison McFadden, Blerta Maliqi, Michaela Petra ten Hoope-Bender, Veronic Verlyk, Eddie Wright, Rebecca Zerzan. Michel-Schuldt, Jean-Pierre Monet, Zoe Mullan, Christophe Paquet, Susan Papp, Annie Portela, Veronica Reis, Mary Renfrew, Eva-Charlotte DESIGN, LAYOUT AND TRANSLATION: Prographics, Inc. Roos, Theresa Shaver, Jeffrey Smith, Kate Somers, Mary Ellen Stanton, FINANCIAL SUPPORT: New Venture Fund, UNFPA. Irum Taqi, Jyoti Tewari, Christiane Wiskow. UNFPA led the development and launch of this report in partnership TECHNICAL CONTRIBUTIONS AND SUPPORT: Mohamed Afi fi , Avni with WHO and ICM, with the support of: Averting Maternal Death Amin, Rondi Anderson, Ian Askew, Chea Ath, Alka Barua, Davide de and Disability, AFD, Bill & Melinda Gates Foundation, Burnet Institute, Beni, Sandra Blanco, Malin Bogren, Meghan Bohren, Mathieu Boniol, ENSURING A HEALTHY START DFID, Direct Relief, Every Woman Every Child, FCI@MSH, International John Borrazzo, Callum Brindley, Jim Buchan, Franka Cadée, Alma Virginia Federation of Gynecology and Obstetrics, FIOCRUZ, Global Financing Camacho-Hübner, Howard Catton, Venkatraman Chandra-Mouli, Laurence • maintaining your health and preparing yourself Facility, GIZ, Human Rights in Childbirth, International Council of Nurses, Codjia, Giorgio Cometto, Myrian Cortes, Allison Cummins, Hugh Darrah, for pregnancy, childbirth and the early months International Labour Organization, International Paediatric Association, Kim Darrah, Deborah Davis, Khassoum Diallo, France Donnay, Winfred Jamia Hamdard, Jhpiego, Johnson & Johnson Foundation, Norad, Dotse-Gborgbortsi,as Alexandre a new family Dumont, Ashok Dyalchand, Alison Eddy, Novametrics, PMNCH, Rwanda Association of Midwives, Save the CREATING A FOUNDATION Patrick Hoang-Vu• Eozenou,receiving Amanda at least Fehn, four Ingrid antenatal Friberg, careBela Ganatra,visits, Children, SIDA, University of Dundee, University of Southampton, Claudia Garcia, Atf Ghérissi, Aparajita Gogoi, Sami Gottlieb, Veloshnee FOR THE FUTURE which include discussing birth preparedness and UNAIDS, USAID, White Ribbon Alliance, Wish Foundation, Women Govender, Peter Griffi ths, Sylvia Hamata, Claudia Hanson, Tawab making an emergency plan Deliver, and Yale University. • starting to breastfeed immediately and being supported Hashemi, Maren Hopfe, Anna von Hörsten, Keith Hurst, Ank de Jonge, Kristy Kade, Bartholomew• demanding Kamlewe, and Bernarreceiving Kilonzo, professional Manasi Kumar, supportive Our appreciation is extended to Novametrics Ltd for their support to continue breastfeeding as long as you wish Christoph Kurowski,and Sandra preventive Land, Étienne midwifery Langlois, care An’war to help Deen you Bolarin and yourand technical leadership in the preparation of this report and • being provided with information about and support in Lawani, Barbara Levy,baby Jenny stay Liu, healthy, Ulrika Rehnström and to deal Loi, withSandra complications Lopez, accompanying materials, and to PMNCH for their leadership on caring for your child in the fi rst months and years of life Veronique Lozano, Carey McCarthy, Fran McConville, Michelle McIsaac, communications and advocacy.. effectively, should they arise • receiving information about family planning so you can effi ciently space your next pregnancy ABBREVIATIONS AND ACRONYMS • being supported by the midwifery team to access child and family health services and vaccination BEmONC basic emergency obstetric and newborn care PPE personal protective equipment DHS Demographic and Health Surveys SDGs Sustainable Development Goals programmes at the appropriate time DSE dedicated SRMNAH equivalent SRMNAH Sexual, reproductive, maternal, newborn and ICM International Confederation of Midwives adolescent health ICN WHATInternational Council ofMAKES Nurses THISSoWMy StatePOSSIBLE? of the World’s Midwifery ISCO International Standard Classification of Occupations UN United Nations MEAP Midwifery Education Accreditation Programme UNICEF United Nations Children’s Fund MLCC midwife-led continuity of care UNFPA United Nations Population Fund MMR maternal1 mortality ratio 2 UHC 3 universal health coverage4 5 6 7 8 9 10 NHWA National Health Workforce Accounts WHO World Health Organization PMD percentageAll women met of demand Governments GovernmentsYML Young Midwife Data Leader collection Midwifery care Midwifery care First-level The midwifery All health-care Professional PMN reproductivepotential met need age, provide and are held and health systems and analysis is prioritized in is delivered in midwifery care workforce professionals associations PMNCH The includingPartnership for Maternal,accountable Newborn for a provide and are are fully embedded in national health collaborative practice is close to the woman is supported through provide and provide leadership & Child Health adolescents, have supportive policy held accountable service delivery and budgets; all women with health-care and her family with quality education, are enabled to their members to universal access environment. for a fully enabled development.
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