State of the World's Midwifery Report

The 2011 International Confederation of Midwives (ICM) conference was held in Durban, South Africa from June 19-23, 2011. The conference was attended by more than 3000 midwives from all over the world and was the first time for the continent of Africa. The five day conference was packed full with workshops plenary sessions, symposiums and many presentations. In addition the conference also attracted the submission of posters from local and international participants. The conference is a triennial celebration and the next location will be Prague, Czech Republic 2014. Prague has been a political, cultural and economic centre of Europe during its 1,100 year existence.

The conference got off to a rousing start at the opening ceremony with lively Zulu dancing welcoming the gusts with several guest speakers such as the First Lady of Malawi. The main focus was on ICM president Bridget Lynch. Our ICM conferences are always memorable events.

The State of the Worlds Midwifery Report was lunch. The release of the long awaited State of the World’s Midwifery Report and the powerful, poignant Stories of Midwives provides new information and data gathered from 58 countries in all regions of the world to:Thousands of midwives nurses physicians and doulas travelled from all over the globe to address the challenges faced by midwives today. I met amazing people who are dedicating their lives and careers to this important cause. I was very touched by the energy and commitment as evident as this conference. I knew I was with passionate people from all over the world. I learned a lot from the midwives from Prague. I was so excited with when they introduced Prague to the world. Also at my hotel was delegation from Trinidad and Tobago India and Indonesia.

• examine the number and distribution of health prfessionals involved in the delivery of midwifey services;
• explore emerging issues related to education, regulation, professional associations, policies and external aid;
• analyse globloal issues regarding health personnel with idwifery skills, most of whom are woen, and the constraints and challenges that they face in their lives and work, and
• call for acceleating investments for scaling up midwifery services, as well as "skiling up" the respective providers.

The report includes statistical tables and applicable global standards, collating relavantmidwifery informations into one reference document. Behind The State of the World's Midwifery 2011 stand 26 international partners involved in materal and reproductive health, with s a specific focus on midwifery, including ICM and PMNCH, and led by the UN Population Fund (UNFPA).

http://www.unfpa.org/sowmy/resources/en/main.htm

I was with a passionate group of people after a full agenda of activities the dinner conversations were filled with the day’s event and mostly sharing of ideas and future contacts. I met a midwife from every African country and it helps broaden my knowledge of their day to day work. Underneath the different accents and perspectives there was seething more. Yes there was a common sentiment that much more needs to be done to improve the ives of mothers and babies. We as midwives are 100% committed to the cause. We are here in Africa to make a difference. And we will I know I will. The time is now…I am ready...we are ready. Africa is ready.

International Confederation of Midwives in Durban 2011

The biggest event in maternal and child care will be coming to Africa. South Africa will host the International Confederation of Midwifery Conference on June 19-23, 2011 in Durban. Midwives from allover the globe will be attending. South Africa is well-known for its big 5 in the world of nature and wildlife preservation, and so it is to be the theme of the conference in Durban. The theme of the ICM 2011 congress is “midwives tackling the “Big 5” globally. The ICM congress has turned to underline the Five Big Challenges facing Midwives Globally which are the leading causes of maternal death and morbidity in the world.

The expert advice is clear and that is that maternal mortality in Africa is facing a crisis. Maternal mortality ratio in Africa is the highest in the world. Sub-Saharan Africa suffers from the highest Maternal morality rates such as about 640 maternald deaths per 100,000 live births. Maternal mortality is a major problem in South Africa. South African rates are unacceptably high and far above comparable international norms and is totally preventable. It lacks political will.

The major organizations will be there such as the World Health Organization (WHO), United Nations Population Fund (UNFPA) United Nations Children’s Fund (UNICEFF) and the Bill and Melinda Gates Foundation, just to mention a few. These major organizations of the UN system are all relevant stakeholders whose emblems I expect to see on the conference website, though there are also the major pharmaceutical company’s competing for a place in Durban. They will all have an opportunity to view the conditions prevailing in Africa, my continent.

