UNFPA calls for more investment in midwife training

Rwanda meets only 59 per cent of its population’s need for medical care surrounding pregnancy and birth, but this percentage is steadily increasing, according to a report released recently by the United Nations Population Fund. The report, called ‘State of the World’s Midwifery 2014’, looked at the proportion of midwives to the population in 73 low and middle-income countries. The report urged more investment in midwife education and training. It found that when midwives are educated to international standards, they can potentially reduce maternal and new-born deaths by two-thirds. “Midwives make enormous contributions to the health of mothers and newborns and the well-being of the community,” explained Dr Babatunde Osotimehin, the executive director of UNFPA. “Greater investment in midwifery is key to making this right a reality for women everywhere,” Osotimehin said. The report’s analysis of Rwanda found that the country does better than many other countries in certain aspects. For instance, Rwanda’s basic health care plan covers 87 per cent of essential pregnancy and birth care. Still, as many as a quarter of births taking place in rural areas had no skilled birth attendant present. This may be due to the low number of midwives in Rwanda, explained Sister Mary Murebwayire, Head of Nursing at the Ministry of Health. “The number of midwives is small, estimated to be about 1000, and there is need to have at least 3,000 extra,” explained Murebwayire, noting that Rwanda started train midwives in 1997. Currently, the ratio stands at one midwife per 44,584 pregnant women in Rwanda, according to the Ministry of Health. The problem will only compound with the projected 55 per cent increase in Rwanda’s population by 2030, according to the midwife report. To meet this increase, midwives must respond to 0.7 million new pregnancies per year by 2030, most of which will be in rural settings. “However, in the future, there are plans to have at least two midwives at each community level health centre,” said Murebwayire. The Ministry of Health target is to have one midwife per every 25,000 people by 2017. Rwanda has already done much to meet this goal. According to Murebwayire, Rwanda already has six schools of nursing and midwifery, as well as a variety of international and regional organisations that promote midwife training. Some of these organisations include the Rwanda Association of Midwives, put in place to help educate about the practice, and the National Council of Nurses and Midwives, which regulates the profession. “There is also a programme to train midwife teachers and tutors,” explained Murebwayire. “With this, we can get a pool of competent midwives who would be trained to teach registered midwives.” The midwife report projects that with measures such as these, Rwanda has the potential to meet 100 per cent of its pregnancy and birth care needs by 2030. According to the report, with current trends, the number of midwives in Rwanda will more than double by 2030, rising from around 1,000 to approximately 3,500. The report predicted that if the number of midwives in Rwanda doubled by 2020, and the country had a two per cent increase in efficiency every year, by 2030 Rwanda will meet 100 per cent of its midwife needs.