Joint Op-ed by Lydia Zigomo, Regional Director, UNFPA East and Southern Africa and Dr. Julitta Onabanjo, Director of UNFPA Technical Division

The wonderful experience of giving life carries the risk of morbidity and mortality.

However, this risk is steadily declining in Sub-Saharan Africa. Between 2000 and 2020, the maternal mortality ratio has declined by one-third or from 807 to 545 maternal deaths per 100,000 live births. This is noteworthy; however, despite progress, the risk of dying while giving birth is still unacceptably high. Lifetime risk of maternal deaths in Sub-Saharan Africa is at least eight times higher than other regions.

In Sub-Saharan Africa, too many women, an estimated 202,000, died from giving life in 2020. This represents 70 per cent of global maternal deaths and translates into over 550 maternal deaths per day, which is one maternal death every two and half minutes. For every death, 20 to 30 more morbidities including obstetric fistula and perinatal mental health occur. The deaths leave behind devastated husbands, partners, children, communities, societies, and nations. Most of these maternal deaths could be prevented by improving availability, accessibility, acceptability and quality of human rights-based Sexual, Reproductive, Maternal, Neonatal, Child, Adolescent Health services.

One of the major barriers to improving access to comprehensive maternal and newborn care in Sub-Saharan Africa is the difficulty in ensuring availability of skilled, motivated, supported and regulated health providers. The good news is that well-trained and supported midwives have the potential to provide 90 per cent of all essential sexual, reproductive, maternal and new-born health services. The bad news is that currently they represent only 10 per cent of the health workforce.

Globally, there are 900,000 midwife deficits by 2035 with 500,000 in Africa.

As the United Nations’ sexual and reproductive health agency, UNFPA is a leader in supporting quality midwifery care across the world. We support governments to improve competency-based training, midwifery regulatory mechanisms and workforce policy that comply with international standards. We are also harnessing the power of technology to train midwives in remote areas or emergency crisis zones.

We are committed to strengthen ‘midwifery-led care’ as a critical pathway to end preventable maternal and new-born deaths and stillbirths.

We are not alone. We are glad to partner with the International Confederation of Midwives (ICM), the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), and with more than 20 global partners from civil society, academia, private sector, professional bodies and development partners to host the 5th Global Midwifery Symposium on 7 and 8th May 2023, a pre-event to the International Maternal Newborn Health Conference (IMNHC2023).

During the Symposium, Global Partners appealed to the United Nations member states to: Promote midwifery care; Strengthen the Midwife Workforce; Improve Working Conditions and Support for Midwives; Address Barriers to Accessing Care from Midwives; Ensure Provision of Comprehensive Sexual and Reproductive Health Services and Rights (SRHR) by Midwives; and Monitor Progress and Strengthen Accountability.

The current pace of progress in preventing maternal deaths in Sub-Saharan Africa is significantly less than the pace of progress required to take the region closer to the Sustainable Development Goals target of 70 maternal deaths per 100,000 births by 2030. In fact, the current pace of progress needs to be improved by five-times to be able to meet the SDG-3 maternal mortality target in Sub-Saharan Africa.

African mothers deserve better. They deserve to feel safe and supported as they bring new life into the world. Investing in midwifery education, training, and professional development is the least we can do to deliver a brighter future for generations to come. Together, we can eliminate preventable maternal and newborn deaths, and empower every woman to give birth with confidence, without having to pay the ultimate price.

Let's take action now, and make sure that no more lives are needlessly lost in the miracle of childbirth.