“One Million More Midwives”: A Global Call to Action for Safer Pregnancies and Newborn Survival
The International Day of the Midwife 2026 is more than just a date on the calendar—it’s a rallying cry for governments, donors, and health leaders worldwide. Under the banner “One Million More Midwives,” this year’s observance highlights the urgent need to address a critical global shortage that could mean the difference between life and death for millions of women and newborns.
Recent analyses paint a stark picture. If current trends of declining development aid persist, the world could face an estimated 22.6 million additional deaths by 2030, according to The Lancet. Even in a more moderate scenario, 9.4 million excess deaths could occur, averaging 1.3 million lives lost annually. These figures underscore the precarious state of global health systems, particularly in Africa, where climate shocks, conflict, and rapid population growth are exacerbating existing challenges.
Progress in Maternal and Newborn Health: Fragile and Uneven
Over the past two decades, significant strides have been made in improving maternal and newborn health. More women and babies are surviving pregnancy, childbirth, and the postnatal period. However, this progress has been uneven. Maternal and newborn deaths remain unacceptably high in many countries, especially across Africa, where health systems are under immense strain.
Shockingly, most of these deaths are preventable. Yet, millions of women still lack access to timely, high-quality care. A critical factor? The global shortage of health workers, particularly midwives. The world is short nearly one million midwives, with the deficit most acute in regions where needs are highest. In Nigeria, for example, gaps in training, deployment, retention, and working conditions are compounding the crisis.
The Midwife Gap: A Life-and-Death Issue
Midwives are uniquely positioned to bridge this gap. They provide essential care before, during, and after pregnancy, ensuring continuity that can detect complications early and prevent them from becoming life-threatening emergencies. Midwives are also central to family planning, supporting healthy timing and spacing of pregnancies.
Yet, their potential remains untapped in many countries. Around 90% of women live in countries with a midwife shortage, driven by population growth and persistent underinvestment in the health workforce. Training more midwives is only part of the solution. Ensuring they are fairly paid, deployed to underserved communities, and equipped with essential supplies is equally critical.
Rethinking Health Systems: Efficiency Matters
The issue isn’t just about access to funding—it’s about how that funding is used. Many health systems prioritize centralized, hospital-based care, which is expensive and difficult to scale in resource-constrained settings. This approach often means women only reach care when complications have become severe, leading to costly emergency interventions that could have been prevented with earlier access to skilled care.
Investing in primary and community-based care, where midwives play a central role, offers a more sustainable solution. Midwife-led models of care, including birth centers and clinics, are associated with equal or better health outcomes at a lower cost. These models reduce unnecessary interventions, shorten hospital stays, and shift care safely to local settings.
Nigeria has already taken steps toward reform through its Strategic Directions for Nursing and Midwifery 2025-2030, which aims to strengthen the training, deployment, and leadership of midwives. However, the success of these reforms will depend on placing midwives at the heart of implementation.
The Return on Investment: Midwives Deliver
The evidence is clear: midwives deliver the highest return on investment in healthcare. Universal coverage of midwifery services could prevent 67% of maternal deaths, 64% of newborn deaths, and 65% of stillbirths, saving an estimated 4.3 million lives annually by 2035. Skilled, regulated, and supported midwives can provide up to 90% of essential sexual, reproductive, maternal, and newborn health services.
What’s more, midwives are often embedded in the communities they serve, making care more accessible and trusted—especially in rural and underserved areas where distance, cost, and transport barriers prevent many women from reaching facilities. In Nigeria, where delays in seeking and receiving care remain a major challenge, midwives can help bridge these gaps by connecting households to essential services like antenatal care, skilled birth attendance, and family planning.
Midwives in Crisis: A Lifeline for Women and Newborns
In conflict and fragile settings, midwives become indispensable. Nearly two-thirds of global maternal deaths occur in countries affected by conflict or instability. When health systems are disrupted, midwives often remain the most reliable part of the response, continuing to provide care even when facilities are damaged or overwhelmed.
For Nigeria, where conflict, insecurity, and weak referral systems shape maternal and newborn outcomes, investing in midwives also supports health system resilience. Community-linked midwifery services can ensure essential care remains within reach, even in the most challenging circumstances.
The Time to Act is Now
In an era of constrained aid and growing health needs, investing in midwives isn’t just a moral imperative—it’s a strategic necessity. Midwives are not an optional investment; they are a lifeline for safer pregnancies, healthier newborns, and stronger health systems. Every dollar invested in midwifery care can generate up to $16 in economic and social returns, making it one of the most cost-effective decisions available today.
The question is simple: will we act on the evidence and invest where the greatest impact can be achieved? The lives of millions depend on the answer.
— Reported by Nexio News
