View allAll Photos Tagged Midwifing
...is the book I'm reading.
another self portrait, sorryyyyy. that's what spending days by myself does to me.
sony a580, 1.8/50
This Nahua woman from Chililico, a pottery making town in Hidalgo Mexico, is a powerful curandera and midwife
Midwife Charlie Rae Young of Barefoot Birth is a Florida Licensed Midwife practicing in Tampa, FL. Photo courtesy of family and shared with permission.
Common Midwife Toad, Alytes obstetricans - tadpole
Series on white background
Njideka is a midwife in northern Nigeria – one of the most dangerous places in the world to give birth. Here, one in 23 women die in childbirth and one in ten newborns do not survive.
Background
In Spring 2012, the British Government launched a new scheme – Women for Health – to support 7,000 girls and women to train as health workers in northern Nigeria by 2016. The new skills they learn will help save the lives of thousands of mums, babies and children.
Find out more at www.dfid.gov.uk/ midwives-in-nigeria
Picture: Lindsay Mgbor/Department for International Development
Here I am in the mid 1980s as a fairly new midwife at Odstock Hospital, Salisbury, UK - in the days when I could wear a belt with a beautiful silver antique buckle that my parents gave me.
6 November 2015. Yambio: Midwife Veronica Bernat assists Josephine Emmanuelle, a pregnant woman ready to delivery at the hospital in Yambio, Western Equatoria. Photo by Albert Gonzalez Farran, UNDP - www.albertgonzalez.net
A third year midwifery student taking part in a practical training session on proper handwashing at the Korle Bu Nursing and Midwifery Training School in Accra, Ghana.
Credit: Kate Holt, JHPIEGO/MCSP
In Afghanistan we visited project sites of Healnet TPO, a Dutch based NGO with years of experience in Afghanistan. We visited project sites in Jalalabad and around to learn more on their midwifery programs that run throughout the government. Their policies have now been implemented by the Afghan government through the whole country.
In Afghanistan we visited project sites of Healnet TPO, a Dutch based NGO with years of experience in Afghanistan. We visited project sites in Jalalabad and around to learn more on their midwifery programs that run throughout the government. Their policies have now been implemented by the Afghan government through the whole country.
A LEGO vignette I made for a friend who graduated as a midwife. The box is printed on photopaper glued on cardboard.
Local call number: c002678
Title:Midwife weighing pregnany woman: Leon County, Florida
Date: 1944
Physical descrip: 1 photoprint - b&w - 5 x 4 in.
Series Title: State Board of Health
Repository: State Library and Archives of Florida, 500 S. Bronough St., Tallahassee, FL 32399-0250 USA. Contact: 850.245.6700. Archives@dos.myflorida.com
Persistent URL: floridamemory.com/items/show/44477
Phyllis Phaju Stevens (right), midwife at the Princess Christian Maternity Hospital, in Freetown Sierra Leone on June 18, 2015. Photo © Dominic Chavez/World Bank
For more information: www.worldbank.org/ebola/
Photo ID: World_Bank_Sierra_Leone_0923
Midwife Charlie Rae Young of Barefoot Birth is a Florida Licensed Midwife practicing in Tampa, FL. Photo courtesy of family and shared with permission.
KITGUM, Uganda, Oct 20, 2009 -- Stella, the head midwife of the Pajimo Clinic in rural Kitgum, Uganda, uses a Pinnard Horn - a wooden listening device to listen to a baby's heartbeat. The expectant mother was rushed into the clinic where Stella and a two Army Reserve Soldiers with the 7225th Medical Support Unit helped her deliver a 5.5 lb. baby boy about 90 minutes later.
U.S. Army photo by Maj. Corey Schultz
Army Reserve Nurse Delivers Baby in Rural Uganda
By Maj.Corey Schultz, U.S. Army Reserve Command
KITGUM, Uganda -- When 1st Lt. Victoria Lynn Watson deployed to Uganda for Natural Fire 10, she never imagined using her labor and delivery nursing skills during the exercise.
