Professional midwifery services during pregnancy and childbirth arecritical to lowering the mortality rate of women and babies, aconference heard on Nov. 10.
Speaking at the eventorganised by the United Nations Population Fund (UNFPA) and Ministry ofHealth, Representative of the UNFPA in Vietnam, Bruce Campbell said thatwhile most births in developed countries were aided by skilledattendants, one in three women in developing countries gave birth aloneor with only relatives.
Figures from the report revealedthat 1,000 women died as a result of pregnancy-related complications andabout 5,500 newborns died in the first week of their life for lack ofadequate daily medical care.
Another 35,000 women sufferedsevere illnesses or disabilities, including obstetric fistula, severeuterine prolapse, depression and infertility, it said.
Thereport also pointed out that unless about 112,000 midwives were trainedand deployed in a supportive environment, 38 of 58 countries surveyedmight not meet their target of 95 percent of births attended by askilled midwife by 2015, as the Millennium Development Goal required.
Currently, the globe is facing a shortage of about 350,000 midwives. Onaverage, the community needs at least six midwives per 1,000 births.
"Pregnant women and newborns will continue to die needlessly without anincrease in the number of midwives and improved clinical skills,"Campbell said.
"If midwives are in the right place andcan accompany the most severe complications to specialised hospitals orhealth clinics, up to 90 percent of maternal deaths could be prevented."
Deputy Minister of Health, Nguyen Viet Tien said thatmidwives and midwifery practice played a crucial role in Vietnam 'smaternal and newborn health care system.
The initiative oftraining village-based midwives was practical and effective, especiallyin remote and hard-to-reach areas where home births were common due topoverty that hindered access to health care services, he said.
Dr Tran Thi Huong of northern mountainous of Ha Giang Province's HealthCentre said that difficult roads, poverty and customs required onlyhusbands or relatives to take care of women during and after delivery,resulting in 80 percent home delivery.
Huong said that themodel of village-based midwives had been more effective than localhealth workers, who hardly knew the ethnic minority language and onlywent to remote areas once a month.
Di Thi Rum, an ethnicminority midwife in Coc Re Commune, Xin Man District in Ha GiangProvince, said she completed a six-month training on midwifery two yearsago and then persuaded many pregnant villagers with potential breechdeliveries to go to local health clinics.
"The roads areso difficult that walking is the only choice when I go to pregnantwomen's houses. My job is to check their health, provide reproductiveinformation, persuade them to go to hospitals if necessary and sometimeshelp them deliver at home," Rum said.
Rum said hervillagers only listened to advice from their locals, adding that localresidents had gradually quit the habit of cutting placenta with brokenterracotta pots or dirty knives.
PhD Luu Thi Hong, deputydirector of the ministry's Department of Maternal and Child Heath, saidthat the quality of midwives was generally limited.
Arecent survey among 232 midwives at the district and commune-levelshowed that most didn't have sufficient skills for birth attendants andnone correctly practised three of the most important skills to aidmothers and newborns.
The reason, according to Hong, isthe lack of training time, which only lasts six to 18 months forvillage-based midwives and two years for district-level ones.
A shortage of official training programmes and low payment forvillage-based midwives also contributed to the low quality improvement.
For example, village-based midwives in northern Dien BienProvince were paid only 50,000 VND ($2.5 USD) per month for theirjobs. Most still had to work in the fields to earn their livings.
Health representatives suggested that the profession of midwiferyshould be further improved by increasing payment and supportive policiesfor midwives, especially those in remote areas.
Thehealth sector should increase the quality of training for midwives,especially with the basic skills of birth attendants while working withinternational and domestic organisations to boost supportive programmeson mothers and newborns.
Office-in-charge of the WorldHealth Organisation in Vietnam Wo Guogao agreed, saying that midwivesshould have appropriate employment, protection, remuneration, incentivesand motivation.
"Midwives don't only deliver babies, theyalso offer many related services before and after the delivery. Theyare crucial in the communities and to the survival of women andchildren," he said./.
