HP+ supports the role of midwives and women’s right to high-quality, respectful maternity care. By engaging stakeholders in a global advocacy campaign, HP+ is highlighting the barriers midwives face in providing care and advocating for midwives to be valued and respected. The campaign strives to make sure that midwives and those working on behalf of midwives speak with one voice to advocate for midwifery and that policy-makers seek the critical expertise that midwives can provide when developing maternal and newborn health policy.
HP+, through our partner the White Ribbon Alliance, is working closely with the World Health Organization and International Confederation of Midwives to promote high-quality maternity care through increased access to midwifery services. Grounded in global frameworks—such as Ending Preventable Maternal Mortality; Every Woman, Every Child; Every Newborn Action Plan; and Ending Preventable Child and Maternal Deaths—and the The Lancet midwifery series research priorities, we are working to:
Convene a global coordinating group for midwifery
Survey the number of midwives in high-level positions
Promote midwives in leadership positions
Train midwives as citizen journalists
What I Want is Simple
White Ribbon Alliance, HP+, and USAID asked mothers around the world what they needed for a healthy and happy life. Together, we can create a world where the right of all women to be safe and healthy before, during and after childbirth is upheld.
Linvell: Midwife and Advocate
White Ribbon Alliance Malawi's 2016 showcase of midwives, midwifery and Linvell Chirwa, a midwife advocate in Malawi.
Advocacy Secures Financing and Commemoration Day for Traditional Midwives in Guatemala
March 2022 —
Following years of advocacy by the National Alliance of Indigenous Women’s Organizations for Reproductive Health, Nutrition, and Education (ALIANMISAR) through letters and petitions to congressional committees, the Guatemalan Congress approved Law Initiative 6026 in March 2022. The law declares May 19 “National Day for the Dignity of Comadronas” (midwives) and allocates an annual payment of GTQ 3,000 (approximately USD 380) to each of the 23,000 nationally registered traditional midwives in the country. Approval of the law is a major step in symbolically and financially recognizing the important and demanding work of midwives, who provide maternal and neonatal health services in Guatemala. This law will be enacted as a part of the 2022 budget and is a result of the capacity strengthening HEP+ provides its civil society partners in the areas of political dialogue and advocacy.
Traditional Midwives in Guatemala Open New Clinic with HEP+ Support
August 2021 —
Traditional Guatemalan midwives—comadronas—recently received property from San Juan Ostuncalco for the creation of their own clinic. HEP+ supported the Observatory on Reproductive Health (OSAR)—Guatemala’s reproductive health watchdog—in the development of a proposal to the San Juan Ostuncalco Municipal Council for clinic space to provide medical services and store equipment. After the June handover of the property, clinic construction can begin. The clinic will be attended by 93 comadronas and remain open 24 hours a day. It is expected to serve 40 percent of the young children and pregnant women in San Juan Ostuncalco.
Malawi Ministry of Health Adopts Minimum Standards for the Care of Women and Children
January 2021 —
The Malawian Ministry of Health in January officially endorsed and adopted the updated Respectful Maternity Care (RMC) Charter: The Universal Rights of Women and Newborns, which sets an international standard for the rights and services women and newborns should receive when seeking care. The charter was updated in 2019 by USAID, HP+ partner White Ribbon Alliance, and other partners to ground the charter in widely accepted international and regional human rights instruments. To advocate for adoption of the charter, WRA Malawi coordinated with key nursing and midwifery institutions including, the Directorate of Nursing and Midwifery Services and the Kamuzu College of Nursing to present, provide feedback on, and approve the updated charter. The effort was buoyed by the What Women Want campaign, whose survey had found the top priority among women and girls was respectful and dignified care. WRA Malawi also introduced and advocated for adoption of the charter with key decisionmakers, such as the Safe Motherhood Technical Working Group and the Reproductive Health Directorate and hosted the official launch event where the MOH officially endorsed and adopted the charter. The MOH and nursing and midwifery training institutions will translate the document into Chichewa and update their curricula to be in alignment with it. WRA will support the Reproductive Health Directorate in distributing the charter to all health facilities in Malawi and will begin introducing the charter to women and health workers.
Exceeding Expectations with a Record Number of Midwives
March 2019 —
On January 25, at a meeting of parliamentarians convened by HP+ partner the White Ribbon Alliance for Safe Motherhood (WRA) Malawi, a representative from the Department of Human Resources Management and Development reported that 925 midwives were recruited and 303 midwives were promoted during fiscal year 2018/2019. This success—which goes even further than the government’s initial commitment to hiring 800 midwives—is in large part due to WRA Malawi’s Bedside Midwives report that highlighted a shortage of 20,000 midwives and has been a key advocacy tool since the campaign began in 2017. At the meeting, WRA Malawi praised the government’s progress to date and asked for continued support through approval of an increased budget to recruit, train, and retain more midwives, and the creation of a district-level nursing and midwifery pathway.
Advancing Respectful Maternity Care
August 2017 —
Based on advocacy by HP+ partner White Ribbon Alliance Malawi, the Government of Malawi committed to train Health Advisory Committee members throughout the country on Respectful Maternity Care. The training aims to sensitize communities about the right to respectful maternity care and open an avenue for women to report issues of disrespect and abuse. The government has also committed to hiring 800 midwives, an important step in addressing the country’s critical shortage of midwives. Similarly, White Ribbon Alliance Zimbabwe conducted three Respectful Maternity Care trainings for all provincial and district nursing officers in Zimbabwe, including midwifery tutors and senior managers from the private sector. Among other materials, each participant was given a locally produced video showing women's experiences of maternity care that the nursing officers can use as an advocacy and education tool at their institutions. This advocacy led to Respectful Maternity Care being incorporated into the monitoring and evaluation criteria used to monitor maternity care in all of Zimbabwe’s health facilities.
Wilson Center Event Features Findings of Midwives Survey Supported by USAID
March 2017 —
The USAID-funded Health Policy Project (HP+) supported the “Midwives’ Voices, Midwives’ Realities” policy dialogue at the Wilson Center, in Washington, DC, on February 27th. The event featured Midwives Voices, Midwives Realities, a global survey conducted by the World Health Organization, International Confederation of Midwives, and White Ribbon Alliance. HP+’s work supporting comprehensive midwifery policy reforms was featured at the event, by Nancy Kamwendo, National Coordinator for HP+/White Ribbon Alliance, Malawi, who provided a country perspective on the broader global survey findings. HP+/White Ribbon Alliance Malawi recently conducted a “headcount” survey of Malawian midwives that found that only one-third the number of midwives previously thought to be in service are actively providing direct midwifery services. This headcount, highlighting the shortage of midwives needed to provide adequate pre and postnatal care, will inform policy-making decisions on midwifery. WRA Malawi and HP+ have shared the findings with the Ministry of Health, Parliament, citizens, and journalists. This advocacy campaign is paying off. Ministry officials have recently agreed to use the country-level survey data generated by the HP+/White Ribbon Alliance Malawi team to inform their health sector strategic planning process.
Midwives Survey by White Ribbon Alliance Malawi guides Malawi MOH officials
September 2016 —
A recent survey conducted in Malawi by the USAID Health Policy Plus project’s partner, the White Ribbon Alliance, found a total of 3,420 bedside midwives serving an estimated population of 17.3 million people; it estimates the need for an additional 20,217 midwives. It is anticipated that increasing the number of midwives in Malawi will positively impact the country’s frequency of safe births. Safe motherhood coordinators from all districts used the survey findings to develop a factsheet on the current status of midwifery positions, which was presented as a guide for the director of nursing and midwifery services at the Ministry of Health.