But when a Ugandan woman, Linda, arrived in labor at Pajimo medical clinic, where the Army Reserve's 7225th Medical Support Unit was partnering with East African medics to offer healthcare to the Kitgum community, Watson sprang into action.
She checked her watch. It was nearly 2:30 pm when medics hurried the 19-year-old expectant mother from the clinic gates where hundreds had gathered to receive care.
During the 10-day exercise, the medics run a daily clinic to treat upwards of 700 Ugandans a day for ailments such as arthritis, minor wounds, skin infections --and dental and optometry care. Soldiers from Uganda, Rwanda, Tanzania, Kenya and Burundi are working alongside U.S. troops on medical, dental and engineering projects in the Kitgum region. Meanwhile, each nation is also taking part in security training and a simulated disaster relief exercise.
While pregnancy was not a planned treatment, the Pajimo clinic staffs a midwife and Watson was eager to assist. If the U.S. Army Reserve officer were back home in Abilene, Texas, she would do the same.
"This is what I do. I'm a labor and delivery nurse in my civilian job," Watson said, hurrying past Ugandan families clutching medicines and awaiting dental checks, "This is what I live for."
Watson serves with the 7231st Medical Support Unit in Lubbock, Texas, but volunteered to augment the 7225th for Uganda.
Once in the clinics maternity ward, Watson and Pfc. Kendra Hinds, a U.S. Army Reserve medic from Lubbock, Texas, joined Stella, the Ugandan midwife. Stella asked the lieutenant to work with her to deliver the child.
Stella and her Ugandan assistant prepared the delivery room. Watson's examined the woman - nine centimeters and having contractions. Her watch read 3 p.m.
Hinds never helped a woman give birth. So, Watson talked her through the exam as they felt the mother's stomach to see where the baby was.
"You can feel the contractions," Watson said to Hines. "Her sides and belly get hard. Feel here...that's the head. It's in the right place, that's good. The baby is aligned right."
The midwife, Stella Betty Lamono – who goes by Stella, produced a Pinnard Horn - a wooden listening device not often seen in America that is used to hear the baby's heartbeat. Watson and Hinds took turns listening.
Then Stella posed a question.
"You are delivering," Stella said. "You should name the baby."
"OK, I'll name the baby," Watson said, in a light-hearted way. "How about, let's see...Gracie for a girl? Yes, I like Gracie."
"And a boy?" asked Stella.
"Okay, for a boy...Cage. I like Cage."
Stella translated. The mother smiled, amused despite her obvious discomfort. It was nearly 3:30 p.m., the baby was coming but the delivery team still had things to do. They tried to start an intravenous drip.
There was a problem, they couldn't find a vein. They spoke with the mother and found she had not eaten anything for two days.
"She's dehydrated, she needs something with sugar," Watson said.
Soldiers offered sweet powdered drink pack from their daily rations - MRE's, such as lemon-flavored ice tea and a lemon-lime electrolyte drinks.
Watson stirred each drink in a green plastic cup and gave it to the mother, who drank thirstily.
The team then found a vein for an IV, the mother tried to relax. From time to time, she would lift a pink curtain and gaze through the window into the dusty yard. Things quieted.
Meanwhile, her sister arranged swaddling clothes on the receiving table at the other side of the room.
"How many weeks is she?" Hinds asked.
"Thirty-eight," Stella said, confidently.
Ugandan midwives determine the duration of the pregnancy by feeling the stomach for the size of the baby's head versus the height of the fundus -- how high the uterus has pressed upwards into the diaphragm.
"This is amazing," Watson said. "In the States, doctors run a sonogram over the belly, ask for the date of the last menstrual period, and go from there. We learn the 'old school' way, but we never actually do it like Stella has."
Certified Ugandan midwifes attend a three-year school, Stella said, herself a midwife with seven years experience who delivers up to 28 babies each month -- often in rural clinics.
The contractions continued. The mother remained stoic despite the lack of any pain medicine. Sweat beaded on her face, veins throbbed along her neck. She would lay calm more moments, the moan softly and slap the nearby wall. Hinds grabbed a cloth and patted her face and held her hands through contractions.