Speaking at the eventorganised by the United Nations Population Fund (UNFPA) and Ministry ofHealth, Representative of the UNFPA in Vietnam, Bruce Campbell said thatwhile most births in developed countries were aided by skilledattendants, one in three women in developing countries gave birth aloneor with only relatives.
Figures from the report revealedthat 1,000 women died as a result of pregnancy-related complications andabout 5,500 newborns died in the first week of their life for lack ofadequate daily medical care.
Another 35,000 women sufferedsevere illnesses or disabilities, including obstetric fistula, severeuterine prolapse, depression and infertility, it said.
Thereport also pointed out that unless about 112,000 midwives were trainedand deployed in a supportive environment, 38 of 58 countries surveyedmight not meet their target of 95 percent of births attended by askilled midwife by 2015, as the Millennium Development Goal required.
Currently, the globe is facing a shortage of about 350,000 midwives. Onaverage, the community needs at least six midwives per 1,000 births.
"Pregnant women and newborns will continue to die needlessly without anincrease in the number of midwives and improved clinical skills,"Campbell said.
"If midwives are in the right place andcan accompany the most severe complications to specialised hospitals orhealth clinics, up to 90 percent of maternal deaths could be prevented."
Deputy Minister of Health, Nguyen Viet Tien said thatmidwives and midwifery practice played a crucial role in Vietnam 'smaternal and newborn health care system.
The initiative oftraining village-based midwives was practical and effective, especiallyin remote and hard-to-reach areas where home births were common due topoverty that hindered access to health care services, he said.
Dr Tran Thi Huong of northern mountainous of Ha Giang Province's HealthCentre said that difficult roads, poverty and customs required onlyhusbands or relatives to take care of women during and after delivery,resulting in 80 percent home delivery.
Huong said that themodel of village-based midwives had been more effective than localhealth workers, who hardly knew the ethnic minority language and onlywent to remote areas once a month.
Di Thi Rum, an ethnicminority midwife in Coc Re Commune, Xin Man District in Ha GiangProvince, said she completed a six-month training on midwifery two yearsago and then persuaded many pregnant villagers with potential breechdeliveries to go to local health clinics.
"The roads areso difficult that walking is the only choice when I go to pregnantwomen's houses. My job is to check their health, provide reproductiveinformation, persuade them to go to hospitals if necessary and sometimeshelp them deliver at home," Rum said.
Rum said hervillagers only listened to advice from their locals, adding that localresidents had gradually quit the habit of cutting placenta with brokenterracotta pots or dirty knives.
PhD Luu Thi Hong, deputydirector of the ministry's Department of Maternal and Child Heath, saidthat the quality of midwives was generally limited.
Arecent survey among 232 midwives at the district and commune-levelshowed that most didn't have sufficient skills for birth attendants andnone correctly practised three of the most important skills to aidmothers and newborns.
The reason, according to Hong, isthe lack of training time, which only lasts six to 18 months forvillage-based midwives and two years for district-level ones.
A shortage of official training programmes and low payment forvillage-based midwives also contributed to the low quality improvement.
For example, village-based midwives in northern Dien BienProvince were paid only 50,000 VND ($2.5 USD) per month for theirjobs. Most still had to work in the fields to earn their livings.
Health representatives suggested that the profession of midwiferyshould be further improved by increasing payment and supportive policiesfor midwives, especially those in remote areas.
Thehealth sector should increase the quality of training for midwives,especially with the basic skills of birth attendants while working withinternational and domestic organisations to boost supportive programmeson mothers and newborns.
Office-in-charge of the WorldHealth Organisation in Vietnam Wo Guogao agreed, saying that midwivesshould have appropriate employment, protection, remuneration, incentivesand motivation.
"Midwives don't only deliver babies, theyalso offer many related services before and after the delivery. Theyare crucial in the communities and to the survival of women andchildren," he said./.
