'Midwives deserve better working conditions'

Sandra Mwarania, White Ribbon Alliance head of programs. [File, Standard]

Tell us about yourself and the organisation you work for

I am a fearless advocate championing youth and women's health and rights. I work with adolescent girls and women at White Ribbon Alliance Kenya with the aim of elevating their voices and pushing for enhanced reproductive and maternal health rights.

Our organisation believes in the power of midwifery services. We have closed the feedback loop between women, girls, and midwives to ensure the delivery of high-quality midwifery services through our efforts.

We recently celebrated International Day of Midwives, what were the key takeaways from different representatives' organisations?

Key takeaways included commitments from policymakers and stakeholders for increased support of midwifery-led care. We emphasised the need for better working conditions and recognition for midwives. Unified action among midwifery was also deemed essential for voicing our demands.

This year's theme, 'Transforming Midwifery from Evidence to Reality', acknowledged the need to turn the midwifery profession into a respected profession with better working conditions for midwives. This would improve the health outcomes for women and newborns.

Many would say we don't appreciate the work midwives do. From a policy perspective, what areas do we need to work on?

In 2021 and 2022, WRA Kenya rolled out a campaign seeking to listen to the midwives themselves on what they needed to improve the quality of their services to women and girls.

Their top requests included; the provision of adequate supplies, enhanced functional facilities, timely and adequate pay for their services, and strengthened midwifery professional bodies.

Kenya launched its first National Nursing and Midwifery Policy during the International Day of the Midwife in 2022. It aimed to strengthen the midwife profession by providing a clear framework for education, workforce management, regulation, leadership, governance, financing, research, innovation, and quality services. It remarkably responded to the top requests made by midwives during our campaign.

What role would the midwives play?

Midwives need to be at the forefront of the implementation process of this policy by being participants in the development and execution of national, county, and health facility investment plans.

They, now more than ever, need to organise themselves and rally for support from diverse groups in multiple spaces so as to accelerate advocacy efforts.

Final thoughts?

High-quality midwifery services are directly linked to the most desirable reproductive, maternal, and newborn health outcomes. Despite this, midwifery models of care are not formally recognised as a standard practice.

Unfortunately, the dominant healthcare models value the biomedical approach which places the obstetrician/ gynecologist's advice as the most reliable.

In Kenya, mothers and newborns are still dying at an alarming rate due to preventable causes. It is time to shift the public perception of midwives from a low level to a more respected and valued service provider to women, girls, and newborns.