"Most girls in the States would be yelling and hollering by now," Watson said.
Unlike in the States, the clinic had no monitors, electrical gadgetry or air conditioning. It did have clean water, sterilized equipment and a trained midwife, plus her U.S. counterparts.
It was around 4 p.m., when the mother groaned and slapped the wall again.
"She's in second stage," Watson said. "All she has to do now is push."
A few minutes passed, the mother began to push – Hinds held her hand and continued to comfort her. Then came a loud cry from a healthy baby boy. It was 4:30 p.m.
Watson wiped him down. He waved his tiny hands and stared around the room with large, alert eyes. Stella tied up the stump of the umbilical cord
"You delivered the baby, what name did you pick for a baby boy,” Stella said, reminding Watson.
“Cage," Watson replied. "But I can't name her baby. It's her baby!"
Hinds placed the infant into his mother's arms. The new mom smiled.
"What is she going to name him?" Watson asked. Stella translated. The mother answered --and Stella began to laugh.
"What did she say?" Watson asked.
"She decided she liked the name you picked," Stella said. "She named her little boy 'Cage'."
Outside, U.S. and East African medics were closing up for the day, handing out the final doses of vitamins and routine medications, when they learned the good news. An officer took out the records reflecting the number of people treated, changing 714 to 715, to add Cage - Kitgum's newest resident.
"It's pretty amazing there's a little one out here that I named and that I helped bring into this world," Watson said. "Pretty amazing."
To learn more about U.S. Army Africa visit our official website at www.usaraf.army.mil
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The midwives arrived shortly before 8 pm and start listening to the baby. All went well for several hours. Not much progress between midnight and 10 am the next day. Concerned that we may have to transfer to the hospital, we tried other labor positions and started to see quick progress. Griffin was born at our home at 11:47 am on November 14th 2009.
A midwife, Radhika, in rural Nepal prepares a vaccination for a newborn. Photo © Aisha Faquir/World Bank
Home birth midwife Charlie Rae Young of Barefoot Birth in Tampa FL. Charlie is a Florida Licensed Midwife, Certified Professional Midwife, and Certified Lactation Counselor.
Photo courtesy of photographer/family/archive and used with permission of the family.
JACKSONVILLE, Fla. (Sept. 22, 2022) - Kim Faust, a certified nurse midwife at Naval Hospital Jacksonville, reviews a birth control model with a patient. Faust, a native of Woonsocket, Rhode Island, holds a Master of Science in Nursing from Georgetown University and says, “My goal is to help women take control of their health throughout the stages of their lives.” October 2-8 is National Midwifery Week, recognize midwives and midwife-led care. (U.S. Navy photo by Deidre Smith, Naval Hospital Jacksonville/Released). #FacesofNHJax #MidwiferyWeek2022
Midwife Amichia Solange attends to Angelica Konate at Mouyassue Health Center in Côte d’Ivoire on 3rd March 2020. Angelica is six months pregnant and had come for a prenatal appointment where she received a dose of Sulfadoxine-Pyrimethamine (SP) to prevent malaria during pregnancy.
Photo Credit: Mwangi Kirubi, PMI Impact Malaria
Caption: KITGUM, Uganda, Oct 20 -- 1st. Lt. Victoria Lynn Watson (left) and Stella, the head midwife of the Pajimo Clinic in rural Kitgum, Uganda, work together to deliver a newborn. The 19-year-old mother arrived at the clinic run by U.S. and East African medical personnel and gave birth about 90 minutes later. Watson, a U.S. Army Reserve Soldier with the 7225th Medical Support Unit (MSU), is a labor and delivery nurse in her civilian occupation and was called upon to assist in the delivery. The mother asked Watson to name her son, and Watson chose the name "Cage." (Photo credit Maj. Corey Schultz, Army Reserve Communications.)
