By the time you finish this article, at least a woman and a child somewhere in Malawi will be breathing their last, not to enjoy their lives due to many shortfalls in our healthcare system including shortage of skilled health workers.
As, everybody is looking for solutions to curb such senseless loss of life from preventable deaths, it has pleased the Nurses and Midwives Council to only accredit six colleges, leaving out many the of them based on what Stella Kamphinda, nursing officer for education calls based on its education standards.
The month of May is loaded with events commemorating Midwives and Nurses contribution to general health, ironically Nurses and Midwives in Dowa and Nkhotakota districts were fighting for their February and March salaries, leading to their downing of tools.
May 5 was the International Day of the Midwife, while May 12 is the International Day of Nurses. Malawi, according to the President of Association of Malawi Midwives (AMAMI) Dr. Address Malata will celebrate the days on 21st May.
Save the Children, a key partner in Everyone Campaign dedicated to saving lives of mothers and children released together with the Ministry of Health and AMAMI, a report on the situation of midwives titled ‘Missing Midwives’ as part of commemorating the all important role of the midwives.
“Each day in Malawi, 13 women die in childbirth and over 50 babies are stillborn during the last 12 weeks of pregnancy. An additional 58 newborn deaths occur every day. The critical constraint is the missing midwives and other key health workers,” observes the fact sheet for Malawi.
This is an improvement from 807 deaths per 100,000 live births to around 580, mainly attributed to investments in the sector by Government with support of partners such as the Save the Children, United Nations Population Fund, United Nations Childrens Fund and the British Department for International Development among others.
The solution mainly arises from the need to close gaps for care at birth, equity gaps to reach the poor especially in rural areas and also quality gap, as measure to reduce maternal and newborn deaths.
The global standard of one midwife for 175 pregnant women is still a far fetched dream for Malawi while 2009 figures indicate at least a population of 4812 as being in service. The Ministry of Health Emergency Healthcare training programme had targeted putting the population of Nurses and Midwives at around 7,000.
There are only about 4 Nurses and Midwives serving a population on 10,000.
“It is a mockery of the 21st century modernization that mothers and babies should continue to die in childbirth for lack of skilled midwives, the most critical person for effective care at time of birth. Stopping women and babies from dying in childbirth is a moral imperative,” says the statement.
With only three years to go to the end of the Millennium Development Goals, goals number 4 and 5, very unlikely to be met, the Missing Midwives report is an opportunity for an independent reflection for the country to try and put things right in terms of increasing the presence of skilled personnel to perform deliveries.
“The challenges midwives and nurses everyday include resources like drugs and supply of crucial materials such as gloves. Infrastructure is another challenge as women over crowd in rooms meant for a few,” Serra Chanachi, District Nursing Officer for Kasungu said at the launch of the report.
Chanachi hailed as model of dedicated midwife, who even after obtaining a Masters Degree in Midwifery has remained in service of the poor working in rural areas such as Karonga, Thyolo and Mulanje, says there is a need to treat the shortage of midwives as a national crisis.
“We do 5,000 deliveries per year or 465 per month and 16 per day. The main hospital in Kasungu admits 200 pregnant women against 70 beds. The midwives and nurses that we have are really dedicated and they serve with passion,” said Chanachi.
The story of midwives and nurses, who provide the first line of support to delivering women, is not complete without the mention of the National Organisation of Nurses and Midwives in Malawi (NONM) a unionized association, which has been fighting to keep the nursing colleges open while improving standards.
“The problem is that we talk about these things without commitment. Government increased capacity of Nursing Colleges without necessary infrastructure, today someone goes and close the same college for lack of capacity, people should work to deliver on life saving. Even in its worst poor state we say hospitals cannot close. That’s why even Nurses in Dowa could not close the hospital despite having no salaries, that the principal we use in healthcare,” says outspoken NONM Director Dorothy Ngoma.
The Callista Mutharika Safe motherhood Foundation announced last year scholarships for community based midwives as part of its contributions towards delivering the safely mothers and children as Malawi looks towards attaining the MDGs.
The many interventions and opportunities created by campaigns such as EVERYONE, needs to do more to reach out the rural areas where the cases of access due to distance or shortages of skilled staff have contributed to preventable deaths.
Everyone, especially the every pregnant woman should have access to a midwife.