The UN Population Fund (UNFPA) office in Yemen has said there is an urgent need for 5,000 more midwives to allow the country to achieve universal access to skilled care at birth and attain Millennium Development Goal 5 "to reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio".
Salwa al-Eryani, UNFPA assistant representative for reproductive health, told IRIN that UNFPA had discussed with the Ministry of Health how to train up the additional midwives. "We are working on a proposal to see how to train these midwives, and in which areas they are needed immediately. We are drafting such a proposal and how to go about training 5,000 midwives," she said.
The official also said legislation on motherhood, which calls for one midwife per village, is being discussed in parliament. "The Health Ministry is trying to push for this UNFPA-supported legislation," she said.
According to her, since Yemen's population is about 22 million, providing one midwife per 5,000 women means the country needs about 20,000 midwives. Al-Eryani said this was a global standard applied to reduce maternal mortality.
Maternal mortality high
"[In Yemen] 20 percent of deliveries are attended by skilled midwives. Studies outside Yemen show that when there is an increase in skilled birth attendants there is a decrease in maternal mortality," al-Eryani said, adding that 80 percent of deliveries in Yemen take place at home.
According to UNFPA, maternal mortality in Yemen accounts for 42 percent of all deaths among women of childbearing age, with 365 deaths per 100,000 live births. This indicates that Yemen has one of the highest maternal mortality rates in the world.
UNFPA said 75 percent of maternal deaths are preventable and occur because of a lack of access to - and availability of - high-quality reproductive health services.
About six in every 10 rural women received no prenatal care, compared with 31 percent of urban women, according to UNFPA.
According to the UN Children's Fund (UNICEF, 2005) the lifetime risk of maternal death is 1:39.
Al-Eryani noted that UNFPA trained about 1,500 midwives in a project it led in 1998-2003.
Huda Jahlan, chairwoman of the Yemeni Midwives Association (YMA), a local non-governmental organisation (NGO), told IRIN midwives were concentrated in the main cities because in rural areas the number of educated women who could be trained as midwives was low. The YMA trains midwives in five of Yemen’s 21 governorates - Amran, al-Jawf, Shabwa, Marib, and Saada.
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