1.

Introduction
Quality midwifery education is urgently needed
to improve quality of care, end preventable
maternal and newborn mortality and stillbirths
and deliver the agenda of UHC. The evidence
presented in this report indicates that midwifery,
where care includes proven interventions for
maternal and newborn health as well as for family
planning, “could avert over 80% of all maternal
deaths, stillbirths, and neonatal deaths” (1).
Midwives, when educated to international
standards of midwifery, are able to provide the
full scope of interventions needed when they
are licensed, regulated, fully integrated into a
well-functioning health system and an
interprofessional team with referral services when
required for complications and emergencies (2).
Although the reasons behind the impact of
midwifery care on mortality reduction are
complex and in process of further research,
improvements in the quality of care provided,
including the satisfaction of women with the
care they receive, are likely to play a major role.
Over 50 additional outcomes are improved by
midwifery care, including a reduction in the
major causes of maternal deaths (haemorrhage,
hypertension and sepsis) (2). Similarly, midwifeled
continuity of care (MLCC) prevents preterm
births by 24% and reduces neonatal sepsis (8).

The Global Strategy for Women’s, Children’s and

Adolescents’ Health 2016−2030 (GSWCAH)
focuses on actions to prevent maternal, newborn,
child and adolescent deaths and improve the
quality of lives for all (18). Progress in mortality
reduction continues, but more is needed (4).
In October 2018, world leaders recommitted
their support to primary health care (PHC) by
endorsing the Astana Declaration, which
commits to care and services that promote,
maintain and improve maternal, newborn, child
and adolescent health; and mental health and
sexual and reproductive health (19).
In 2018 the United Nations Population Fund
(UNFPA), the United Nations Children’s Fund
(UNICEF), the World Health Organization (WHO)
and eight other global partners developed the
SDG 3 Global Action Plan for Healthy Lives and
Well-being for All (2018−30), in which they
commit “to align our joined-up efforts with
country priorities and needs, to accelerate
progress by leveraging new ways of working
together and unlocking innovative approaches,
and account for our contribution to progress in a
more transparent and engaging way” (20).
Alongside the above, the Global Strategy on
Human Resources for Health: Workforce 2030
focuses on the need to invest in capacity-building
of educational institutions and to deliver
competency-based learning through
transformative education (21).
Midwifery makes the connections over time
(from birth to adulthood), and place (from home
to community to facility), and can deliver many
of the intervention packages described in the
GSWCAH targets (Fig. 1).
Fig. 1. Midwifery makes the critical connections to deliver proven interventions