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Potential impact of midwives in preventing and reducing maternal and neonatal mortality and stillbirths: A Lives Saved Tool modelling study

The Lancet Global Health Dec 20, 2020

Nove A, Friberg IK, de Bernis L, et al. - Global health organisations have emphasized strengthening the capacity of midwives to deliver high-quality maternal and newborn health services as a priority. To support low-income and middle-income countries (LMICs) in their decisions concerning investments in health, researchers sought to determine the potential impact of midwives on lowering maternal and neonatal deaths and stillbirths under several intervention coverage scenarios. For this modelling study, they employed the Lives Saved Tool identifying that a substantial rise in coverage of midwife-delivered interventions could avoid 41% of maternal deaths, 39% of neonatal deaths, and 26% of stillbirths, equating to 2·2 million deaths averted per year by 2035, relative to those projected to occur under current coverage. Sixty-five percent of all these deaths could be averted by achieving universal coverage. Overall findings suggest that substantial reductions in maternal and neonatal mortality and stillbirths could be achieved in LMICs with the help of midwives. The impact was largest in correlation with family planning interventions that can be delivered by midwives, but a substantial contribution was also evident of periconceptual, antenatal, childbirth, and postnatal midwife-delivered interventions. To realise this potential, midwives are required to have enough skills and competencies, be part of a team of adequate size and skill, and work in an enabling environment. This analysis overall underscores the potential of midwives however, in addition to this type of modelling exercise, it is necessary to review systematically evidence on midwife-delivered interventions to reinforce the evidence base and foster relevant investment. Health systems will be better able to yield effective coverage of essential SRMNAH interventions if increased coverage of midwife-delivered interventions can be attained.

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