Building Health Systems that Work for Mothers, Newborns, and Midwives

This post originally appeared on Management Sciences for Health’s Global Health Impact Blog.

For many people living in poor and underserved regions – whether rural communities or growing cities – midwives are the health system.

Midwives play a vital role for women during pregnancy and childbirth, but their care expands much more than that. Midwives provide solutions that ensure girls and women have access to a comprehensive range of services promoting their right to physical and mental health. They provide family planning and reproductive health services and care for newborns and young children not only at health facilities but also in communities. They deliver the respectful and excellent quality of care that can prevent more than 80 percent of all maternal deaths, stillbirths, and newborn deaths worldwide.

But they face tremendous sociocultural, economic, and professional barriers within weak health systems that prevent them from practicing their full potential. Midwives know that they play just one role within the larger health system, and that if another part of the system fails, they may not receive the supplies, support, or funding they need to maintain their essential maternal, newborn, and child health services. Midwives know that they cannot do it alone.

In order to end preventable newborn and maternal deaths, we need to get serious about empowering midwives and strengthening systems to support them.

Empowering Midwives to Lead

Midwives are often confronted with situations that appear beyond their control, but empowering them with confidence and skills in leadership and management can help them take charge and pioneer new and creative solutions that build strong and responsive systems capable of delivering quality care.

To help them build these skills, under the USAID-funded Leadership, Management, and Governance (LMG) Project, Management Sciences for Health (MSH) worked with LMG Project partner, Amref Health Africa, to develop the LMG for Midwifery Managers Course.

The course transforms the way midwives tackle challenges they face every day, like negative stereotypes of midwifery in South Sudan or staffing shortages in Tanzania. With renewed confidence, midwives become advocates for their profession and services and leaders in their own local health systems.

Agnes Masawe, a midwife trainer in Tanzania, explained the transformation, saying, “Sometimes you don’t need money, you need your mouth. You need to lobby, communicate, and demand resources. Sometimes you think you need to talk to people in the capital city, but you can mobilize in the community. You can do things yourself, not wait on the decision-makers.”

When midwives get involved in making decisions, women and children win.

Building on these experiences, MSH is now developing a six-month long program to build the advocacy capacity needed to strengthen professional midwifery. With support from the John D. and Catherine T. MacArthur Foundation, the FCI Program of MSH is rolling it out across six states in Mexico. This program will reinforce the conceptual foundations supporting midwifery and will build midwives’ capacity to plan and implement advocacy actions that are tailored to the context, needs, and goals of each state.

By empowering midwives to lead and building health systems that support them, we can ensure that their practice reaches its full potential, creating lasting impact for all women and children.