Midwives Matter: Expanding Midwifery in Malawi for Healthy Mothers and Babies

Dr. Margaret Chan, Director-General of the World Health Organization, was asked the question: “Does the world have enough midwives?” Her response was emphatic and urgent: “We need more midwives, we need more midwives, we need more midwives!” Despite that the field of midwifery has been “long-neglected” and given insufficient respect within healthcare settings, Chan noted that midwives are crucial in any healthcare system due to their ability to deliver high-quality maternal care.

Studies have shown that when midwives are effectively integrated into medical and public health systems, maternal and newborn deaths are reduced rapidly and sustainably. Yet the benefits of a larger midwifery workforce are not limited to health — they are economic. Investing in the training, employment and empowerment of midwives yields substantial returns; as Margaret Chan herself reflected, “a well-trained motivated, and respected midwifery workforce brings a more efficient use of resources” to the health sector.

Midwifery is not just in the interest of the communities that will benefit from services, but is in the best interests of policy-makers. As Margaret Chan commented, studies have shown that the promotion of midwifery and the empowerment of midwives within healthcare decision-making “brings a welcome shift from the previous focus on provision of life-saving interventions, to a focus on preventing life-threatening conditions in the first place.”

Giving birth in Malawi is one of the most dangerous things a woman or baby could do. 1 in 26 Malawian women will die in childbirth in their lifetimes.Childbirth and life’s first 7 days claim 2.4% of Malawian newborns, and almost 5% of infants do not survive their first year. One of the main reasons for the deadly nature of birth in Malawi is what has been described as a“severe shortage of maternity care professionals.”

Malawi, therefore, has much to benefit from expanding the quantity, quality and integration of midwifery care into our training colleges and health facility services. As a leader in the healthcare field and the largest non-governmental healthcare provider in Malawi, the Christian Health Association of Malawi (CHAM) has taken a stand that midwives matter, and is committed to expanding midwifery to rural and underserved populations throughout Malawi.

Each year, we at CHAM grow our commitment to midwifery. In 2015, we graduated 642 midwives from our 11 training colleges. In less than 5 years, our graduating classes of midwives have nearly doubled. Our incoming class this year is almost 1,000 students strong!

CHAM also employs midwives with diverse levels of training in our 170+ health facilities. CHAM facilities are renowned throughout Malawi for their high-quality maternal care and delivery services. Within these facilities, CHAM midwives work on care teams with nurses, doctors, clinical officers, and other healthcare practitioners, working tirelessly to increase Malawian communities’ access to high-quality maternal care.
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Thanks to the partnership of organizations like the Centers for Disease Control and Prevention, KfW Bankengruppe, Norwegian Church Aid, PAI,USAID and more, CHAM has also increased the number of its facilities which employ and utilize midwifery services, promoted access to and utilization of of life-saving maternal care medicines, improved and expanded nurse and midwife training, and constructed and modernized maternity wings. High-quality, affordable maternal care has never been more accessible in Malawi.