5th May 2017, Zambia joined the rest of the world in commemorating the International Day of the Midwife under the theme "Midwives, Mothers and Families: Partners for Life!" National celebrations in Kitwe, Copperbelt Province, recognized the critical role of a strong, skilled, regulated and coordinated midwifery workforce as key actors in ending preventable maternal and newborn deaths in Zambia. Evidence shows that skilled midwives are able to provide 87% of the essential health care needed by women, infants, children and adolescents, when they operate within an enabling environment.
This is showcased by Mr Bartholomew Kondwelani Mbewe, a male midwife working at St. Luke Mission Hospital in Luangwa district of Lusaka Province. With only nine months of service, Bartholomew has successfully conducted 57 deliveries, 10 of which were complicated cases (twins, breech, shoulder distortion and haemorrhage) and performed five successful neonatal resuscitations. He has also actively advocated for male involvement in Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH), including actions that reduce teenage pregnancies, increase the Prevention of Mother-To-Child Transmission and uptake of postnatal services. Government and the Midwives Association of Zambia presented Awards to Bartholomew and 12 other midwives (1 male and 11 female) who had all showcased exemplary service.
Encouraging all midwives of its commitment and policy direction in ensuring ‘no woman should die while giving life’; government noted successes achieved through a wide range of interventions, including recent actions in filling 3,003 midwifery posts representing 49.1% of the total 6,126 positions required. Increases of new intakes in existing midwifery training schools, and commencement of the Registered Midwifery program in the country were highlighted towards ensuring increased availability of skilled midwives. However, despite these, Zambia continues to battle with a high midwife-patient ratio of 1:50, maternal mortality rate of 398 per 100,000 births, neonatal mortality rate of 185 per 100,000 live births, shortages of midwives especially in rural and underserved areas, as well as weak capacity of health facilities to meet the health needs of a fast growing population. Gender disparities, poor households, poor road network and transport challenges continue to pose external challenges to the health system performance.
Acknowledging these challenges, the Honorable Minister of Health, Dr. Chitalu Chilufya committed to “interventions that improve maternity care to accelerate the reduction of maternal, neonatal and child mortality in Zambia, through ensuring a continuum of care from community to high levels of care. Some of these interventions are joint programs between the Government of Zambia, the United Nations, the European Union and other partners”.
UNFPA, the United Nations Population Fund through its Country Representative in Zambia, Dr. Mary Otieno “committed to sustaining collaborations with government at all levels in ensuring well-trained midwives work within enabling and regulated environments and communities to provide compassionate, respectful and culturally sensitive care that households and individuals need, especially women, infants, children and adolescents”. UNFPA has supported pre- and in-service training of 252 midwives in Western, North Western, Luapula and Central provinces in the last three years, as well as functional midwifery skills laboratories in targeted midwifery schools. To ensure quality and standards, the General Nursing Council, Ministry of Health UNFPA and Clinton Health Access Initiative (CHAI) developed and revised various Midwifery Curricula, including a BSc Midwifery program with the University of Zambia program.
As Zambia advances towards achieving Vision 2030 and the Sustainable Development Goals, it is important to ensure increases in the current average output of 300 midwifery graduates per year, while strengthening deployment, retention, regulation and the association of midwives.