Full Story:
Army Reserve Nurse Delivers Baby in Rural Uganda
By Maj.Corey Schultz, U.S. Army Reserve Command
KITGUM, Uganda -- When 1st Lt. Victoria Lynn Watson deployed to Uganda for Natural Fire 10, she never imagined using her labor and delivery nursing skills during the exercise.
But when a Ugandan woman, Linda, arrived in labor at Pajimo medical clinic, where the Army Reserve's 7225th Medical Support Unit was partnering with East African medics to offer healthcare to the Kitgum community, Watson sprang into action.
She checked her watch. It was nearly 2:30 pm when medics hurried the 19-year-old expectant mother from the clinic gates where hundreds had gathered to receive care.
During the 10-day exercise, the medics run a daily clinic to treat upwards of 700 Ugandans a day for ailments such as arthritis, minor wounds, skin infections --and dental and optometry care. Soldiers from Uganda, Rwanda, Tanzania, Kenya and Burundi are working alongside U.S. troops on medical, dental and engineering projects in the Kitgum region. Meanwhile, each nation is also taking part in security training and a simulated disaster relief exercise.
While pregnancy was not a planned treatment, the Pajimo clinic staffs a midwife and Watson was eager to assist. If the U.S. Army Reserve officer were back home in Abilene, Texas, she would do the same.
"This is what I do. I'm a labor and delivery nurse in my civilian job," Watson said, hurrying past Ugandan families clutching medicines and awaiting dental checks, "This is what I live for."
Watson serves with the 7231st Medical Support Unit in Lubbock, Texas, but volunteered to augment the 7225th for Uganda.
Once in the clinics maternity ward, Watson and Pfc. Kendra Hinds, a U.S. Army Reserve medic from Lubbock, Texas, joined Stella, the Ugandan midwife. Stella asked the lieutenant to work with her to deliver the child.
Stella and her Ugandan assistant prepared the delivery room. Watson's examined the woman - nine centimeters and having contractions. Her watch read 3 p.m.
Hinds never helped a woman give birth. So, Watson talked her through the exam as they felt the mother's stomach to see where the baby was.
"You can feel the contractions," Watson said to Hines. "Her sides and belly get hard. Feel here...that's the head. It's in the right place, that's good. The baby is aligned right."
The midwife, Stella Betty Lamono – who goes by Stella, produced a Pinnard Horn - a wooden listening device not often seen in America that is used to hear the baby's heartbeat. Watson and Hinds took turns listening.
Then Stella posed a question.
"You are delivering," Stella said. "You should name the baby."
"OK, I'll name the baby," Watson said, in a light-hearted way. "How about, let's see...Gracie for a girl? Yes, I like Gracie."
"And a boy?" asked Stella.
"Okay, for a boy...Cage. I like Cage."
Stella translated. The mother smiled, amused despite her obvious discomfort. It was nearly 3:30 p.m., the baby was coming but the delivery team still had things to do. They tried to start an intravenous drip.
There was a problem, they couldn't find a vein. They spoke with the mother and found she had not eaten anything for two days.
"She's dehydrated, she needs something with sugar," Watson said.
Soldiers offered sweet powdered drink pack from their daily rations - MRE's, such as lemon-flavored ice tea and a lemon-lime electrolyte drinks.
Watson stirred each drink in a green plastic cup and gave it to the mother, who drank thirstily.
The team then found a vein for an IV, the mother tried to relax. From time to time, she would lift a pink curtain and gaze through the window into the dusty yard. Things quieted.
Meanwhile, her sister arranged swaddling clothes on the receiving table at the other side of the room.
"How many weeks is she?" Hinds asked.
"Thirty-eight," Stella said, confidently.
Ugandan midwives determine the duration of the pregnancy by feeling the stomach for the size of the baby's head versus the height of the fundus -- how high the uterus has pressed upwards into the diaphragm.
"This is amazing," Watson said. "In the States, doctors run a sonogram over the belly, ask for the date of the last menstrual period, and go from there. We learn the 'old school' way, but we never actually do it like Stella has."
Certified Ugandan midwifes attend a three-year school, Stella said, herself a midwife with seven years experience who delivers up to 28 babies each month -- often in rural clinics.
