DURBAN MEET 'Midwives can be safe motherhood guides'

Nurul Islam Hasib
bdnews24.com senior correspondent from Durban

Durban, June 20 (bdnews24.com) ? Nearly a thousand lives can be saved everyday in developing countries, including Bangladesh, if proper midwifery services can be ensured, a new report says.

The first-ever 'State of the World's Midwifery 2011' report released on Monday in South Africa's Durban said around 1,000 women die from pregnancy and childbirth each day in 58 developing countries.

The death could be avoided if midwifery services can be ensured, it said.

The report said, "Proficient, motivated and supported midwifery workforce is a key to success in tackling this heavy toll of death."

It suggested the governments to recognise midwifery as 'a distinct profession' and promote it as a career with posts at the national level policy.

The report, launched at the International Confederation of Midwives' 29th triennial congress, unveiled that there is a wide gap between the numbers of the practising midwives and those needed to save lives.

"The report points to an urgent need to train more health workers with midwifery skills and ensure equitable access to their life-saving services in communities to improve the health of women and children," said Bunmi Makinwa, UNFPA's regional director for Africa in his speech while unveiling the report.

UNFPA coordinated preparation of the report.

The report said unless an additional 112,000 midwives are trained, deployed and retained in supportive environments, 38 of 58 countries surveyed, might not meet their target to achieve 95 percent coverage of births by skilled attendants by 2015, as required by Millennium Development Goals.

The report, however, represented old statistics of Bangladesh's MDG indicators.

It said maternal mortality ratio is 340 per 100,000 in Bangladesh which means the county is far off the MDG 5.

But results of the nationwide Maternal Mortality Survey 2011 suggest that maternal deaths fell to 194 per 100,000 in 2010 from 322 per in 2001, putting Bangladesh on track to achieve the goal.

MDG 5 requires the country to reduce the maternal mortality ratio by three quarters between 1990 and 2015.

"We used data from similar sources for all countries. We used joint statistics (2008) of World Health Organisation, World Bank, UNFPA and Unicef," UNFPA maternal health adviser Vincent Fauveau told bdnews24.com.

He, however, said they lately came to know Bangladesh's progress.

Dr Khaled Shamsul Islam, who is attending the congress as the Bangladeshi representative, told bdnews24.com that he had talked with the UNFPA coordinator soon after the report release.

"Basically they collected all information in 2010, but our survey findings (Maternal Mortality Survey 2011) came out in February 2011," he said.

He said Bangladesh has started preparing strategies to scale-up midwifery services despite its successes in cutting maternal deaths.

"We've already made some policy decisions that include creating separate midwifery workforce, converting Bangladesh Nursing Council into Bangladesh Nursing and Midwifery Council and Department of Nursing Services into Department of Nursing and Midwifery Services."

He said the government is committed to produce 3,000 midwives by 2015.

Chief of UNFPA's Sexual and Reproductive Health Branch Dr Laura Laski commended Bangladesh's 'big' policy decision on midwifery.

"Its (midwifery) one aspect is to reduce maternal deaths, but another significant aspect is improving women's health," she told bdnews24.com.

"In Bangladesh the number of adolescent girls is increasing and they are entering into reproductive age and becoming sexually active.

"You (Bangladesh) need to provide them with a package of services that include maternal health services, contraceptives and information on adolescence.

"They don't know when to get pregnant and even what to do when pregnant," she said.

She added that midwives posted at community levels could help in this regard.

ICM president Bridget Lynch said it is the first-ever comprehensive report that clearly identified the need of a competent and active midwifery workforce, working as a key part of an effective healthcare system.

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DURBAN MEETWe're here, proclaim midwives

Nurul Islam Hasib
bdnews24.com senior correspondent from Durban

Durban, June 19 (bdnews24.com) ? Traditional dance, beating of drums and school children's parading, with flags of over 85 countries swaying in the breeze, gave a perfect start to the 29th triennial congress of midwives in the busiest port city of South Africa on Sunday evening.

The International Convention Centre (ICC), Durban wore a festive look where hundreds of midwives gathered, representing their countries at the grand opening of the event.

International Confederation of Midwives (ICM) president Bridget Lynch formally opened the five-day congress by thanking all who "extended support to make the event happen".

"It (the congress) proves midwives can do what they want when united," she said, adding, "We (midwives) are moving forward."

"We could develop a global standard of education and regulation for midwives. It's the only profession in the healthcare profession that could do that," she said amid thunderous applause and cheers.

"We must know a midwife is a midwife wherever she goes," she underlined.

Referring to Saturday's five-kilometer walk, Lynch said, "It's clear to the world that midwifes will no longer be invisible?"

Midwives from across the globe walked five kilometres along the Durban waterfront on Saturday, a day prior to the opening of the congress, to send the message across that "the world needs more midwives now than ever to save mothers".

