Strengthening Midwifery in Africa: Advocacy Skills Required

By Rose Mlay, WRATZ Coordinator

It has been difficult for me to forget this event where about 50 midwives from African countries met to discuss their issues. In the week beginning May 14, 2012, I was privileged to be among these midwives in a workshop “Strengthening Midwifery in Africa” co-organized by the International Confederation of Midwives (ICM) and White Ribbon Alliance for Safe Motherhood. There was a great emphasis on who a midwife is and her/his role in saving mothers and newborn lives, that is, when she is in the labor ward she is autonomous and her decisions are paramount. “A midwife is therefore a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice during pregnancy, labor and the postpartum period, to conduct births on the midwife’s own responsibility, and to provide care for the newborn and infant. This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures” (ICM definition). To me this is saving pregnancy and childbirth related lives!

The White Ribbon Alliance for Safe Motherhood (WRA) was represented by Frances Ganges and Katy Woods from the Global Secretariat, Lennie Kamwendo and team from WRA Malawi, Robina Bitey and team from WRA Uganda, while me and Anastazia Lyima represented WRA Tanzania (WRATZ). Together under the facilitation of Katy and Frances, we oriented the participating midwives from various African countries and ICM headquarters on advocacy strategies for safe motherhood. Examples of advocacy successes from the National Alliance represented in Kampala were quite inspiring. Each participant was given a chance to communicate a one minute message to inform, persuade and convince a decision maker to support a safe motherhood issue in front of a camera. This dramatized activity was a very interesting exercise. I could see how the midwives were excited and enthusiastic. They realized how important it is for a midwife to have advocacy knowledge and skills so they can speak on behalf of themselves and their clients. A call was extended to WRA to allocate time and resources to provide opportunities for midwives to gain skills in advocacy.

The other point of emphasis was that all midwives must have seven essential competencies outlined by ICM, regardless of whether they are working in rural or urban areas, in developed or developing countries. This is because when a pregnant woman in labor decides to go to a health facility, be it a dispensary or a referral/consultant hospital, she expects the midwife who will take care of her to do so holistically, making sure the woman and baby are safe. To any woman in labor, the midwife is her consultant and so one cannot afford placing someone called a midwife without the seven essential competencies. Bottom line is the woman should not be fragmented by her health system.