The contractions continued. The mother remained stoic despite the lack of any pain medicine. Sweat beaded on her face, veins throbbed along her neck. She would lay calm more moments, the moan softly and slap the nearby wall. Hinds grabbed a cloth and patted her face and held her hands through contractions.
"Most girls in the States would be yelling and hollering by now," Watson said.
Unlike in the States, the clinic had no monitors, electrical gadgetry or air conditioning. It did have clean water, sterilized equipment and a trained midwife, plus her U.S. counterparts.
It was around 4 p.m., when the mother groaned and slapped the wall again.
"She's in second stage," Watson said. "All she has to do now is push."
A few minutes passed, the mother began to push – Hinds held her hand and continued to comfort her. Then came a loud cry from a healthy baby boy. It was 4:30 p.m.
Watson wiped him down. He waved his tiny hands and stared around the room with large, alert eyes. Stella tied up the stump of the umbilical cord
"You delivered the baby, what name did you pick for a baby boy,” Stella said, reminding Watson.
“Cage," Watson replied. "But I can't name her baby. It's her baby!"
Hinds placed the infant into his mother's arms. The new mom smiled.
"What is she going to name him?" Watson asked. Stella translated. The mother answered --and Stella began to laugh.
"What did she say?" Watson asked.
"She decided she liked the name you picked," Stella said. "She named her little boy 'Cage'."
Outside, U.S. and East African medics were closing up for the day, handing out the final doses of vitamins and routine medications, when they learned the good news. An officer took out the records reflecting the number of people treated, changing 714 to 715, to add Cage - Kitgum's newest resident.
"It's pretty amazing there's a little one out here that I named and that I helped bring into this world," Watson said. "Pretty amazing."
To learn more about United States Army Africa or Natural Fire 10, visit us online at www.usaraf.army.mil
I didn't know it at the time I was there, but the Historic Dockyard is used for many of the exterior locations in Call the Midwife. I think the midwives ride their bicycles over these cobbles at the beginning of each episode. I'd really love to go back to the Dockyard for one of their Call the Midwife tours.
A skilled birth attendant (midwife), Radhika, consults with her patient in rural Nepal. Photo © Aisha Faquir/World Bank
During PBS’ CALL THE MIDWIFE session at the TCA Summer Press Tour in Los Angeles, CA on Saturday, July 21, 2012, actresses Helen George, Laura Main, Jessica Raine and producer Hugh Warren discuss the colorful stories of midwifery and families in London’s East End in the 1950s. (Premieres Sundays, September 30 to November 4, 2012)
All photos in this set should be credited to Rahoul Ghose/PBS.
time.com/26789/w-eugene-smith-life-magazine-1951-photo-es...
Original caption: A tuberculosis case, 33-year-old Leon Snipe, sat morosely on a bed while Maude arranged with his sister for him to go to a state sanatorium.
W. Eugene Smith/Life Pictures/Shutterstock
W. Eugene Smith’s Landmark Photo Essay, ‘Nurse Midwife’
“In December 1951, LIFE published one of the most extraordinary photo essays ever to appear in the magazine. Across a dozen pages and featuring more than 20 of the great W. Eugene Smith’ pictures, the story of a tireless South Carolina nurse and midwife named Maude Callen opened a window on a world that, surely, countless LIFE readers had never seen — and, perhaps, had never even imagined. Working in the rural South in the 1950s, in “an area of some 400 square miles veined with muddy roads,” as LIFE put it, Callen served as “doctor, dietician, psychologist, bail-goer and friend” to thousands of poor (most of them desperately poor) patients — only two percent of whom were white.”
“Nurse Midwife” as it appeared in the Dec. 3, 1951, issue of LIFE magazine.
archive.org/details/Life-1951-12-03-Vol-31-No-23/page/134...
During PBS’ CALL THE MIDWIFE session at the Television Critics Association Summer Press Tour in Los Angeles, CA on Tuesday, August 6, 2013, actress Miranda Hart discusses the third series of the hit British drama.
