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The State of the World’s Midwifery 2021 report: findings to drive global policy and practice

The State of the World’s Midwifery 2021 report: findings to drive global policy and practice
The State of the World’s Midwifery 2021 report: findings to drive global policy and practice

The third global State of the World’s Midwifery report (SoWMy 2021) provides an updated evidence base on the sexual, reproductive, maternal, newborn and adolescent health (SRMNAH) workforce. For the first time, SoWMy includes high-income countries (HICs) as well as low- and middle-income countries. This paper describes the similarities and differences between regions and income groups, and discusses the policy implications of these variations. SoWMy 2021 estimates a global shortage of 900,000 midwives, which is particularly acute in low-income countries (LICs) and in Africa. The shortage is projected to improve only slightly by 2030 unless additional investments are made. The evidence suggests that these investments would yield important returns, including: more positive birth experiences, improved health outcomes, and inclusive and equitable economic growth. Most HICs have sufficient SRMNAH workers to meet the need for essential interventions, and their education and regulatory environments tend to be strong. Upper-middle-income countries also tend to have strong policy environments. LICs and lower-middle-income countries tend to have a broader scope of practice for midwives, and many also have midwives in leadership positions within national government. Key regional variations include: major midwife shortages in Africa and South-East Asia but more promising signs of growth in South-East Asia than in Africa; a strong focus in Africa on professional midwives (rather than associate professionals: the norm in many South-East Asian countries); heavy reliance on medical doctors rather than midwives in the Americas and Eastern Mediterranean regions and parts of the Western Pacific; and a strong educational and regulatory environment in Europe but a lack of midwife leaders at national level. SoWMy 2021 provides stakeholders with the latest data and information to inform their efforts to build back better and fairer after COVID-19. This paper provides a number of policy responses to SoWMy 2021 that are tailored to different contexts, and suggests a variety of issues to consider in these contexts. These suggestions are supported by the inclusion of all countries in the report, because it is clear which countries have strong SRMNAH workforces and enabling environments and can be viewed as exemplars within regions and income groups.

Health workforce, Human resources for health, Midwifery, Midwives, Sexual, reproductive, maternal, newborn and adolescent health
1478-4491
Nove, Andrea
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ten Hoope-Bender, Petra
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Boyce, Martin
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Bar-Zeev, Sarah
ad8e3750-2c2f-4f9e-95b3-de14eb1574be
de Bernis, Luc
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Lal, Geeta
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Matthews, Zoë
ebaee878-8cb8-415f-8aa1-3af2c3856f55
Mekuria, Million
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Homer, Caroline S.E.
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Nove, Andrea
91c50c0f-ae3d-482f-b5f0-f981d703c0fe
ten Hoope-Bender, Petra
1cebd8b5-c9aa-4c3d-9c1b-175edb08fc13
Boyce, Martin
2da3ba68-a566-401a-a71b-ebd5d3ef43b6
Bar-Zeev, Sarah
ad8e3750-2c2f-4f9e-95b3-de14eb1574be
de Bernis, Luc
85a35a15-4f9b-436c-a085-205f3788eb15
Lal, Geeta
e4deca3d-ef63-4559-9cd1-9772d4f31ad1
Matthews, Zoë
ebaee878-8cb8-415f-8aa1-3af2c3856f55
Mekuria, Million
1640935c-d3e0-4179-a881-e815e5ceb48f
Homer, Caroline S.E.
e6b96d2a-fbe2-4f31-b5ac-f46ea2c0cbfc

Nove, Andrea, ten Hoope-Bender, Petra, Boyce, Martin, Bar-Zeev, Sarah, de Bernis, Luc, Lal, Geeta, Matthews, Zoë, Mekuria, Million and Homer, Caroline S.E. (2021) The State of the World’s Midwifery 2021 report: findings to drive global policy and practice. Human Resources for Health, 19 (1), [146]. (doi:10.1186/s12960-021-00694-w).

Record type: Article

Abstract

The third global State of the World’s Midwifery report (SoWMy 2021) provides an updated evidence base on the sexual, reproductive, maternal, newborn and adolescent health (SRMNAH) workforce. For the first time, SoWMy includes high-income countries (HICs) as well as low- and middle-income countries. This paper describes the similarities and differences between regions and income groups, and discusses the policy implications of these variations. SoWMy 2021 estimates a global shortage of 900,000 midwives, which is particularly acute in low-income countries (LICs) and in Africa. The shortage is projected to improve only slightly by 2030 unless additional investments are made. The evidence suggests that these investments would yield important returns, including: more positive birth experiences, improved health outcomes, and inclusive and equitable economic growth. Most HICs have sufficient SRMNAH workers to meet the need for essential interventions, and their education and regulatory environments tend to be strong. Upper-middle-income countries also tend to have strong policy environments. LICs and lower-middle-income countries tend to have a broader scope of practice for midwives, and many also have midwives in leadership positions within national government. Key regional variations include: major midwife shortages in Africa and South-East Asia but more promising signs of growth in South-East Asia than in Africa; a strong focus in Africa on professional midwives (rather than associate professionals: the norm in many South-East Asian countries); heavy reliance on medical doctors rather than midwives in the Americas and Eastern Mediterranean regions and parts of the Western Pacific; and a strong educational and regulatory environment in Europe but a lack of midwife leaders at national level. SoWMy 2021 provides stakeholders with the latest data and information to inform their efforts to build back better and fairer after COVID-19. This paper provides a number of policy responses to SoWMy 2021 that are tailored to different contexts, and suggests a variety of issues to consider in these contexts. These suggestions are supported by the inclusion of all countries in the report, because it is clear which countries have strong SRMNAH workforces and enabling environments and can be viewed as exemplars within regions and income groups.

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More information

Accepted/In Press date: 16 November 2021
e-pub ahead of print date: 27 November 2021
Published date: December 2021
Additional Information: Funding Information: Funding for the SoWMy report and this paper was provided by the New Venture Fund. The funder had no role in the study design, data collection, data analysis/interpretation or writing. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
Keywords: Health workforce, Human resources for health, Midwifery, Midwives, Sexual, reproductive, maternal, newborn and adolescent health

Identifiers

Local EPrints ID: 454651
URI: http://eprints.soton.ac.uk/id/eprint/454651
ISSN: 1478-4491
PURE UUID: 93e4c297-0016-48aa-9fad-ec612877311f
ORCID for Zoë Matthews: ORCID iD orcid.org/0000-0003-1533-6618

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Date deposited: 17 Feb 2022 17:52
Last modified: 18 Mar 2024 02:40

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Contributors

Author: Andrea Nove
Author: Petra ten Hoope-Bender
Author: Martin Boyce
Author: Sarah Bar-Zeev
Author: Luc de Bernis
Author: Geeta Lal
Author: Zoë Matthews ORCID iD
Author: Million Mekuria
Author: Caroline S.E. Homer

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