Review article
Professionals with Delivery Skills: Backbone of the Health System and Key to Reaching the Maternal Health Millennium Development Goal
Meg Wirth
; Shool of Public Health, Columbia
Abstract
The attainment of the fifth Millennium Development Goal requires adequate
national reserves of skilled birth attendants. Nurses, midwives,
and their equivalents form the frontline of the formal health system are
a critical element of global efforts to reduce ill-health and poverty in the
poorest areas of the world. Planning and policies supporting these cadres
of workers must be placed high on the development agenda and championed
by key international and national players. This article first sets forth
an argument for the equity and efficiency of nurses, midwives, and their
equivalents as the cadre largely responsible for maternal health. Second, it
traces the root causes of neglect of this critical cadre, including a vacuum
in political will in the context of poverty, lack of protections for frontline
workers, the historical political position of the field of midwifery, lack
of a pipeline of secondary school graduates, and gender inequity. Investment
in the largely female cadre that cares for the majority of the world’s
poorer women has simply not been a high enough priority. Five key
policy recommendations include harnessing political will and adequate
metrics, protection of frontline workers’ safety and livelihoods, ensuring
an adequate pipeline with a focus on girls’ education, donor support for
training and professional organizations, and a rapid scale-up of a robust
cadre of delivery care professionals. Finally, a call for unified international
support of rapid scale-up of cadres of delivery care workers is put forth.
Keywords
women’s health; midwifery, nursing; skilled birth attendants; health resources; world health, maternal welfare
Hrčak ID:
29248
URI
Publication date:
15.6.2008.
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