All photos in this set should be credited to Rahoul Ghose/PBS.
Midwife Charlie Rae Young of Barefoot Birth is a Florida Licensed Midwife practicing in Tampa, FL. Photo courtesy of family and shared with permission.
On 8/30/14, The Midwife Center for Birth & Women's Health hosted Black Women Do Breastfeed in celebration of the 2nd annual Black Breastfeeding Week.
Sherifa, 21, shows signs of following in her principal's determined footsteps. "I want to be like our principal, I see her as a mentor. She's very inspiring." Sherifa dreams of furthering her career to teach others to become midwives: "This is what I'm called for," she says. "This is what I'm suppose to do."
Background
In Spring 2012, the British Government launched a new scheme – Women for Health – to support 7,000 girls and women to train as health workers in northern Nigeria by 2016. The new skills they learn will help save the lives of thousands of mums, babies and children.
Find out more at www.dfid.gov.uk/midwives-in-nigeria
Picture: Lindsay Mgbor/Department for International Development
During PBS’ CALL THE MIDWIFE session at the Television Critics Association Summer Press Tour in Los Angeles, CA on Tuesday, August 6, 2013, actress Miranda Hart discusses the third series of the hit British drama.
All photos in this set should be credited to Rahoul Ghose/PBS.
During PBS’ CALL THE MIDWIFE session at the Television Critics Association Summer Press Tour in Los Angeles, CA on Tuesday, August 6, 2013, actress Miranda Hart discusses the third series of the hit British drama.
All photos in this set should be credited to Rahoul Ghose/PBS.
Opinion
Investing in midwives
By Dr Ghulam Nabi Kazi
May 10, 2022
Pakistan observed the International Day of the Midwife on May 5, which also marked the 100th anniversary of the International Confederation of Midwives (ICM) that together with the UNFPA and the WHO organizes the day. The main objective was to ensure that the global community recognized the importance of instituting quality midwifery programmes and amplifying the life-promoting work of this virtuous profession.
The WHO has also recently set out the Global Strategic Directions for Nursing and Midwifery 2021-2025 based on an interrelated set of policy priorities designed to help countries to ensure that midwives and nurses optimally contribute to achieving universal health coverage (UHC) and other population health goals. The document uses the terms “midwife” and “nurse” as different occupational groups by appreciating the professional distinction between midwives and nurses.
The government of Pakistan is determined to achieve the Sustainable Development Goals relating to health, particularly the attainment of UHC, by the year 2030. A major impediment in this colossal undertaking is an acute shortage and lopsided balance within the Human Resources for Health (HRH). Pakistan falls within the countries with the most acute shortage of HRH. While the WHO recommends a density of at least 45 doctors, nurses and midwives per 10,000 to attain UHC with one doctor for four nurses, midwives or lady health visitors (LHVs), Pakistan in end-2017, with a population of close to 208 million, was at 14.5 and that too with a lopsided balance.
The number of doctors was almost double the number of nurses, midwives and lady health visitors combined. This indicated that between 2018 and 2030 we have to bridge the 8-fold shortage in the number of nurses, midwives and lady health visitors by producing around 800,000 of these crucial professionals.
Until now we have focused mainly on maternal, neonatal and child health (MNCH) care in addition to communicable disease control and have yet to properly address the control of noncommunicable diseases such as cancer, diabetes, cardiovascular diseases and chronic respiratory diseases. Despite this focus, however, our maternal mortality rate, infant mortality rate and population growth rate are the highest in our region signifying that we are missing some crucial link.
When we use the term midwife, it refers to a woman who assists a prospective mother in childbirth. It stands to reason that professionals belonging to this cadre are likely to play the most pivotal role in improving our critical MNCH indicators and warrant our priority attention. However, midwifery was usually lumped with nursing, disallowing the profession to develop an identity of its own. Until quite recently when diploma programmes were the norm, candidates were admitted after 10 years of schooling to a four-year nursing training, only the last year of which was devoted to midwifery. Thus, the majority of registered diploma holders had little or no experience in deliveries.
