Midwives sit at the centre of hope. The skilled, knowledgeable and compassionate care that a midwife provides a woman through the life course is essential, particularly at times of uncertainty and anticipation.
The International Day of the Midwife, marked on the 5th of May, is an annual reminder and celebration of the sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) services provided by midwives. SRMNCAH is, of course, an essential component of the Sustainable Development Goals.
The theme for this year's International Day is 'Midwives: A Vital Climate Solution.' We are reminded that 'midwives deliver environmentally sustainable health services and play a key role in making health systems more climate resilient.' The theme points out that 'during climate crises, midwives can adapt to ensure safe, respectful, and quality care for women and gender diverse people.'
The challenge of diseases and illnesses caused by global warming and climate are felt by the people of our South-East Asian Region. Climate-related events are increasing each year, and the disruptions wrought by the changes in the climate directly impact sexual and reproductive health and rights.
Evidence shows there are increased preterm births and pregnancy complications when women are in warmer, hotter areas. High levels of stress and anxiety during pregnancy can increase births before 37 weeks of pregnancy, or babies with a low birthweight. Deploying midwives to respond to humanitarian crises and to climate-vulnerable areas as emergency preparedness allows for much-needed continuity of SRMNCAH services.
Our Regional Strategic Directions on Strengthening Midwifery 2020-2024 positions midwifery as central to strong and resilient health systems that provide respectful and comprehensive SR MNCAH care in the context of primary health care. The strategic goal is to create a world in which all women of reproductive age, as well as adolescents, newborns and children have universal access to quality care provided by midwives when needed. This is to be achieved by increasing the availability, accessibility, acceptability and quality of the midwifery workforce.
Countries in our Region have established policies to implement midwifery models of care to improve maternal and newborn health, and progress toward UHC. In fact, in the 2022-23 SRMNCAH policy survey, all our Member States reported having a national policy or guideline for the education of midwifery care providers that includes competencies in pre-pregnancy and antenatal care, care during labor and birth, as well as ongoing care of women and newborns.
The International Day of the Midwife is an appropriate occasion to reflect on areas that we can strengthen.
First, we must seek and listen to what women, families and communities want. We have to ensure formal and legal mechanisms are in place for them to have a voice in decision making, make complaints and suggestions, and have access to legal support
Second, we have to educate and deploy midwives. Allow midwives professional development opportunities to strengthen their personal and professional leadership, and prepare educational institutions, practice settings, and clinical mentors. We should support respective professional associations to build on midwives 'voices.
Third, the health system must be built around what women, families and the communities need and want - not what is simply convenient for health service delivery. Midwives must be integrated into the health system and be supported with adequate referral pathways.
Fourth, midwives need enabling policies and environments to work to demonstrate their leadership and to advocate for the rights of women. Strengthening governance, to enable more midwives in decision-making roles to review current policies, can influence policies favourable to women. These policies include improving physical infrastructure in primary and secondary settings, enabling access to clean water, sanitation, and menstrual hygiene for women and midwives.
Sexual, reproductive and maternal health services can - and must - be built around what women want. This can be done by listening to women, and educating and deploying competent midwives to where they are most needed.
Midwives are a vital health workforce for ensuring quality SR MNCAH services, and for building climate resilient health systems. Today, on International Day of the Midwife, let us appreciate the work they contribute to ensuring health for all and support them by implementing the recommendations above.