The State of the World’s Midwifery Report 2021 published to mark IDM

on 05 May 2021

The International Confederation of Midwives (ICM), the United Nations Population Fund (UNPF), the World Health Organization (WHO) and Novametrics have developed and published The State of the World’s Midwifery Report 2021 (SoWMy) to coincide with International Day of the Midwife (IDM).

The SoWMy report presents findings on the maternity care workforce of 194 countries showing progress and trends since the 2011 edition of the report. It also identifies the barriers and challenges when it comes to advancing maternity and midwifery care.

This year’s report found there is a global shortage of 1.1 million in Sexual, Reproductive, Maternal, Newborn and Adolescent Health (SRMNAH) workers and that investment is urgently needed in education and training.

It also identifies the need for the improvement of midwife-led models of care and midwifery leadership and governance.

When talking about why countries should be investing in midwives, the report says: “Since the first SoWMy report in 2011, the body of evidence demonstrating the return on investment in midwives has grown. It indicates that investing in midwives facilitates positive birth experiences and safe and effective comprehensive abortion services, improves health outcomes, augments labour supply, favours inclusive and equitable growth, facilitates economic stabilization, and can have a positive macroeconomic impact.”

As part of analysis for the report, it was found that in 88 countries that account for the vast majority of the world’s maternal and neonatal deaths and stillbirth an increase in midwifery-led services and interventions by 25% (every five years to 2035) could prevent 40% of maternal and newborn deaths and 26%  of stillbirths.

When focusing on midwifery education out of 80 countries it was found that 41% of midwifery programmes offer only direct-entry programmes, 21% offer only post-nursing midwifery courses, 6% offer combined nursing and midwifery courses, and 31% offer direct-entry and another type of programme.

In the chapter for midwifery education, the key messages included: “COVID-19 has prompted new ways of providing midwifery education and services. These need to be developed and used effectively, including innovative digital technologies and online learning opportunities. Their effectiveness also needs to be assessed during ‘normal’ conditions.”

From the responses of 70 countries, 49% reported that all of their midwifery educators are qualified midwives and 6% reported that none of their midwifery educators were midwives.

When looking at the availability of midwives and other SRMNAH workers, the biggest shortages are in low-income countries, especially in the WHO African region.

However, the report states that the current progress being made, by 2030 things will have improved “slightly”, with the most improvement being seen in middle-income countries.

To close the gap by 2030, the SRMNAH workforce will need 1.3 million new DSE posts to be created (mostly midwives/nurse-midwives and mostly in Africa) over the next 10 years to meet demand.

The health workforce is 70% on average women, with midwives most likely to be women.

In conclusion to the report it said: “SoWMy 2021 shows that, if available in sufficient numbers, and if educated and regulated according to recognized standards and working across their whole scope of practice as part of an integrated team within an enabling environment, midwives could meet about 90% of the global need for essential SRMNAH interventions.”

Read the full report here.

The Royal College of Midwives (RCM) has a blog post by Board Member of the Northern European Region at ICM, Trude Thommesen, on keeping midwifery on the global agenda. Read it here.