After 1952, the government began establishing public health schools offering two-year courses for LHVs focusing on midwifery and essential elements of public health. Subsequently, the government launched a cadre of community midwives, which were not of adequate quality and failed to impact our indicators. Later, the Pakistan Nursing Council allowed registered nurses to undertake a two-year Bachelors’ programme in Midwifery in the Aga Khan University Karachi and later at the Dow University of Health Sciences Karachi.
Meanwhile, in the run up to attaining UHC, the Ministry of National Health Services, Regulation and Coordination developed a PC-I for the strengthening of the nursing and midwifery sub-sector in 2019, which called for four-year degree programmes in nursing and midwifery after 12 years of schooling. However, a lot of time was taken up in apportioning the share of federal and provincial costs and subsequently a PC-I at federal level was approved, which has not taken off yet due to lack of releases in view of the Covid-19 response and other funding modalities.
What is important is that the federal and provincial governments have resolved to do away with nursing and midwifery diploma programmes and shifted to four-year Bachelors’ programme after FSc. They have also agreed to institute a two-year bridging programme for registered nurses leading to a BSc in Nursing or Midwifery will also be available.
The good news is that after an extensive dialogue with several stakeholders, an advanced draft of the Midwifery Strategy has been developed based on which each province can draw up its strategic framework and operational plan. The principal and foremost consideration of the strategy is to establish a separate, distinct and discrete identity for the midwifery profession and not obscure it as part of nursing.
The strategy also envisages reducing the overlapping in some related cadres in the health and population sectors that could be merged with the midwifery cadre after establishing the bridging programmes. Efforts will also be made to ensure that midwives enjoy the same career pathways allowed to nurses (Grade 16-20) or even higher by changing the nomenclature of certain positions, reserving certain positions manned by doctors for midwives and creating new positions. This is important as currently very low grades are allowed to midwives and lady health visitors with no opportunities for personal or professional growth.
The Pakistan Nursing Council Act should be renamed the Pakistan Nursing and Midwifery Council, while incorporating a code of conduct relating to the practice of midwifery to remove any ambiguity. The larger schools of nursing recently upgraded as colleges of nursing should apportion a significant proportion of their seats for midwifery as well, while all the 27 public health schools producing LHVs in Pakistan should also be upgraded as midwifery colleges.
The federal MoNHRSC should expedite its support for the upgraded colleges in faculty development and provision of equipment for skills laboratories, anatomy laboratories, science laboratories, IT laboratories, audiovisual laboratories, library books/journals and access to online databases to maintain a high quality of teaching. The provincial governments should also work on the upgradation of these institutions on a priority basis.
New positions of midwives will need to be created at all levels of the health system, including teaching hospitals, district headquarter hospitals, tehsil headquarter hospitals, rural health centers and basic health units where female paramedics are not available. The MoNHRSC and PNC need to ensure uniformity and standardization in the implementation of all public policies relating to midwives to establish similar job descriptions, roles and responsibilities for all the professionals.
Each province will need to decipher the exact number of midwifery professionals required by 2030 in order to attain UHC, based on an accurate needs analysis in each district within their jurisdiction. Efforts must be made to adhere to the ICM standards for accreditation, advocacy, autonomy, admissions, assessments, competence, curriculum, and midwife-led continuity of care, educational standards of care and their evaluation process including continuing education.
Moving forward these strategy elements need to be rapidly endorsed by all stakeholders as soon as practicable so that the provincial operational plans can be developed on a priority basis along with an equitable allocation of funds. Planning should be carried out realistically with achievable targets and foreseeing challenges together with the means to mitigate them. However, the bar should be set high so as not to compromise on the quality of education imparted.
These measures can enable Pakistan’s coveted dream of bringing down its indicators for maternal and child health to acceptable levels, while attaining Sustainable Development Goal No 3 encompassing Universal Health Coverage by the stipulated timeframe of 2030.
The writer is a senior public health specialist and editor-in-chief of the Public Health
Action journal of the International Union Against Tuberculosis and Lung Diseases.