SoWMy 2014 Equitable access to Quality Midwifery care PMNCH Partners Forum, Johannesburg, South Africa 30 June 2014 Petra ten Hoope-Bender and Luc de Bernis
A message from Ban Ki-moon The midwifery workforce, within a supportive health system, can support women and girls to prevent unwanted pregnancies, provide assistance throughout pregnancy and childbirth, and save the lives of babies born too early. I fully support the Midwifery 2030 vision articulated in this report. This vision is within reach of all countries, at all stages of economic and demographic transition.
SoWMy 2014: participants 73 out of the 75 Countdown countries, of which: o 40 countries in Sub-Saharan Africa, of which: 17 Francophone 21 West and Central Africa
Page v SoWMy 2014: Key findings
Effective coverage CRUDE COVERAGE EFFECTIVE COVERAGE AVAILABILITY ACCESIBILITY ACCEPTABILITY QUALITY Midwifery workforce is AVAILABLE? Midwifery workforce is ACCESSIBLE? Midwifery workforce is ACCEPTABLE? Midwifery workforce provides QUALITY CARE? A midwife is available in or close to the community As part of an integrated team of professionals, lay workers and community health services Woman attends A midwife is available As needed Financial protection ensures no barriers to access Woman attends A midwife is available As needed Providing respectful care Woman attends A midwife is available As needed Providing respectful care Competent and enabled to provide quality care. Source: Campbell J. SoWMy 2014
Availability The availability of the midwifery workforce can only be measured by reference to full-time equivalent not headcount. Midwifery education must be actively managed to ensure that the future workforce meets the needs of future populations. A career as a midwife is perceived to be more attractive than other professions open to people with a similar level of education, but not in all countries. Midwives salaries are among the lowest for health-care professionals in low- and lower-middle-income countries.
PLANNING AND PREPARING SUPPORTING A SAFE BEGINNING ENSURING A HEALTHY START CREATING A FOUNDATION FOR THE FUTURE Supported by universal access to midwifery care, delivered through collaborative practice from household to hospital along the continuum of care, by a workforce that is educated, regulated and enabled to deliver quality. - accountability - inclusion in the national health budget
What if...?
{Country} Brief for policy discussion EXAMPLE COUNTRY
Sub-Saharan Africa Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Comoros, Congo, Democratic Republic of the Congo, Côte d'ivoire, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania Mozambique, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, South Africa, Swaziland, Togo, Uganda, United Republic of Tanzania (+Zanzibar), Zambia, Zimbabwe West and Central Africa Burkina Faso, Cameroon, Central African Republic, Chad, Congo, Democratic Republic of the Congo, Côte d'ivoire, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Sao Tome and Principe, Senegal, Sierra Leone, Togo Francophone Africa Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Comoros, Congo, Democratic Republic of the Congo, Côte d'ivoire, Gabon, Guinea, Madagascar, Mali, Niger, Senegal, Togo
Pregnancies (Sub-Saharan Africa only) Source: ICS Integrare/U.of.Southampton_PregMod
Projected need in Sub-Saharan Africa Between 2012-2030, the health workforce in SSA will need to respond to: 3.96 billion antenatal visits 0.72 billion births 2.9 billion postnatal visits Source: ICS Integrare ECoMod-RMNH
Skill mix and met need (2012)
Kenya Case Study
Kenya Case Study Projected outflows + Projected Inflows to 2030
Kenya Case Study
Chad Case Study
Chad Case Study Projected outflows + Inflows From 2012 to 2030
Chad Case Study