Reflections on the ICM in Durban

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By: France Donnay, Interim Deputy Director, Maternal, Neonatal & Child Health, Senior Program Officer, Maternal Health, The Bill & Melinda Gates Foundation

I am sitting in a huge auditorium filled with a very special crowd: midwives from all over the world. They are cheering, arguing, listening, celebrating. In Durban, South Africa, the 29th Congress of the International Confederation of Midwives is in full swing. Here are my three highlights.

First, the presentation by the President, Bridget Lynch, of the Global Standards, Competencies and Tools for Midwifery, covering Education, Regulation, and Country Associations Capacity Assessment. While this sounds trivial, it is no small achievement. Until now, midwives from various countries trained and practiced in many different ways. Standardization of education and practice across countries will now be possible. There is a long way to go before this newly available guidance is put into action, but it already makes midwives stronger and more united. Go to for more.

Second, the launch of the first ever State of the World ‘s Midwifery – Delivering Health, Saving Lives – prepared by UNFPA with support from – no less – than 30 organizations, from USAID to DFID, AMDD to Save The Children, WHO to UNICEF. The report outlines the key role of midwives in delivering care at all levels, and presents country specific profiles of midwifery in 58 countries in all world regions. The role of skilled birth attendants, in particular midwives and others with midwifery competencies, is crucial to addressing maternal and newborn mortality and to promoting women’s and children’s health. In addition to evidence accumulated over time from Sweden, the United Kingdom, Australia and France, quality midwifery has spurred development in countries like Sri Lanka, Malaysia, Tunisia and Thailand. Midwifery personnel and services are unequally distributed –between countries as well as within countries. The report examines the number and distribution of health professionals involved in midwifery services. Most midwives are women, and the report explores the constraints and challenges that they face in their lives and work; and the report calls for accelerating investments in midwifery services, as well as “skilling up” other categories of providers living and working in communities under the supervision of midwives. Attending the sessions were many pediatricians and obstetricians, and that is a first as well.

Finally, the Foundation with AMDD organized a panel with three outstanding voices from the field: Kaosar Afsana from BRAC/Bangladesh, Fatima Muhammad from the Society for Family Health in Abuja/Nigeria, and Phoebe Balagumyetime, from the Ghana Health Services. They presented encouraging results from projects operating in very challenging environments, from crowded impoverished slums in Dhaka, to remote villages in the North East of Nigeria and the Northern part of Ghana. They showed how locally designed configuration of health services and transportation systems can increase access to life saving care for women and children. Helen de Pinho, from the Columbia University based Averting Maternal Death and Disability, brought all of this together to show that intelligent health leadership engages communities in driving local solutions.

The audience was good too: midwives clad in colorful outfits, listening attentively, getting up to share their own challenges.