Midwives not only help to ensure sexual and reproductive health – they save lives.
Greater numbers of well-trained midwives could help avert roughly two thirds of all maternal and newborn deaths and stillbirths. They can deliver 90 per cent of all essential sexual, reproductive, maternal and newborn health services. Yet because of a lack of investment and support, they account for only 10 per cent of the global health workforce.
Since 2008, UNFPA has collaborated with partners and governments to build a skilled and supported midwifery workforce in low-resource settings, focusing on these key areas: advocating for investments in midwifery models of care; strengthening midwifery education and training; preparing midwives to deliver comprehensive and integrated sexual, reproductive, maternal, newborn and adolescent health services; establishing an enabling environment and regulatory mechanisms for midwives to ensure quality services; and raising the voices of midwives by strengthening the leadership of midwifery associations and young leaders.
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Why are midwives needed?
Every day, more than 700 women and 6,300 newborns die during pregnancy and childbirth, and 5,200 babies are stillborn. Additionally, for every woman who loses her life, between 20 and 30 experience serious complications, often leading to lasting health challenges and disabilities. In under-resourced crisis and conflict settings, these figures are only intensified; more than two thirds of global maternal deaths occur in sub-Saharan Africa, which has seen multiple humanitarian emergencies and wars proliferate over the past years.
Most of the deaths are preventable with proper antenatal, childbirth and postnatal services provided by midwives. Beyond preventing maternal and newborn deaths, quality midwifery care improves more than 50 other health-related outcomes and contributes to fewer interventions such as Caesarean sections.
Midwives are crucial
Midwives work in partnership with women to ensure respectful, person-centred care, using culturally appropriate practices and evidence-based interventions for optimal health outcomes.
In emergency situations, midwives are pivotal to accessing treatment that can save lives. As first responders, they meet the most urgent demands by deploying the Minimum Initial Service Package for Sexual and Reproductive Health in Crisis Situations.
Beyond pregnancy care and childbirth, well-trained midwives provide comprehensive sexual and reproductive health information and services, and are critical in promoting health within their communities. They provide family-planning counselling and services, as well as screening, information and support for breast, cervical and other reproductive health cancers and non-communicable diseases of reproductive health significance. Midwives also help prevent and respond to female genital mutilation and obstetric fistula and can support survivors of gender-based violence. And they provide sexual and reproductive health services to adolescents, who often face barriers in access at a great cost to their health and rights, including through unintended pregnancies.
Challenges and barriers midwives face
Despite the fact that properly trained and supported midwives offer one of the most cost-effective and person-centred approaches to achieving universal healthcare, the world is short of 900,000 midwives. Midwives often don’t receive adequate training or funding, and work in restrictive environments that prevent them from reaching their full potential. These deficits and barriers are highest in the areas where the needs are greatest, particularly in Africa.
Midwives also face significant discrimination and challenges: They endure heavy workloads with poor pay and limited career-advancement opportunities, and can be confronted with disrespectful attitudes. With women accounting for 90 per cent of midwives, gender inequality is often at the root of the problems they experience.
What is UNFPA doing?
Together with partners, UNFPA works to strengthen quality midwifery education, policies, regulations and midwifery associations and leadership around the world. It supports over 125 countries, including those with the highest rates of maternal mortality, with tailored support through the UNFPA Maternal and Newborn Health Fund.
UNFPA and partners recently launched the global Midwifery Accelerator, aimed at improving maternal and newborn health outcomes by scaling up midwifery models of care. The initiative offers governments, funding partners and stakeholders a clear set of priorities to optimize investments and achieve measurable impact in line with the Start with Her: UNFPA Strategy for Reproductive, Maternal and Newborn Health and Well-Being 2025–2030. Details on the three pillars and seven priorities of the initiative are outlined in the chart below.
Through the Maternal and Newborn Health Fund, UNFPA has educated and trained more than 776,000 midwives and other sexual and reproductive healthcare professionals, and equipped more than 1,600 midwifery schools with training equipment and materials. More than 750 midwifery schools in developing countries are now accredited to national or international standards, and a growing number are launching higher-education programmes for midwives, including bachelor’s, master’s and Ph.D. degrees.
As of 2024, UNFPA has also supported the training of more than 80,000 midwifery educators and commissioned a study to explore the pathways to becoming an educator, the challenges they experience in the role and the ways their professional development. To standardize the quality of midwifery education globally, UNFPA is leading the development of a sample curriculum for direct-entry midwifery, in addition to a post-nursing curriculum.
UNFPA supports more than 80 national midwifery associations and more than 200 sub-national branches of midwifery associations. In collaboration with national nursing and midwifery councils and governments, UNFPA works to ensure the profession is well regulated and autonomous, with a clear scope of practice and a defined title of a “midwife”.
UNFPA has also commissioned a global study on the policy and regulatory barriers and enablers affecting midwives’ scope of practice. In addition, with the International Confederation of Midwives and the World Health Organization, UNFPA provides invaluable data through the State of the World’s Midwifery reports to demonstrate progress and trends and identify barriers to future investment. In 2024, UNFPA launched an updated State of the World’s Midwifery in Eastern and Southern Africa report and the Midwifery Education in Eastern Europe and Central Asia report. Others include the 2022 State of the Midwifery Workforce in the Arab Region.
In humanitarian and fragile settings, UNFPA supports the critical needs of women and girls by providing life-saving care, distributing essential supplies and supporting safe spaces and reporting mechanisms for survivors of violence. UNFPA is in the process of developing programmatic guidance for midwives as front-line actors in humanitarian response.
UNFPA is also researching how gender inequality shapes midwives’ professional experience and capacity to deliver quality maternal and newborn care in Benin, Côte d’Ivoire, Ethiopia, Namibia, Senegal and Zambia. The findings will be catalytic in designing strategies for intervention and policy development to enhance the overall work environment for midwives and support their important role within the health system.
The power of partnerships
Since it was highlighted in the Global Strategy for Women’s, Children’s and Adolescents’ Health launched by the UN Secretary-General in 2015, more governments are recognizing the value of investing in quality midwifery care. Yet these investments remain inadequate. UNFPA has joined with partners to continue advocating for enhanced and coordinated investments in quality midwifery education and services.
One major advancement is the Alliance to Improve Midwifery Education, established in 2021 and comprising UNFPA and partners such as the Burnet Institute, the International Confederation of Midwives, Jhpiego, Laerdal Global Health, the Liverpool School of Tropical Medicine, UNICEF and the World Health Organization. This global partnership aims to improve the quality of care for women, newborns and their families by strengthening midwifery education, professional development and faculty skills. Supporting countries’ implementation of the Framework of Action for Strengthening Quality Midwifery Education, the alliance works with a consortium of global partners to create and develop tools, knowledge products and cross-country research, and to facilitate learning to accelerate progress in strengthening midwifery education.
In 2023, working with more than 20 global partners, UNFPA organized the Fifth Global Midwifery Symposium at the International Maternal Newborn Health Conference. At the symposium, the partners launched a Global Call to Action and Commitment, highlighting the critical role midwives play in improving health outcomes worldwide and the importance of strengthening quality midwifery models of care.
The global Midwifery Accelerator described above builds on this momentum and marks a new era of global partnerships.
Updated 15 July 2025
