1. Access to quality midwifery care for women and newborns: findings from the State of the World’s Midwifery 2011. Track 4: Global access to care for women and children. 7 th European Congress on Tropical Medicine and International Health Wednesday 5 th October 2011. Jim Campbell Director ICS Integrare, Barcelona, Spain jim.campbell@integrare.es

2. June 2010 Concept (Women Deliver) November 2010 NORAD/UNFPA commission Dec 2010 – Feb 2011 Country survey Mar – June 2011 Report and launch

6. MIDWIFERY – the INTERVENTION MIDWIFERY - the PROFESSION intervention is practised not only by “midwives”. – ‘skilled birth attendants’ – ‘community health workers’ – ‘traditional birth attendants’ respective cadres have (some) competencies COMPETENCIES in the COMMUNITY

8. Summary messages 1.Practising workforce (and quality) not known 2.Inadequate numbers – inequitable coverage 3.‘Triple gap’ – competencies, coverage, access 4.Education, regulation, professional association – weak 5.Policy coherence – missing “Failed to reach” NOT “Hard to reach”

9. MDG5.2 – 95% births assisted by a SBA Estimates for ‘practising’ collated by WHO 38 countries – 112,000 more midwives needed 20 countries – volume, but distribution, utilisation, quality etc remain barriers (still low % SBA) 9 countries: x 6 to 15 7 countries: x 3 to 4 22 countries: x 2

10. Conditions for achieving quality 1.Education, Regulation and Professional association development 2.Access to facilities and referral mechanisms 3.Human resource management based on ‘Strategic Intelligence’ 4.National health plans and policies integrating human resources for maternal health

11. LiST - Impact of increased coverage of midwifery (Bartlett L, Sikder S, Friberg I. - JHSPH) Double the current access to practising midwives => 21% reduction of maternal, foetal and newborn deaths Add universal coverage of all births in a BEmONC facility with midwives => 56 % reduction Total: 3.6 million lives saved in 2015 – 61% of maternal deaths, – 49% of foetal deaths, and – 60% of newborn deaths

12. “Ensuring that every woman and her newborn have access to quality midwifery services demands that we take bold steps” Ban Ki-moon, Secretary-General of the United Nations

13. Sept 2011 UNGA / EWEC 2011-12 Country studies (x 7) Sept 2012 EWEC Progress report Sept 2012 The Lancet Special Series on Midwifery

14. Special Series on Midwifery September 2012

15. Report (EN, FR, SP) www.stateoftheworldsmidwifery.org Further information: Jim Campbell ICS Integrare C. Diputacio 262 08007 Barcelona Spain jim.campbell@integrare.es