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Health workforce- Midwifery

©UNFPA/Rada Akbar.
Samira, a midwife, gives health advice to a patient in Foladi clinic in October 2016 in Bamyan, Afghanistan.

Supporting midwifery and midwifery models of care

Midwifery and midwifery models of care are essential to improve maternal and newborn health and prevent stillbirths.  The 2024 World Health Organization Transitioning to midwifery models of care: global position paper collates  inputs of over 100 individuals and organisations and defines midwifery models of care. 

Implementation guidance is forthcoming. 

©UNFPA/Lisa Thanner.
A midwife is presenting a newborn to the mother at Panzi Hospital in the Democratic Republic of the Congo, in January 2022.

What are midwifery models of care?

Midwifery models of care are models of care in which the main care providers for women and newborns, starting from pre-pregnancy and continuing all the way through the postnatal period, are educated, licensed, regulated midwives who autonomously provide and coordinate respectful, high-quality care across their full scope of practice, using an approach that is aligned with the midwifery philosophy of care, which: promotes a person-centered approach to care, values the woman-midwife relationship, optimises physiological, psychological, social and cultural processes, and uses interventions only when indicated. 

©UNFPA.
Pregnant women doing balance ball exercises with a midwife in a health facility in China.

In midwifery models of care, midwives provide integrated care, addressing the needs of each individual woman and newborn, within functional and enabling health systems, equipped with necessary resources and streamlined consultation and referral processes. They collaborate within networks of care as part of interdisciplinary teams characterized by equality, trust and respect. This approach guarantees that every woman and newborn receives personalized care, tailored to their health needs.

Midwifery models of care are adaptable to all levels of care and contexts, including home-, community- and hospital-based settings; the public and private sectors and public–private partnerships; resource-constrained environments; and humanitarian and crisis settings. This ensures wide accessibility, equity and relevance across different cultural contexts for women, newborns, partners, families and communities.

Why midwifery models of care matter?

60% of all maternal deaths, stillbirths and neonatal deaths

could be averted by 2035 with universal coverage of interventions provided by midwives.

90% of the global need

for essential sexual, reproductive, maternal, newborn and adolescent health interventions could be met by midwives, with the support of interdisciplinary teams.

Midwifery models of care

Save lives and improve health and well-being of women, newborns, partners, families and communities

Humanize care and are responsive to the needs of women

Contribute to a better society and advance human capital in an uncertain world

Are a cost-effective intervention with potential long-term economic benefits

Guiding principles of midwifery models of care

Midwifery models of care are informed by the following guiding principles:

Who is a midwife?

In midwifery care models, midwives are the primary caregivers for women and newborns before, during, and after childbirth, working as part of interdisciplinary teams. They specialize in supporting healthy and physiological processes during this crucial time, with their care potentially extending before pregnancy and beyond the postnatal period. Midwives are responsible for their own decisions and actions within their scope of practice. If more complex care or specialized treatments are needed, they collaborate with specialist doctors like obstetricians, pediatricians, and anesthesiologists to ensure women and newborns receive the best possible care. When midwives are well-educated, licensed, and work in teams with other healthcare providers, they can deliver respectful, high-quality, and personalized care tailored to the specific needs of each woman and newborn.

©UNFPA.
A woman receives midwifery care during pregnancy in the Lao People’s Democratic Republic in September 2017.

Currently, there are 2.5 million midwives in 177 countries. But many more are needed: there is a shortage of 900,000 midwives worldwide.

Sources:

  • World Health Organization. Transitioning to midwifery models of care: global position paper. Geneva: World Health Organization; 2024. Licence: CC BY-NC-SA 3.0 IGO.
  • Nove et al. 2021 –Nove A, Friberg IK, de Bernis L, McConville F, Moran AC, Najjemba M et al. Potential impact of midwives in preventing and reducing maternal and neonatal mortality and stillbirths: a Lives Saved Tool modelling study. Lancet Glob Health. 2021;9(1):e24–32 (https://doi.org/10.1016/s2214-109x(20)30397-1).
  • United Nations Population Fund, World Health Organization, International Confederation of Midwives. The state of the world’s midwifery 2021: building a health workforce to meet the needs of women, newborns and adolescents everywhere. New York: United Nations Population Fund; 2021 (https://www.unfpa.org/publications/sowmy-2021).

©WHO/Faizza Tanggol>
Maternal and Child Health Nurse Temalesi Lalabalavu helps soothe a baby after administering a vaccine, as part of the National Immunization Programme in Fiji., in October 2023.

News and events

Resources

Maternal and Newborn Health Fund Annual Impact Report 2024

Since 2010, countries supported by the Maternal and Newborn Health Fund have reduced maternal mortality by 40%, nearly twice the global rate, contributing to avert an estimated 75,000 maternal deaths. The Maternal and Newborn Health Fund is UNFPA’s flagship initiative to expand equitable access to quality reproductive, maternal, and newborn healthcare.

The Fund’s Annual Impact Report 2024, released this month, details significant progress in reducing maternal and newborn mortality in 32 priority countries. In particular, the report highlights the impact of training and deploying midwives, enhancing emergency obstetric and newborn care, supporting national maternal and perinatal death surveillance and response systems and providing surgical fistula repair.

Download the report

Programme manager’s handbook for maternal, child and adolescent health

The World Health Organization maternal, newborn, child and adolescent health e-handbook is a new resource for Ministry of health programme managers. It offers  step-by-step guidance for implementing effective health programmes, from planning to monitoring and evaluation, with concise overviews of key activities and interventions along the life course.  The e-handbook references WHO documents, to ensure that programme managers have access to evidence-based strategies and best practices tailored to various contexts.

This e-handbook contains a prioritised list of documents; for a full list of documents go to the resource library for maternal, newborn, child, adolescent health and ageing: https://uhcc.who.int/mca/

Born Too Soon Supplement

A new journal supplement, “Born Too Soon: progress, priorities and pivots for preterm birth,” led by PMNCH, was published in BMC Reproductive Health last month. The supplement adapts and expands the content from the 2023 WHO report “Born Too Soon: A Decade of Action on Preterm Birth.”

Globally, a baby is born preterm every two seconds, and a preterm newborn dies every 40 seconds, making preterm birth the leading cause of under-five deaths.

Authors highlight the progress made in the last decade, outline the need for improved data to enhance programs, and emphasize the necessity for comprehensive, high-quality, and respectful sexual, reproductive, and maternal health services.  They call for investments in small and sick newborn care to ensure equitable access, particularly in conflict areas and among marginalized populations.  For the first time, this supplement also focuses on human rights law and global health processes and their role in upholding the rights of women, babies, parents, families, and healthcare providers.

Read more

Download the supplement

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