Kenya is among countries that have an acute shortage of midwives, a UN report shows.
According to the ‘State of the World Midwifery Report 2021,’ Kenya has only 2,092 midwives against the required number of at least 28,000.
The report was prepared by the World Health Organization, UNFPA and the International Confederation of Midwives.
Just one midwife attends to at least 10,000 people at any given time in Kenya according to the report.
It projects the situation to be worse by 2030 should no investment be made in addressing the shortage, with the demand for midwifes expected to rise to 32,000 in 2025 and 34,000 by 2030.
Out of the 58,079 community health workers that Kenya has, only 5,808 have dedicated 10 per cent of their time to provision of sexual, reproductive, maternal and new-born health services.
At least 6,200 more community health workers are needed.
The report shows that only 62 out of 100 pregnant women are attended to by skilled birth attendants.
The maternal mortality stands at 342 per 100,000 live births, neonatal mortality rate stands at 20 per 1,000 live births while stillbirth rate stands at 20 per 1,000 live births.
“Increased investment in midwives could save up to 4.3 million lives every year by averting 67 per cent of maternal deaths, 64 per cent of neonatal deaths and 65 per cent of stillbirths globally,” UNFPA representative Dr Ademola Olajide says.
He adds: “Investing in midwives is one of the most cost effective strategies to achieving universal sexual and reproductive health coverage and realisation of reproductive rights of women.”
The report says 20,549 out of the 46,703 nursing professionals without midwifery training in the country have dedicated 44 per cent of their time to offer the services.
Kenya has 5,602 general medical practitioners out of whom 1,120 have dedicated 20 per cent of their time to offer maternal and new-born services.
Similarly, half of the 400 gynecologists and 51 of the 339 paediatricians in the country have dedicated 50 per cent and 15 per cent of their time respectively to offer such services.
“In the ongoing Covid-19 pandemic, Kenyan midwives have put their own lives at risk to bring life into this world, working in difficult hospital environments and sometimes venturing outside health facilities to provide much needed care to mothers and new-borns,” Health CAS Mercy Mwangangi said.
“The knowledge base of the midwife must be widened through additional education to allow complex decision-making skills and clinical competence for expanded practice,” she added.
From the report, Kenya has one midwife at the national government leadership, 337 at the sub national level at three in regulatory authorities.
“Limited opportunities for midwives to hold leadership positions and the scarcity of women who are role models in leadership positions hinder midwives’ career advancement and their ability to work to their full potential,” the report says.
Kenya is not the only country grappling with the shortage of midwives.
There is a global shortage of 900,000 midwives, a number that could worsen if no investment is made.
In neighbouring Uganda for instance, the ratio is two midwives per 100,000 people. The country has 9,802 midwives with a maternal mortality ratio of 375 per 100,000 live births and with annual pregnancies of 2.3 million.
Somalia on the other hand has just 677 midwives with the maternal mortality and neonatal mortality standing at 829 per 100,000 live births and 37 per 1,000 live births respectively. The annual number of pregnancies in the country stands at 925,015.
Fully educated, licensed and integrated midwives supported by interdisciplinary teams and an enabling environment can deliver about 90 per cent of essential SRMNAH interventions across the life course, the report says.
“For midwives to achieve their potential, greater investment is needed in four key areas: education and training; health workforce planning, management and regulation and the work environment; leadership and governance; and service delivery.”
Edited by P.O
