Cradles of Hope

Midwives safeguarding safe births in East and Southern Africa

Midwives are the cornerstone of essential sexual, reproductive, maternal, newborn, and adolescent health care, capable of delivering around 90 per cent of critical services.

Despite the demand and the needs of women, girls and communities across the world, there is a shortage of midwives—a shortfall of approximately 900,000. The United Nations Population Fund (UNFPA) has raised the call to fill 1.3 million new health worker positions by 2030, particularly in Africa, to address this gap.

Despite the shortage, midwives are spread out across East and Southern Africa, and often serve in humanitarian crises and climate disasters. They are the frontline warriors, tirelessly providing services to entire communities under challenging conditions.

In Mozambique's conflict-ridden Cabo Delgado, Joaquina, a traditional “parteira,” has been a lifeline. Over five years, she has helped deliver more than 300 babies. Despite the violence that has displaced nearly a million people, she is part of a mobile brigade delivering crucial health services to the most affected areas.

Photo: Mbuto Machili / UNFPA Mozambique

Gender inequality is one of the drivers of the enormous midwife shortage. Under-investment in midwifery highlights how the needs of women, and the skills of a mostly female workforce, are often neglected. But, when midwives are well-trained, adequate in number, and appropriately supported to provide a better quality of care, they can avert about two-thirds of preventable maternal and newborn deaths.

With enough midwives and better conditions for them, we could save 4.3 million lives a year by 2035.

Jasmine Machibya, a midwife in Tanzania shares her experience: “I am committed to serve the lives of mother and a newborn - My happines is to see mother and a newborn survive and walk safely from labour room, my hands are the bridge between a newborn and a mother”.

Photo @UNFPATanzania / Warren Bright

Empowering midwives also strengthens healthcare systems, particularly in developing regions most vulnerable to climate change's impact. These skilled professionals not only provide essential reproductive care but also build more resilient communities that can better respond to climate change challenges.

In Kampala, Uganda, Edinah goes beyond her role in the delivery room. She supports refugees, offering not just medical assistance but psychological comfort and friendship. Her deep empathy and understanding, honed through formal training and personal experience, make her a source of strength for her patients.

Her expertise shines through her ability to not only guide women through the physical process of childbirth, but to provide emotional support, easing fears and empowering them to trust their own strength. With a foundation of both formal training and the formative experience of her own mother's childbirth, Edinah understands the complex interplay of medical knowledge and deep empathy. Her commitment to her patients is unwavering, ensuring the well-being of both mother and child.

“To be a midwife is joyful but at the same time can be very stressful because sometimes you have to deal with anything that might unexpectedly arise. It takes three components to be a great midwife: knowledge and continuous learning; passion, to feel a sense of connectedness and desire; and faith to have confidence in what you do.”

The 2021 State of the World’s Midwifery Report highlights that universal coverage of midwife-delivered interventions by 2035 would avert 67 per cent of maternal deaths. There is ample evidence that shows that investing in midwives facilitates positive birth experiences and safe and effective comprehensive abortion services, and improves health outcomes, among other benefits.

Photo: UNFPA Tanzania / Warren Bright

While individuals may hold preconceived notions about a midwife's appearance or age, Jairos’ journey began with a lifelong fascination with babies and birth. From an early age, he was drawn to infants and the stories surrounding childbirth. After observing a birth as a teenager he decided to pursue formal midwifery training in Korogwe, Tanzania.

“By age 23, we had relocated to Kigoma, Tanzania in Nyarugusu Refugees Camp, where I began a formal apprenticeship with a local midwife. That opened so many more doors, and I have had the wonderful privilege of training under and working with other fabulous midwives. Midwives form a special sisterhood, one that is universal. I’m so grateful for the privilege of being a member”.

In Rwanda, UNFPA supports midwifery students with scholarships. Answering to a ratio of 1 skilled health professional per 1000 people. The Government has taken important steps to strengthen the healthcare force. One of UNFPA’s sponsored students, Alleluia Betty explains her experience, “I wanted to pursue midwifery so that I can help save the lives of those mothers and babies who are in need. Some people discouraged me from choosing this area due to perceived risks that come with it but I am ready to overcome the challenges by prioritizing my passion for the course and focusing my genuine interest in saving lives.”

"I gained experience of high risk deliveries and have been able to empower women in the birthing centre. I really enjoy coming to work and making a difference." Justina Rwehembiza, Midwife in Tanzania.

Midwives like Alleluia, Edinah, Jarius, Justina, Jasmine, and Joaquina do much to advance women’s and girls’ rights. Their guidance and expertise can prevent female genital mutilation,assist survivors of gender-based violence, and provide key support in communities devastated by climate change. They are always there, hand in hand with those who need them the most, and in a noble profession championing life and dignity in their communities.