Midwives and Midwifery
Respectful Maternity Care
History & Mission
With a population of 17 million people, every two out of three people in Malawi is under age 25 and more than 20% of adolescent girls have begun bearing children by age 17. Despite significant gains around the world, Malawi’s maternal mortality ratio is still very high, with 460 women per 100,000 dying in childbirth. WRA Malawi is working to support the reduction of maternal and newborn mortality through advocacy to promote midwifery.
There are only 3,420 individuals working mainly as midwives in the entire country of Malawi. Dangerously below the WHO recommended ratio of one for every 175 women of reproductive age, the midwife shortage is a significant factor in its maternal and newborn health crisis.
An additional 20,217 midwives are needed to reach the WHO recommended ratio of one midwife for every 175 women of reproductive age. To achieve this, the Government of Malawi must include a specific budget line for midwifery services. In working with partners, they must also create a clear career path for the midwifery profession, and ensure increased respect and improved working conditions for midwives across the country.
In Malawi, an overall shortage of midwives, coupled with poor working conditions and status, are affecting the provision of high-quality maternity care for women. As a result, many women are giving birth at home without skilled attendants, increasing the risk of maternal and newborn illness and death. WRA Malawi is working to raise the profile of midwives in the country by addressing both the lack of midwives and the stress these few midwives are under through Citizen Journalist Trainings for midwives. By empowering midwives to self-advocate for resources, training and support that are essential to providing safe, supportive and high-quality care for women, WRA Malawi is ensuring a brighter future for families and communities across Malawi.
WRA Malawi was established in 2002 to support the reduction of maternal and newborn mortality, which was understood even then to be connected to the overall shortage of midwives. In 2013, WRA Malawi, through the USAID-funded Health Policy Project, launched “Happy Midwives for Happy and Healthy Mothers,” a campaign to draw attention to the poor status, inadequate numbers and substandard working conditions of midwives and the impact on the provision of high-quality care. As a result of the campaign led by WRA Malawi, all midwives who graduated in the last two years have been employed and ongoing training on Respectful Maternity Care is increasing the status of these essential health workers. Read the Impact Brief for more information.
WRA Malawi News
MIDWIVES MATTER: WRA Malawi’s “Bedside Survey of Midwives” revealed the dire state of Malawi’s midwifery services, with just 3,420 midwives working throughout the country. With an estimated need of 20,217 additional midwives, maternal health clinics are severely understaffed and the overworked midwives are not always able to give expectant mothers the care they need and deserve.
MEETING DECISION MAKERS: White Ribbon Alliance Malawi members celebrate International Day of the Midwife by advocating for Respectful Maternity Care to the Principal Secretary for Health and Director of Nursing and Midwifery Services (L).
COMMUNITY ENGAGEMENT: By starting community dialogues with traditional dances – like this Kungoni cultural troop performing “Gule wamkulu” – WRA Malawi encourages local citizens to openly discuss the trauma of maternal mortality in their region.
CITIZENS’ VOICES: By creating a safe space for citizens to speak frankly about their community’s health centers, WRA Malawi’s Citizens’ Hearings, like this one in Chitipa, have become essential advocacy tools for improving the services for mothers and their newborns.
CHANGEMAKERS: White Ribbon Alliance Malawi’s National Coordinator Nancy Kamwendo is commended by First Lady Gertrude Maseko following WRA Malawi’s eye-opening “Bedside Survey of Midwives,” which revealed the shocking fact that Malawi has just 1 midwife working per every 5,058 people.
MIDWIVES’ VOICES: WRA Malawi celebrated International Day of the Midwife by amplifying the voices of overworked and underpaid midwives as they demanded respect and an increase in the government’s hiring of midwives throughout the country.
MIDWIVES IN POWER: WRA Malawi’s Citizen Journalist program met with Member of Parliament – and midwife and maternal health advocate – Juliana Lunguzi to discuss the positive impact of Respectful Maternity Care on maternal health outcomes.
CITIZEN JOURNALISTS CELEBRATE: Newly-trained Citizen Journalists celebrate after graduating from WRA Malawi’s training program. By bringing midwives from every part of the country together to give them the advocacy skills needed to tell their stories and to demand change, WRA Malawi has empowered a new generation of maternal health leaders.
THE POWER OF MIDWIVES’ VOICES: WRA Malawi-trained Citizen Journalists have been given the essential advocacy skills needed to share their stories and reveal the true nature of Malawi’s maternal health services.
RESPECTFUL MATERNITY CARE: By treating new mothers with respect and dignity, midwives and other health workers can improve maternal health outcomes by encouraging more women to seek the qualified care they need
Thank you to our partners
Health Policy Plus Project
National Coordinator, WRA Malawi
As National Coordinator, Nancy leads all of WRA Malawi’s planning efforts, developing and implementing costed annual work plans for the alliance. She is a member of the Malawi Ministry of Health Quality Management Technical Working group, the Safe Motherhood Sub-committee and the family planning committee of the Reproductive Health Directorate. Nancy joined WRA Malawi in 2015 as a Respectful Maternity Care project officer and was appointed to the National Coordinator position in May 2016.
Nancy is a registered nurse and midwife who rose to community nurse and midwife specialist after obtaining a Master of Science Degree in Community Nursing and Midwifery from the University of Malawi, Kamuzu College of Nursing. Nancy has 26 years’ experience working as a registered nurse and midwife in leadership positions including research nurse team leader at the University of North Carolina project in Malawi, and as a lecturer in community nursing and midwifery at Nkhoma College of Nursing and Midwifery. From 2010 to 2013, she coordinated the Christian Association of Malawi and Centers for Disease Control HIV Project at Mua hospital, while also serving as a senior community nurse midwife, acting as a link between the community and the hospital. Nancy is a member of the Association of Malawian Midwives and is passionate about empowering communities to demand their rights for reproductive health.
Outside of work, Nancy is a committed member of the Catholic Women Organization, previously serving as the Dedza Diocese CWO Chairperson and enjoys listening to gospel music. The first born in a family of seven and the first woman to graduate college in her village, Nancy is a role model to many.
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