‘Gender inequality’ fuels 1 million midwife shortage

到2035年，助产士每年可以预防430万婴儿和孕产妇死亡，但前提是解决严重短缺。

So says a report on the global state of midwifery which highlights the limited investment, gender disparities and inequitable access to education that has resulted in gaps in maternal health services – especially in the low-income countries that need them most.

国际助产士联邦首席执行官萨利·帕曼（Sally Paimman）说：“有证据表明，通过对助产士的投资对妇女和家庭的投资是有效的。”“如果政府想要健康的人口，他们必须认真对待这一点。”

“许多[女孩]无法获得基础教育。没有这些，就不可能考虑诸如助产士之类的高等教育选择。”

Pauline Bakibinga，非洲人口和健康研究中心副研究科学家

助产士是性，生殖，孕产妇，新生儿和青少年健康（SRMNAH）劳动力的核心成员。负责提供产前和产后护理，他们还提供计划生育，检测和治疗性传播感染，并为各种社区医疗保健需求做出贡献。

However, there is currently a global shortage of 900,000 midwives, according to the2021 State of World’s Midwifery报告于5月5日由国际助产士和合作伙伴国际联合会（WHO）和联合国人口基金发表。

该报告记录了世界上的SRMNAH劳动力，包括来自所有194名WHO成员国的数据。它建立在2011年和2014年发布的系列中的先前报告的基础上，以显示110万全职SRMNAH工人的全球差距，主要是助产士，主要是非洲。

Pauline Bakibinga, an associate research scientist at the African Population and Health Research Center, based in Nairobi, Kenya, said: “This is a result of years of limited investments in the health sectors of especially the low- and middle-income countries (LMICs), which as no surprise have the worst SRMNAH indicators.”

One in three births globally will take place in Africa by 2050, according to theWHO。In the Sub-Saharan African region alone, fewer than 50 per cent of all births are assisted by a skilled birth attendant,says the body。

Poor work conditions, limited career opportunities and low pay push midwives out of Africa and on to wealthier nations in search of better opportunities, says Bakibinga. Those who stay are often inadequately skilled.

“一些机构仍有一个狭窄的关注midwifery without empowering graduates to attend to the wider needs of their patients,” she added, calling for updated curricular and financial support to boost training programmes.

“Strategic partnerships with countries that receive midwives from LMICs are also necessary to share best practices and identify strategies to ensure that countries retain well trained and motivated professionals,” she says.

Over 90 per cent of the midwifery workforce are women in countries that submitted data to the report. Only half reported having midwife leaders within the national ministries of health.

“Gender stratification in midwifery persists and reflects a bigger challenge within the health sector with women taking on more service delivery roles while men tend to be in leadership positions,” Bakibinga says.

Access to education is another barrier to midwifery in low-income countries, says Kate Wade, a Cape Town-based midwife who has practiced across the continent including in Benin, Sierra Leone, Ethiopia and Tanzania.

“Many don’t have access to basic education. Without that, it’s impossible to think about tertiary education options like midwifery,” she says. In some regions, women are barred from education opportunities in general.

In Sub-Saharan Africa, nine million girls will never attend school, compared to six million boys according toUNESCO。

性别据Pairman称，助产士国际联合会的说法，不平等可能是助产士职业障碍的根源。“直到政府开始解决这些问题并带来更多性别阳性的政策和流程，障碍将继续。”

对于韦德来说，直到女性的健康增长到尽可能多的关注，才会发生变化COVID-19to draw the necessary political and financial will.

The pandemic has underscored the value of midwifery amid overburdened health systems, the closing of maternity facilities, and fears among women of attending hospital.

“我们已经看到世界许多地方的助产士能够保持这些服务的运行。他们已经有创造力，面临着在社区中提供护理的风险。”“我们需要投资于助产士作为主要卫生服务，以从大流行中更好地恢复。”