Why the role of midwives in health systems is more imperative now
On International Midwives Day today, it is important to highlight that midwives and midwifery care services are vital to ensure the quality and continuity of essential sexual, reproductive, maternal and newborn services.
We are witnessing the impact of the Covid-19 pandemic on our health systems. As India reels under the second Covid wave, healthcare professionals are at the forefront, battling the pandemic in the mitigation of the spread and ensuring the continuity of essential healthcare services. The pandemic has brought to the fore the need for more human resources for health in the public health system.
Mathematical model estimates shared in a recent Global Financing Facility (GFF) brief indicate that large service disruptions in India have the potential to leave more than four million women without access to facility-based deliveries and also reduce women’s access to prenatal and antenatal services. The brief states that as a result of disruptions in essential services, over the next year, child mortality in India could increase by 40 per cent and maternal mortality by 52 per cent.
On International Midwives Day today, it is important to highlight that midwives and midwifery care services are vital to ensure the quality and continuity of essential sexual, reproductive, maternal and newborn services. The structure of midwifery care emphasises the agency of a woman. It is located within the universal health care model ensuring continuity of care that is woman-centric, quality-focused, respectful, compassionate and personable in addition to ensuring the equitable provision of psychosocial support and services. An adequate supply of midwives within a health system is to not lose momentum on the significant improvements made in the reductions in maternal and new-born mortality and ensure continued access to quality, affordable sexual and reproductive health services in these challenging times, there needs to be an urgent shift to protect disrupted essential health services with the women-and-girls-first approach.
The introduction of the cadre of nurse PR actioners in midwifery by the Government of India is a very welcome and necessary step that will help in expanding coverage of essential health services and delivering improved maternal and newborn health outcomes. Midwives and midwifery care are crucial to the achievement of national targets in reproductive, maternal, child health in SDGs, primary health care and universal health coverage. A midwifery model of care that pays attention to the gendered impact of Covid-19 and combats health inequities is integral to a gender-responsive health system response, recovery and reset. Midwifery also provides the impetus for health reform priorities such as achieving access, quality and equity within the health system with a people-centric approach, thus building trust and accountability with the engagement of women, families and communities.
Investing in midwives contributes to achieving a convergence: reducing infections, ending preventable maternal mortality and ending preventable newborn deaths.
Collectively, we must seize the moment on this International Day of the Midwife (IDM) to work together to invest in and prioritise continued access to essential and quality health interventions for sexual, reproductive, maternal, newborn health and strengthen equitable and resilient health systems.