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Midwives leading the way with quality care in rural Western Province

Limulunga District, Western Province – Gift Kalinda is an enrolled midwife in Limulunga District of Western Province. He is among five enrolled midwives working within the District and serving a rural population of over 50,741. Every day, Gift provides life-saving information and delivers services to women of reproductive age, young people, children and new-born babies, to mention a few.

Working in a remote rural setting, Gift often encounters diverse challenges in the call of duty, key among being the only midwife at Nang’oko Health Post in Limulunga District. Yet, Gift remains optimistic in the discharge of his duties. The enormity of his task has also led Gift to think of innovative solutions to some of these challenges.

Recounting his experience, he says: “Bieng the only midwife at the clinic, I have taken the initiative of mentoring and sharing knowledge and skills with the nurses and other health personnel at the clinic. With this, they have been able to assist with responding to some uncomplicated cases such as providing family planning counselling and services, as well as ante-natal care services during times when the clinic is overwhelmed with clients. I feel proud when I make a difference as a midwife” – says Gift.

Gift also works with community-based volunteers to raise awareness on important household decisions and practices that encourage women to use ante-natal services on time and deliver in health facilities.

Making every childbirth safe

Gift is among over 3,000 midwives who are leading the way in providing quality health care and saving the lives of thousands of women, adolescent girls, young people, children and infants across Zambia.

Over the past decade, Zambia has recorded significant progress in reducing maternal mortality rates, from 726 per 100,000 live births in 2002 to 278 per 100,000 live births in 2018. Ensuring the availability of skilled midwifery personnel has been critical in securing this achievement, as Zambia has almost doubled the number of births assisted by a skilled attendant - from 42% in 2002 to 80% in 2018. This underscores the evidence that when deployed in adequate numbers, trained midwives can avert approximately two thirds of preventable maternal deaths (Source: UNFPA | 2016).

However, more needs to be done to sustain these gains in Zambia. For a country with a population projection of 18,383,955 (Source: World Population Prospects | The 2019 Revision | United Nations Population Division), an estimated 3,000 midwives falls far below the World Health Organization (WHO) recommended threshold of 4.2 midwives per 1,000 population.

Acknowledging that improving care around birth is one of the most impactful strategies for reducing maternal and newborn deaths, UNFPA in Zambia continues to support key actions towards achieving Universal Health Coverage (UHC), in line with the goals of Zambia’s National Nursing and Midwifery Strategic Plan (2017-2021) and the Midwifery 2030 vision. Specific contributions by UNFPA in Zambia have included:

  • Development of a Bachelor of Science in Midwifery Curriculum to improve skills and service quality within the national midwifery workforce;
  • Review of existing midwifery curricula to ensure consistency with the International Confederation of Midwives (ICM) standards;
  • Sponsoring the training of more midwives especially for underserved populations - including providing educational materials, supplies and equipment; as well as capacity building of tutors in midwifery institutions;
  • Building the capacity of the Midwives Association of Zambia, which aims to explore innovative ways of improving the provision of quality care, build capacity among its members, as well as enhance professionalism and advocacy.

As UNFPA in Zambia, we believe that such efforts will not only deliver on women’s rights to health, but will also ensure that women and newborns obtain the care they need and contribute to the global and national shared vision of ending preventable maternal and newborn deaths by 2030. This is also in line with the declaration of maternal and perinatal deaths as a public health emergency by H.E. Mr Edgar Chagwa Lungu, President of the Republic of Zambia.

“As midwives, we play a very important role in maternal and child health. We appreciate the support provided by the Government of Zambia and indeed development partners such as UNFPA. This motivates us to work beyond the call of duty to ensure that no woman dies giving life, even in difficult circumstances, hard to reach locations and with limited resources” Gift underscores.