World Africa Day - reflecting on the triumphs and challenges in African midwifery

World Africa Day - reflecting on the triumphs and challenges in African midwifery
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Today, on World Africa Day, we are graced with an opportunity to reflect on the progress this continent has made, as well as the challenges that lie ahead. Since 1963, in Addis Ababa in Ethiopia, Africans across the continent have celebrated African unity, collaboration, and African-driven betterment of the continent at large. Since that time, much has changed. Although many parts of Africa, the continent of my birth, remain troubled, there have been some truly amazing developments in recent years.

Let’s take medicine as an example. Just last month, a breakthrough opened up new avenues for maternal health in Africa, with the successful trial of the drug tranexamic acid, which has been proven to reduce post-partum deaths as a result of haemorrhage by a third. Medicine continues to advance, and new and effective treatments are become increasingly available in African countries. Tranexamic acid, for example, is already sold at just $3 per dose.

Other aspects of African healthcare have also seen huge improvements. Although the average life expectancy on the continent remains low, at just 58 years old, this is a 10 year improvement from 1980, and is a direct result of better healthcare systems.

As the Founder and President of the Wellbeing Foundation Africa, Africa’s premier maternal health charity, my interest and commitments lie in the betterment of healthcare – particularly maternal and child healthcare – in Nigeria and West Africa. My organisation provides training to thousands of midwives across the region, and strives to give mothers and infants the best possible opportunities at birth and in life.

Sadly, maternal mortality rates remain high in most areas of Africa. Nigeria alone accounts for 13% of all maternal mortalities worldwide, and it is estimated that a Nigerian woman has a 1 in 23 chance of dying during childbirth during her lifetime. In Chad, this figure rises to around 1 in 17. A dearth in trained midwives impacts women from South Africa to Mali, and must be addressed at both a regional and global level. Experts calculate that the risk of stillbirth or death due to intrapartum–related complication can be reduced by 20% with the presence of a skilled birth attendant, yet around 50% of women in Sub-Saharan African are subjected to this increased risk, due to a plain lack of trained professionals and equipped hospitals. The World Bank estimates that in Nigeria there are less than 2 midwives per 1,000 births. These figures speak for themselves.

In 2001, all members of the African Union pledged to spend 15% of their budgets on national healthcare, at the signing of the Abuja Declaration. Yet we have not seen results. Nigeria spends a mere third of the pledged amount on healthcare, despite widespread poor health outcomes. Increased investment is absolutely critical in supporting healthy, happy and productive populations, and under no circumstance should be allowed to fall to the wayside. Policy reform is necessary, in Nigeria and beyond, to ensure that commitments are met, and stakeholders and governments and held accountable.

In addition to efforts from national governments, it is the responsibility of the international community to play a complimentary role in delivering improved healthcare, including maternal care and midwifery, to the continent. The International Confederation of Midwives, of which I am Goodwill Ambassador, works closely with midwives and midwives associations to secure women’s rights and access to midwifery care before, during and after childbirth, providing a midwifery framework that is designed to improve maternal and newborn health and ensure that midwives associations have the tools necessary to be effective. The ICM’s triennial congress will be held in Toronto in June, and will bring together policymakers, ministers and former leaders from Africa, the USA and Canada to discuss the ICM’s strategy in combatting maternal deaths in the years to come, while showcasing the good works that are already in motion.

The ICM is not alone in tackling maternal mortality. Identifying the extent to which maternal care is lacking in Africa, the World Health Organization has created a curriculum for nurses and midwives for Africa, to address the knowledge and training deficit and generate tangible and sustainable change in the field of midwifery.

Africa has come a long way since the first declaration of World Africa Day in 1963, and of this we should be proud. But this does not negate the paramount importance of intensifying local, regional and global efforts to keep the momentum going. It is my hope that in my lifetime, no woman fears death during childbirth, and every child has the opportunity to live a happy and healthy life. This requires action: the future of Africa lies in our hands, we must act now.

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