I wanted to be a midwife for as long as I can remember and have now been practicing this noble profession for 30 years. I joined the Aga Khan Hospital as the nurse manager for maternal and child health in 1990 and was appointed director of nursing and midwifery services in 2006. Since then I have participated in various forums organized by the Ministry of Health to plan the country’s nursing and midwifery curriculum and other strategic planning related to maternal and newborn health. I’m also on the board of the Tanzania Nursing and Midwifery Council, which regulates midwifery and nursing education and practices and a member and leader in the Tanzania Midwives Association (TAMA).
We have seen some positive results of this sensitization. For example, the country has increased its maternal and child health budget, and the Ministry has made firm commitments to strengthening the midwifery training system, increasing the number of midwives in the country, and deploying them more efficiently. We have initiated a dialogue for recognition of a standalone midwifery training program that would also register and regulate midwives. The Ministry of Health Community Development, Gender, Elderly and Children (MoHCDGEC) is facilitating stakeholders including the Tanzania Nurses and Midwives Council, TAMA, and other stakeholders to reach a consensus on implementation of this program.
This initiative is very important, because public health facilities in rural areas are experiencing a severe shortage of resources – including competent midwives. This shortage contributes to underutilization of health facilities and leads to high rates of home deliveries where delivering women are attended by unskilled people. Consequently, services are not provided in a timely manner (or at all). Women may then not see the point of traveling to a facility and choose to give birth at home supported by a traditional birth attendant or family member.
I plan to continue my advocacy, through TAMA, the Ministry, and the hospital, to accomplish four tasks.
First, I want all to recognize that midwifery is a profession! Tanzania needs a clearcut policy stating that midwifery is a profession in itself, not a branch of nursing.
Second, schools of midwifery need to be strengthened to graduate high-quality midwives in good numbers.
Third, facilities need to be well equipped to provide quality and dignified care to women and children. We need delivery rooms that offer women privacy and the ability for a family member to stay with the woman throughout labor. We need modern equipment to monitor the mother and the baby during labor and delivery. We need basic supplies, medicines, and protective gear the midwives.
Finally – and above all – we need to work harder to ensure we have train and deploy adequate numbers of competent midwives to where they are most needed. All of these things are essential for quality care delivery that can ensure the health and wellbeing of our mothers and babies.