Debating the midwife profession

The 31st International Congress on Midwives (ICM) in Toronto, Canada has been discussing means to address challenges facing midwives and how to strengthen their professional associations throughout. DW spoke with Toyin Sakari, a Nigerian healthcare philanthropist and the founder and president of the Wellbeing Foundation Africa, about the importance and future of midwives.

DW: You are attending the international confederation of midwives in Toronto. How significant is this Congress?

First and foremost, it is an incredible learning phase. This time we have 4200 midwives from 113 countries attending. There is a lot of innovation here on the plate, a lot of plenary, a lot of research being shared and it allows us to listen to midwives' voices, to learn their reality and to argue governments and donors to recognize midwifery as a unique and vital medical profession. And also to support it financially and through further policy change.  

Do we really need midwives at a time where we have modern hospitals that offer safe deliveries?

Of course, we need them. First of all, midwives play a very vital role providing care and counsel to women and newborns. A midwife is usually and should be the first eyes to see and the first hands to hold a newborn. And because they are themselves, women, they have received specialized training and education on how to support, inform and to educate a woman about her own body and to prepare her for the birth. As you know, maternal mortality rates are still quite bad across the world. It ranges from 1-6 in some regions, 1-12 in others and 1 in 100,000 in places that regulate midwifery and make sure that midwives are available to women. So the evidence is there that a midwife is a woman's best career and best counselor during pregnancy. We try to avoid over-medicalising pregnancy because if you are having a normal pregnancy and you have been properly prepared, you do not need to have an over-medicalized delivery or an unnecessary surgery.

Midwives are trained and educated professionals and they have specialized life-saving skills which provide vital primary health care. So we just believe that before, during and after the birth, professional and specialized skills of the nurse are actually the distance between life and death for millions of mothers and babies.

I understand the theme for this year's congress is 'midwives making a difference in the world.' How is midwifery viewed as a profession in Africa?

Midwifery as a profession in Africa is actually viewed highly. Midwives are often the pillars of community life and society. They are trusted members in their communities and the women are actually very happy to go to a midwife because they probably know her in a social context and when they are pregnant, they find her easier to approach.

Secondly, midwifery care is not an expensive investment because it is not as expensive as the care with a doctor. I actually do promote midwives being integrated into health systems very strongly. If a woman is pregnant, I would hope that you would go to hospital and enroll with your midwife who will look after you throughout the pregnancy. But if do run into a complication that needs surgical attention, your doctors will provide that. So I would say in Africa and Asia, midwifery is already respected.  But what we need to do now is to raise the voices and visibility of midwives. We need to make sure that the infrastructure is strengthened to really support midwifery as a premium care for mothers during their pregnancy.

The G20 summit is coming up in July in Hamburg. What can African countries expect from this summit?

I think a lot of African countries view the G20 summit as somewhere where the rest of world is going to decide how to help Africa. But I also do know that African leaders are now staging a more practical approach. I have been joined by his Excellency Jakaya Kikwete former Tanzanian President to do a major call, greater and strategic investment in midwifery. So we are equalizing the terrain where we can begin to have a better partnership whereby instead of looking at aid, we are looking at investment in social impact and I think that is the way to go in a resource constrained world. 

Africa asked for private investors ten years ago. Why is it coming this late for instance it is only now that the Marshall plan with Africa is put up?

It is because Africa is rising. Leadership in Africa is beginning to take very innovative responsibility. We are better able to pick a sort of collaboration and partnership that would actually make a very good social impact on the ground. If you look at investing in midwifery, investing in one midwife is investing in three human lives. That automatically has an economic, humanitarian and development impact on the mother, her child, and her community.  

Could we say that the G20 is taking place among partners who are at the same level?

I would not say that they are exactly at the same level but I would say that each side has very important intelligence to exchange that would shape the partnership better to actually deliver impact, the social investment and the social demographic dividend. At the end of the day, a problem in one region has dominance on the other. The world is really looking at global security, migration and the refugee displacement situation. If we can make things better socially and economically at home, the rest of the world can benefit from that.

Toyin Saraki is Nigeria's philanthropist with two decades of advocacy covering maternal, newborn and child health, gender-based discrimination and violence, improving education, socio-economic empowerment and community livelihoods in Africa.  She is the Newborn Champion for Save the Children Nigeria and was the inaugural Global Goodwill Ambassador to the International Confederation of Midwives in 2014.

Interviewer: Eunice Wanjiru