The New Humanitarian Annual Report 2021

  1. Home
  2. Asia
  3. Lao Peoples Democratic Republic

Midwife training resumes after 20 years

Arming health workers to fight maternal mortality
(Phuong Tran/IRIN)

The first group of 140 students to undergo specialized midwifery training in Laos in 22 years is expected to graduate by the end of December.

Nationwide, 405 women died for every 100,000 live births in 2005; 72 percent of those deaths were preventable, according to the UN Population Fund (UNFPA).

A big part of the problem is that nine out of 10 deliveries take place in the home, with untrained people delivering eight of those babies, according to government data.

In a midwife training programme in the capital, Vientiane, community nurse BounLouan Seng Phachanh spoke of how wrong things can go during a delivery based on her work at a clinic in the central province of Bolikhamsai.

"A mother in her ninth pregnancy came in for delivery and we were forced to do it in the dark when the electricity went off. Her uterus was not contracting after the delivery; there was no refrigeration and no ice to treat her haemorrhaging."

Phachanh was the only one on duty and at a loss.

"I did not know what to do and just stuffed gauze up her vagina and massaged her stomach."

When asked how she might handle the case differently after her year-long training financed by UNFPA and the government, she replied that she was now qualified to administer oxytocin, a drug that can be used to treat such bleeding.

There are 100 midwives nationwide who trained 20 years ago and are still working. Even if the government can continue annual training programmes, reaching an additional 160 health workers every year, it would take another decade to staff each of the country's 825 health centres and 122 district hospitals with at least one trained midwife, said the deputy general director of health personnel at the Health Ministry, Phouthone Vangkonevilay.

And training is just part of the equation he added. "Our biggest challenges are how to equip centres with enough medical supplies and how to motivate these new workers with incentives to stay in and improve performance in remote areas."

In the southern province of Attapeu a competition is being piloted among health centres to see which one can get the most pregnant women in for at least three pre-natal examinations.

Vangkonevilay said the Health Ministry had submitted a health reform development plan, which proposes an increased health worker training and incentive budget, to the prime minister.

"We keep asking. And they keep denying [us]."


This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information:

Share this article
Join the discussion

Right now, we’re working with contributors on the ground in Ukraine and in neighbouring countries to tell the stories of people enduring and responding to a rapidly evolving humanitarian crisis.

We’re documenting the threats to humanitarian response in the country and providing a platform for those bearing the brunt of the invasion. Our goal is to bring you the truth at a time when disinformation is rampant. 

But while much of the world’s focus may be on Ukraine, we are continuing our reporting on myriad other humanitarian disasters – from Haiti to the Sahel to Afghanistan to Myanmar. We’ve been covering humanitarian crises for more than 25 years, and our journalism has always been free, accessible for all, and – most importantly – balanced. 

You can support our journalism from just $5 a month, and every contribution will go towards our mission. 

Support The New Humanitarian today.

Become a member of The New Humanitarian

Support our journalism and become more involved in our community. Help us deliver informative, accessible, independent journalism that you can trust and provides accountability to the millions of people affected by crises worldwide.