The State of the World’s Midwifery 2021

The State of the World’s Midwifery (SoWMy) 2021 presents findings on the Sexual, Reproductive, Maternal, Newborn and Adolescent Health (SRMNAH) workforce from 194 countries. The report, produced by UNFPA, the International Confederation of Midwives (ICM), the World Health Organization (WHO) and Novametrics, shows the progress and trends since the inaugural 2011 edition and identifies the barriers and challenges to future advancement. The report establishes a global shortage of 1.1 million SRMNAH workers, the largest shortage (900,000) being midwives.

Investment is urgently needed in education and training; management, regulation and work environment; leadership and governance, and service delivery. Analysis indicates that fully educated, licensed and integrated midwives supported by interdisciplinary teams can deliver about 90 per cent of the essential SRMNAH interventions across the life course, yet they account for less than 10 per cent of the global SRMNAH workforce. For midwives to achieve their full potential, bold investments by governments, policymakers, regulatory authorities, educational institutions, professional associations, international organisations, global partnerships, donor agencies, civil society organisations and researchers are needed at country, regional and global levels.

Highlights

• Midwives can provide about 90% of the sexual, reproductive, maternal, newborn and adolescent health (SRMNAH) care needed, yet they account for less than 10% of the global SRMNAH workforce.
• The world needs 900,000 more midwives, mostly in low-income countries and in Africa.
• At current rates, there will still be a shortage of 750,000 midwives in 2030.
• Without additional investment the gap between rich and poor countries is projected to widen by 2030.

Investment is urgently needed in four areas:

Health workforce planning, management and working environment

• Optimize midwives’ autonomy and scope of practise.
• Provide an enabling work environment, free from gender-related stigma, violence and discrimination.

High-quality education and training

• Competent educators and trainers, equitably distributed.
• Well-resourced education and training institutions.

Midwife-led improvements to service delivery

• Midwife-led models of care
• Optimized roles for midwives

Midwifery leadership and governance

• Senior midwife positions in government, research and education
• Midwives drive SRMNAH policy