Country experience with strengthening of health systems and deployment of midwives in countries with high maternal mortality
Van Lerberghe, W.; Matthews, Z.; Achadi, E.; Ancona, C.; Campbell, J.; Channon, A.; de Bernis, L.; De Brouwere, V.; Fauveau, V.; Fogstad, H.; Koblinsky, M.; Liljestrand, J.; Mechbal, A.; Murray, S.F.; Rathavay, T.; Rehr, H.; Richard, F.; ten Hoope-Bender, P.; Turkmani, S.
Lancet 384(9949): 1215-1225
2014
ISSN/ISBN: 1474-547X PMID: 24965819 DOI: 10.1016/s0140-6736(14)60919-3Document Number: 624776
This paper complements the other papers in the Lancet Series on midwifery by documenting the experience of low-income and middle-income countries that deployed midwives as one of the core constituents of their strategy to improve maternal and newborn health. It examines the constellation of various diverse health-system strengthening interventions deployed by Burkina Faso, Cambodia, Indonesia, and Morocco, among which the scaling up of the pre-service education of midwives was only one element. Efforts in health system strengthening in these countries have been characterised by: expansion of the network of health facilities with increased uptake of facility birthing, scaling up of the production of midwives, reduction of financial barriers, and late attention for improving the quality of care. Overmedicalisation and respectful woman-centred care have received little or no attention.