The countries of Africa will all come together to celebrate birth. Regrettably the numbers of midwives will be few because the majority of needed midwives will not be able to make this journey. The cost is very high. Most midwives in Africa don’t earn the kind of money required to afford the trip.. If they can’t come to an event like this it means they will never get the valuable information that will be presented at the conference. These midwives are the frontline workers, they do the dirty work while the other’s drinking the wine and enjoying the cheese; the sweet life.

I am fortunate to be able to attend these conferences. As a matter of fact I have been attending international conferences for the last 10 years. Many times I am the only person from Africa. Why; because many can't afford the high cost, hotel, airplanes, not to mention visas.

Many countries will come and present their papers. Some of them I have previously heard and listened to. They refer to us as the Third World. Third world is such a derogatory term, but it is the most used term in North America. In 2001 at the UN more then 189 countries agreed that the term third world will never be used again but unfortunately people in the developed world don’t seem to understand that. The term Third World is actually a Cold war nomenclature because at the time they did not know what to do with those countries that neither aligned with the Western World powers nor the Soviets. From day one the term started out to be some kind of a stereotype. 

I feel angry when they us that term. It feels as if they refer to me as nigger. It is so distasteful that I can't explain but many midwives continue to talk like that when writing in journals or presenting papers. In midwifery we do not need demeaning terms like that. I don' expect an organization like ICM will tolerate language like that. Most of the people that will speak at ICM are all graduates, PhDs, so I am sure they will respect us in this beautiful continent of us. I hope they will use “developing world” or “developing nations.”  The Third World Term is just a very very bad label! African nurses do not deserve that label.

World Health Organization and Agencies

The World Health organization recommends that a skilled attendant be present at every birth. The WHO recommends lots of things but in reality it is not possible. Yes, the WHO renamed  African midiwives to become "traditional birth attendants." I am ne of those attendants the WHO is taking about. WHO strongly advocates for “skilled care at every birth” to reduce the global burden of 536 000 maternal deaths, 3 million stillbirths and 3.7 million newborn deaths(3) each year.

The WHO recommends two midwives per mother in labour. According to the WHO skilled attendance at birth remains drastically low in sub-Saharan Africa; only about 42% of the childbirths are assisted by a skilled attendant in the Africa region, some countries registering as low as 5%. This is against the target of 80% of births being assisted by a skilled attendant by 2015 if the goal of reducing maternal mortality rate by three quarters (between 1990 and 2015), is to be achieved.

In 2000, the United Nations agreed to reduce the mortality rate for children younger than five with the implementation of the Millennium Development Goals (MDGs).  Achieving the health MDGs will be a major challenge but 2015 is around the corner.

The Safe Motherhood Initiative was launched at the Nairobi Safe Motherhood Conference in 1987. This is a global initiative to reduce maternal mortality in developing countries through a collaborative effort of international agencies, national governments, and nongovernmental organizations, but it is 20 years later and little progress has been made to reach that goal.  In some countries, the situation has actually worsened. So where do they go wrong? In 1999 with the WHO's guidance, many countries launched the " Making Pregnancy Safer" initiative, aimed to reducing te burden of maternal mortality.

Several Maternal health messages have focused largely on the size of the problem of maternal mortality and its human rights dimensions. But what is wrong with the mesage. What has been missing has been clarity about the interventions that work to reduce unsafe motherhood. Too many programmes try to do too much while simultaneously failing to focus on the interventions known to be effective. Most of these programmes have included major international conferences, women’s health advocates, uplifting of health care professionals with the help of  donor-funded support. Yet on the whole all these efforts have lacked conviction because there is no political will.

Political leaders are not involve or do not know what is going on, and generally not a priority either nationally or internationally. Everybody writes beautiful papers but nobody really put presure on governments to imporve education of midwves and improve access to health centres. here are very few roads in Africa and most women live in remote areas and walk for days to the nearest healthcare centre. Imagine if better training can be done for the African women by African women designed by African women. What if these traininees can be scattered around the continent to offering good antenatal care and clean safe deliveries with good access to healthcare centres.