Delivering Health, Saving Lives: Delivering a better future depends on midwives Feature

Today in the village of Nyakwibereka in Nyanza District (Southern Province of Rwanda); there was a small kind of miracle. A healthy baby girl was delivered safely into the arms of her mother and a new life began. For Fanny Umuhoza, the moment that she held her first child in her arms was especially poignant. In her joy, she remembered her sister who had died during childbirth just a year ago. Umuhoza’s sister had lived in the same village, but she went into labour before Divine Mukamazimpaka, a qualified experienced midwife had been posted to the local area. Umuhoza’s sister only had her mother-in-law to help when she went into labour. When her baby was delivered, she had started to bleed heavily. There was no-one there who knew how to stop the bleeding, or who could administer the medicines that might have saved her life. Umuhoza knows that perhaps all that stood between her new life and a death was Mukamazimpaka. Mukamazimpaka is just one of the trained midwives working to make sure that the potential of each new life in Rwanda is realised. For the women, babies and communities she serves, Mukamazimpaka is a life saver. Thanks to global efforts to make sure more women get access to midwifery expertise, figures released last year show a decline in the number of deaths related to childbirth; our work and investment to make sure that healthcare workers are trained and supported are clearly working. However, further commitment and investment in health systems is urgently required, if we are to meet Millennium Development Goals relating to infant and maternal mortality by the 2015 deadline. The figures speak for themselves; here in Rwanda, according to a 2007/8 World Health Organisation SBA report, 51 percent give birth with a skilled birth attendant. This compares to 99 percent in the United Kingdom (UK). The lifetime chance of a woman dying here as a result of complications in pregnancy or childbirth is 1 in 35, compared to 1 in 4,700 in the UK. If you ask Mukamazimpaka what still needs to be done to help save women and babies in her community, she’d give you a very short list. She’d say women need access to midwives with the right education, the right working environment and the professional recognition to make sure every birth is safe. When things do go wrong, midwives need to be able to refer mothers to a wider healthcare team who have the skills to respond to obstetric emergencies. She’d tell you that mothers, babies and families thrive when every birth is wanted, which means access to family planning. Most of all, she’d say, we need to address the specific needs of poorer women who continue to pay the highest price for pregnancy. We can be proud of our global advances in reproductive healthcare. As we head towards 2015, however, Millennium Development Goals 5 &4 still remain the least advanced of all the MDGs. And yet, tackling maternal mortality is fundamental to reaching all of our global development goals. Children in Rwanda and other low resource countries who don’t have a mother are less likely to go to school, less likely to be immunised against disease and less likely to grow than those whose mothers survive. Mukamazimpaka probably wouldn’t calculate the financial cost of the lives of the mothers and children in her village who have died during childbirth, but we know that maternal and newborn death translates into US$ 15.5 billion in lost potential productivity worldwide. Midwives don’t just save lives. By playing a significant part in reducing poverty, improving education and preventing disease, they help make life worth living. Later this month midwives and policy makers from around the world, including the Rwanda Association of Nurses and Midwives will come together at the International Confederation of Midwives Congress in Durban, South Africa to participate in the launch of a landmark report on the state of the world’s midwifery. This pivotal document, Delivering Health, Saving Lives, will draw the world’s attention to the need for greater and more equitable access to essential midwifery services and will provide added impetus for a global gear change to ensure more women get the support of a skilled midwife. Delivering Health, Saving Lives provides us with a reminder of what still needs to be done and a benchmark for our progress. We know what works, what know what needs to be done. Now that the goal is in sight, we need to keep up our international and national efforts to make sure that by 2015 there are many more midwives like Mukamazimpaka and many more mothers like Umuhoza. The authors are members of the White Ribbon Alliance for Safe motherhood in Rwanda. Ends