The theme of the congress is midwives tackling the "Big 5" globally that include globalisation, listening to women and their partners, continuum of care, strengthening midwives and midwifery, and taking consideration of culture, tradition and society.

South Africa's deputy health minister Gwendoline Ramokgopa welcomed global midwives in South Africa and thanked them for their contribution in cutting maternal deaths and improving lives of women.

Apart from ensuring a skilled attendant during delivery, midwives also ensure family planning, pregnancy check-ups and post-delivery care, and prevent transmission of diseases from mother to child.

"The historic event brings hope and encouragement to the women, and children," Kiran Bajracharya, president of Midwifery Society of Nepal, told bdnews24.com.

"The congress gives a platform for sharing a best practice model towards improving the midwifery," she said.

Midwives are the hope for many villagers in Nepal, who do not see doctors, according to her.

An Afgan midwife Madina Rashidi and a Nigerian midwife Catherine Oluwatoyin Ojo were honored on the occasion with Save the Children Everyone Midwife award for their outstanding contribution in developing midwifery in their respective countries.

Dr Christina Mudokwenyu-Rawdon with 38 years of experience in midwifery was awarded Marie Goubran Award for her leadership in developing midwifery education and research.

The United Nations Population Fund (UNFPA) that supports midwifery development observes that competent midwives are cost-effective solution to cut maternal deaths.

"But the point is midwives have to be supervised. Supervision is extremely important," a UNFPA coordinator for midwifery programme told bdnews24.com earlier.

The UNFPA-coordinated State of the World Midwifery 2011 report will be released in the congress on Monday.

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DURBAN MEETMidwives go miles to give 'life mantra'

Nurul Islam Hasib
bdnews24.com senior correspondent from Durban

Durban, June 18 (bdnews24.com) ? Hundreds of midwives from across the globe have walked 5 km along the Durban waterfront on Saturday in a clear call that 'the world needs more midwives now than ever to save mothers'.

They chanted, "I'll never depart from the golden rules, until I reach my goal, until he says well done, until she shakes hand?"

They danced and sang in the colorful walk with banners and flags, in an exciting show to share their commitment to help mothers deliver safely.

A Nigerian midwife Lare who joined the walk wearing a special T-shirt that read "Midwives Save Life", told bdnews24.com that "I am very proud of being a midwife".

"It's a very much humanitarian service. We can share the joy of a family."

She came to share experiences of other countries and "to be energised and feel better".

President of International Confederation of Midwives (ICM) Bridget Lynch kicked off the walk, a day before the opening of their 29th Triennial Congress, saying, "We must be visible. We must join hands and work together."

"Midwives will be of same standards across the globe," she committed and called all to join in the effort.

She told bdnews24.com that midwifes should be 'visible' to improve maternal health and to decrease mortality.

She extolled Bangladesh's 'quick' progress in developing midwives. "What it (Bangladesh) needs is to continue its efforts to develop strong and high quality midwifery services."

"They will need global help. We (ICM) are helping the country."

Bangladesh government has handed over certificates to 59 nurses-turned-midwives after six months of extensive training on May 5 ? the International Midwifery Day.

To cut maternal deaths further from 194 per 100,000, Bangladesh has targeted to train 3,000 midwives by 2015, staffing them at sub-district health centres to provide round-the-clock services.

A separate comprehensive curriculum has been developed for the three-year diploma course starting from 2012 maintaining the international standards.

ICM's Asia Regional Midwifery Advisor Pashtoon Azfar told bdnews24.com that Asia was moving forward with midwifery issue, and added that Afghanistan could be a role model.

"Their (Afghanistan) midwifery education is very impressive and it's a very strong association," she said.

Azfar is optimistic about Bangladesh's development as well. "I am very hopeful. They started their association in August 2010, but progressed a lot in such a short time."

"I am very confident?to see their dedication," she said referring to her recent Bangladesh visit.

The walk was just an advocacy, the Afgan midwife said, "No mother should die because of pregnancy and giving birth. Mothers deserved to be saved."

Bangladesh Midwifery Association's president Halima Akhter said she was here to honour women. "I am representing Bangladesh midwives. We are no more lagging behind. We have already developed strategies to create more midwives."

The United Nations Population Fund (UNFPA) that supports developing midwives in different countries observes, "Investing in midwives is a good investment for a country particularly for developing ones."

"They (midwives) are the best way forward to attain at least three millennium development goals ? cutting child and maternal mortality (4 and 5) and battling against HIV, malaria (6)," said Geeta Lal, coordinator, UNFPA Midwives Programme.

"But countries must follow the three key pillars of midwives ?education, regulation and association," she told bdnews24.com.

The state of the world midwifery 2011 report will be published on Monday in the five-day congress.

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