Malawian Midwives Unite for Their Rights During the COVID-19 Crisis and Beyond

As the COVID-19 pandemic brings new challenges to healthcare workers, Malawian nurses and midwives are advocating for their rights within the healthcare system to be respected, protected and fulfilled during the crisis.

By Newton Kalua, Communications Intern, White Ribbon Alliance Malawi

For years, the health sector in Malawi has faced many challenges, including a shortage of health facilities and health workers, critically lacking adequate numbers of trained midwives. In a 2017 study by White Ribbon Alliance, more than 20,000 additional midwives were needed to support women of reproductive age. As the COVID-19 crisis continues to stretch an already overstrained health system, hiring additional health workers and fulfilling their commitment is more vital than ever. WRA Malawi was pleased to see that as part of the Government of Malawi’s COVID-19 response, the Ministry of Health (MOH) committed to hiring 2,000 more health workers to ease the overburdened system and has already hired 755 healthcare workers.

While the government recruits additional health workers, they must also navigate how to adequately equip and protect health workers serving on the frontlines. In mid-April, healthcare workers staged a sit-in to protest working conditions and lack of personal protective equipment – referred to as PPE – while demanding increased risk allowances, or hazard pay, in the wake of the coronavirus pandemic. Led by the National Organization of Nurses and Midwives (NONM), protesters sought an increase to their risk allowances which were at an average of MK2,000 (around $2.00 USD). To their credit the Government of Malawi approved the increase and subsequently granted an additional increase to 20,000 MK/month minimum. The increase has been secured through the end of the COVID-19 pandemic, while the NONM further negotiates with the government to make the increase permanent.

During the risk allowances strike, some district hospitals were partially closed while referral hospitals were completely closed. Other facilities only attended emergency care needs.  Healthworkers have since resumed normal duties, following the accepted risk allowance increase.

Rex Kamwana, Nurse and Midwife Technician and Vice Secretary for NONM Zomba District Health Office Chapter, noted, “As of now, the care is normal as usual, women are being attended to. The messages for COVID-19 are as well being given to patients and of course infection prevention measures are being provided to prevent the spread of the virus.”

However, the shortage of PPE continues as the Government has not provided full PPE kits to all health facilities. While their messages to encourage frequent handwashing, social distancing and wearing face masks is a start, they must ensure health workers are appropriately protected.

Luseshelo Simwinga, a nurse and midwife working at Queen Elizabeth Central Hospital (QECH), in Blantyre city, Malawi said, “In the past weeks my facility did not have adequate Personal Protective Equipment for healthworkers but at the same time, we were supposed to be providing quality respectful and dignified maternity care to our clients.  Personally, I had a lot of fears when providing care to my clients, especially when they would cough or sneeze without covering their mouth, as I was not putting on any type of protective wear. My work became very stressful, especially when going home, thinking that I might have contracted the virus.”

Nurses and midwives face unprecedented challenges with the COVID-19 pandemic and need support now more than ever. Ensuring an adequate number of providers and proper protective equipment are key to enabling health workers to provide respectful maternity care during the COVID-19 pandemic. The Global Respectful Maternity Care Council, convened by White Ribbon Alliance, launched the Safer Together campaign to help women, healthworkers and governments navigate this unprecedented crisis. Join the campaign, and help everyone stay safer, together.

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