International Day Of The Midwife
In addition to assisting in childbirth, midwives serve as the main source of health care for millions of women. In many countries IntraHealth has worked to develop and support the profession of midwifery and to help midwives provide vital services to women and families in need. Current highlights of this work include projects in Mali, Senegal and Ethiopia. In Mali, IntraHealth has trained midwives in active management of the third stage of labor (AMTSL), a life-saving practice to reduce postpartum hemorrhage, the leading cause of maternal death in developing countries. In turn, through a pilot project of the USAID-funded Prevention of Postpartum Hemorrhage Initiative (POPPHI) and the IntraHealth-led Capacity Project, the midwives are helping to train a cadre of skilled health care providers known as matrones. The project is designed to show that matrones can also safely perform AMTSL (including the administration of oxytocic drugs). Authorization of matrones to provide this service will enable many more Malian women to be reached with AMTSL.
In Senegal, IntraHealth is engaging midwives to help correct misconceptions about family planning through the Maternal, Neonatal and Child Health/Family Planning Project. Maternal mortality is the leading cause of death among Senegalese women of reproductive age. A high fertility rate (5.3 children per woman), underutilization of modern contraceptives and socio-cultural barriers to family planning exacerbate this problem. IntraHealth believes that working with midwives—the health care personnel closest to most Senegalese women—will encourage healthier family planning practices.
The IntraHealth-led Hareg Project in Ethiopia has teamed up with midwives to address Ethiopia's high pediatric HIV rates. Without preventive treatment between 20 and 45% of HIV-positive women pass the virus to their children during pregnancy and delivery and through breastfeeding. When pregnant women know their HIV status they can take steps to reduce the risk of transmission to less than 5%. Through Hareg, midwives have been trained to help pregnant women get tested for HIV and, if infected, to help them get appropriate care. In their communities, Hareg-associated midwives are also working to reduce stigma and discrimination against people with HIV.
Other IntraHealth projects over the past five years have assisted midwives in improving pre-service education (Rwanda), strengthening services for adolescents (Ghana), scaling-up postabortion care (Kenya), expanding their scope of work in maternal and infant health (rural Armenia) and supporting their inclusion in the national professional association for ob/gyns (Ukraine).
In all of these activities, IntraHealth builds on the key role of midwives in providing access to safe motherhood, family planning and other services that would otherwise be unavailable to those who need them. As the theme of this year's International Day of the Midwife proclaims: "Midwives reach out to women—wherever they live."