May 5 is International Midwives Day, celebrated in Yemen for first time

Mortality rates among women of reproductive age in Yemen are among the highest in the developing world. The high mortality and morbidity rates among mothers and children imply a great need for services provided by qualified midwives.  There are various categories of midwives providing health services at all levels of service delivery. Like their professional colleagues in health and non-health areas, midwives have their own ambitions and hopes for a better future, such as development of the midwifery profession, improvement in their professional level and career structure, and upgrading the quality of health services.

International Midwives Day, which will be held on May 5, is an opportunity for midwives to express themselves and shed light on the issues they face. It is also a good venue to better introduce the National Association of Yemeni Midwives and its work. In anticipation of the International Midwives Day, Yemen Observer conducted an interview with Su’ad Qasem Saleh, the association’s executive and financial manager, as well as a program coordinator with the Basic Health Services project in Yemen.      


When was the National Association of Yemeni Midwives established?   

The YMA was established on September 2, 2004. It has financial, administrative and technical autonomy. It operates in accordance with the constitution and the provisions of Law No.1 for the year 2001, pertaining to national associations, institutions, and the relevant laws.
 

What were the reasons for establishing this association?

The idea for establishing this association is to prove the midwife’s important role. The present number of Yemeni midwives reaches more than 5,000. So, such a high number of midwives requires the establishment of an association to address the midwives’ professional issues. However, this number is insufficient to cover all the health services needed by mothers and children. At its inception, the association included about 97 midwives. Later, this number increased to about 1,200 midwives distributed throughout 22 governorates.    


To what extent is the YMA able to serve Yemeni midwives?

The association helps to build civil society by giving midwives a means of identifying their needs and advocating for them with the Ministry of Public Health and Population, the Health and Manpower Institutes, as well as with officials in the health system at the governorate and district levels. The association can also be a voice for midwives in discussions about donor-funded programs that affect health service delivery and the profession of midwifery.  


What was the main goal behind the establishment of the YMA?

The association aims to promote and strengthen the midwifery profession in Yemen. This goal will contribute to upgrading the reproductive health, family planning and child care standards of service in order to reduce mortality and morbidity rates among mothers during pregnancy and labor, and among newborns and children under five.  


What is the association mostly concerned with? 

Participating in activities in the development and improvement of standards, policies and strategies of the reproductive health, family planning services and training midwives to apply these standards with the coordination of other related agencies; contributing to the training of midwives in quality of performance; strengthening outreach activities, home visits and women’s development activities; contributing to reviewing the job descriptions of midwives; supporting midwives in defending  their rights in employment and improving their job position; developing a continuous education system to ensure development of knowledge and skills of midwives at all levels of service delivery; initiating relationships with other related organizations, service and educational institutions, and NGOs at the local, regional and international level; assisting in developing management and leadership capacities of midwives; seeking government and donor support for the development of the association, in accordance with laws of the Republic of Yemen; raising awareness of women in the area of reproductive health, family planning and child care; developing the Midwifery Code of Ethics.  


Are there any government ministries that actively support the work of the association?

The Ministry of Public Health and Population and the Ministry of Social Affairs and Labor have played a major role in encouraging the midwives to establish their association and make their hopes come true. Who else do you credit with providing support for the establishment and the activities of the association?  The United States Agency for International Development- funded Partners for Health Reformplus (PHRplus) Project has actively provided technical and financial support to enable the midwives to establish and manage their association.


Tell us about some of the association’s recent activities.

Since its establishment, the Association has managed to gain several experiences and attained achievements with the financial and technical support of donor agencies, mainly USAID through PHRplus, the BHS project and  the Extending Service Delivery project as well as the United Nations Fund for Population Activities. Such achievements include: several training courses to develop the skills of midwives; weekly health awareness classes are conducted at the association, which 500 women of reproductive age have attended; the association runs a mother and child health/family planning center that provides various services for poor families; the association conducted a survey to study the situation of midwives to establish a database; members of the association conduct monthly field visits to identify the training needs of midwives and to provide on the job training to develop midwives’ technical skills in the governorates of Amran, Marib, Shabwa, Sa’ada and al-Jawf; USAID through BHS and ESD projects are currently supporting the association to implement private practice for unemployed midwives who are interested in running their own clinics in order to increase the percentage of deliveries performed by skilled birth attendants. 


What are the reasons that a large percentage of Yemeni women give birth in their homes instead of at health facilities?

About 77 percent of Yemeni women prefer to give birth in their homes with the help of unskilled and untrained women. This percentage comes as a result of the limited number of skilled midwives in Yemeni society, especially in the rural areas where all deliveries take place at home. The health facilities that provide delivery services are also very crowded, so women prefer to stay in their homes and avoid the crowded places. Moreover, the health awareness, especially in the rural areas, is very low—thinking that delivery in the health facilities is a big shameful thing. The financial costs, particularly those paid for transportation from distant areas to the hospitals in the governorates, are an obstacle.

 
What are the goals that you hope to achieve in the future?

The association seeks to establish natural delivery centers in the future, to help the public hospitals to serve such delivery services. These centers need to be supported with the necessary equipment, ambulances and skilled workers. We hope to establish these centers in cooperation with the specialized and donor bodies. We also seek to continuously develop the midwives’ skills. Moreover, we will try to create licenses for midwives, who prefer to work in their own private clinics, to practice their work. A guide will be made for these midwives in the correct behaviors that they should follow.


At this time, the association is not very well known to the public, so its services may not be reaching them; how can the YMA better introduce itself?

Midwives all over the world celebrate International Midwives Day on May 5, which offers the opportunity each year to celebrate midwives’ work and the profession of midwifery. This year, the Yemeni Midwives Association is celebrating on this occasion, under the slogan “Midwives reach out to women – where ever they live”. This year will be the first time International Midwives Day is celebrated in the Republic of Yemen.


Does the YMA have any activities planned for International Midwives Day?

Different activities will be carried out on this day. We will try to review the activities and achievements made by our association through a film report. A simple play will show some important issues related to some of the problems women face through pregnancy and delivery, and the midwife’s important role in helping these women. There will be a exhibition for the training methods put on by the midwives who are in the training course to help them do such things with their own hands, so as to not depend completely on the training methods provided in the rural areas.  


I know that YMA sent a team to Uganda recently; what was the goal of that trip?

A YMA team consisting of seven midwives, visited the Republic of Uganda from March 12 to 21 in order to benefit from the Ugandan midwives’ experience in establishing private projects to serve the local society in the health services field, such as the maternal and childhood fields, family planning services and delivery services. This experience in Uganda22 may help the Basic Health Services Project in Yemen, which is funded by USAID in coordination with the Ministry of Public Health and Population, to provide health services in Amran, Sa’ada, Marib, al-Jawf and Shabwa.

Are there any activities that the YMA is currently conducting?
Since the beginning of April, there have courses to train midwives in the governorates of Amran, Marib and Shabwa. In each of these governorates there are two courses that each train 25 women. The project supports those trainees with teachers, a residence and a stipend. Those trainees will graduate after two years.

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