Posted on: Tue 30-06-2020

HE Toyin Ojora Saraki – Midwives Are the Heart of Reproductive Health – ICM Inaugural Global Goodwill Ambassador Valedictory Address – 26th May, 2020.

It has been a huge honour and an incredibly valued privilege to serve the International Confederation of Midwives as its Inaugural Goodwill Ambassador since the first of June 2014.

On that day in Prague, as I addressed world midwives on the theme, ‘Education: the bridge to midwifery and women’s autonomy’, I looked at the faces of the midwives, and I pledged to walk focused, fearlessly and fervently with you all. My commitment was to actualise a rightful yearning for recognition, remuneration and much-deserved respect in a line of duty that so palpably personified care, continuity and courage. I was all too aware that it would be a daunting task, but I knew also, that it would be a fulfilling one.

The journey had actually begun in May 2011 when I attended the launch of Monique and the Mango Rains - a multi-layered tale of midwives’ realities amplifying the heroic voices of a Malian midwife and a Peace Corps volunteer. This midwife had so tenaciously mobilised resources while vividly demonstrating the numerous responsibilities so often synonymous with midwives and echoing their primary charge too; standing with women right up until the point of their life’s most anticipated introduction. That particular story immediately caused me to recall the names of the midwives who had laboured with me as I welcomed my own children into the world. As a result, I instantly became a convert-interlocutor on a mission, determined to amplify the ethos of recognition, rights and a much-needed redemption of respect for the ancient and modern profession that was, and still is midwifery.

I embraced the global call to action in 2014, to increase respect for midwifery education, in order to join the ICM as it stands with hundreds of millions of women who had and would labour and deliver new life – and as I walked with the world midwives of the ICM, so did my Wellbeing Foundation Africa, by intentionally and immediately placing midwives at the heart of our unique institutional actions.

It is of utmost importance to me that all healthcare professionals are given opportunities to upskill, progress and demonstrate the highest level of competency, repeatedly. Midwifery in particular, is a daily-charge, an exercise of accountability and a lifelong commitment directed towards holistically practicing what I as an advocate, and midwives as front-line professionals, work so intentionally hard to preach. So together with the ICM Midwives, and armed with the goals of the Midwifery Services Framework, I have travelled far and wide proudly bearing the responsibility of being the first Global Goodwill Ambassador.

2014 saw us address American Midwives in Washington DC, and the following year included my humble donation to midwives in Lesotho and the launch of EmONC in my native Nigeria. During this time, WBFA Mamacare classes were birthed, and brought forth the ability to teach advanced clinical and maternal skills using Laerdal anatomical models. The UNFPA are also a great partner in co-signing our SRH efforts. Through it all, the desire to position midwives at the heart of global health policy actions began to grow. In 2016, we worked together to host Nigeria’s First Global Midwifery Conference – an incredibly proud and fullcircle moment for me.

As we marched for more midwives in Toronto in 2017, the Canadian Government announced plans for the reparations of indigenous midwives – a conversation and a figure which sees a deserved increase, right up until today. This served as encouragement that both change, and recognition were on the horizon. Windhoek, Abuja and Suriname were also among the communities we frequented, and every step of the way, we engaged with midwives, policy makers and parliaments to reiterate the commission to this great call.

In 2017, we advocated the importance of midwives needing to administer the long acting Sayana Press injectable contraceptive at the Family Planning Summit. Within this very same year, the WBFA Alive and Thrive Initiative was in full effect, and midwives were proudly educating women and their families about the importance of MNIYF Care and Nutrition. Through your eyes, I have witnessed the extension of midwifery practices and capacities in Brazil, Mexico, South Africa, India, Japan, and the United Kingdom – all while encapsulating the heart, passion and desires of the ICM Midwives. In doing so, we have successfully and strategically urged governments to invest in midwifery education and mandatory training in a bid to encourage the promotion and facilitation of safer approaches to practice worldwide.

No journey is without regret, and my inability to attend our ICM Congress in Jamaica still weighs heavily on my heart, as I looked forward to frontline observation of midwifery-led birthing centres as a goal to be realised globally. However, in these inaugural six years together, we’ve beckoned the world to take another long and intentional look, which has in turn, caused me to hone in on the core causes and constructs I so passionately started with – mobilising resources to empower independent midwifery, and harnessing the competencies of midwives as the backbone, and heart, of primary and community health.

We have signposted and amplified promising examples of research and policies which will shape the future of midwifery and have proudly recognised and championed some of the most hardworking hands in the realms of global health diplomacy. We have addressed and welcomed alliances with global organisations, the United Nations, African Union, ECOWAS and the WHO World Health Assembly, as well as celebrating remote village-level ward development committees as they continue to challenge stigma, and harmful cultural practices on behalf of the women and families in their care.

Many of us are aware by way of research that women from the black and minority ethnic classification are five times more likely to die from pregnancy and childbirth related complications. The introduction of the WBFA- JNJ- Liverpool School of Tropical Medicine and Hygiene’s highly specialised BEmONC and EmONC training gaining acceptance across Africa was an incredibly pertinent and refreshing moment for me, as a welcomed and proactive contribution directed at helping mothers to survive, babies to breathe and families around the world to continue celebrating a million more birthdays. WBFA’s new partnership with the Chelsea and Westminster Trust will cascade this innovative learning.

Excitingly, the London School of Hygiene and Tropical Medicine’s WOMAN Trial of tranexamic acid as an early intervention for post-partum haemorrhage was recorded in 2017, and the game changing Ferrings’ heat-stable Carbetocin arrived in this year - both reassuring signs of progress and impact that our ambassadorial advocacy for research-based support and intentional curricula reaps and delivers results.

Each construct pertaining to health and wellbeing from birth to age and beyond - be it pregnancy and delivery, neonatal and infant feeding or boldly reinforcing the need for adolescents to understand sexual and gender-based violence - all contribute to building a more positive socio-economic road to maintaining our wellbeing. That being said, the entire spectrum of reproductive health has been and must continually remain a primary consideration.

By representing the significant and globally resounding voice of the ICM Midwives, we have recalibrated previously held misconceptions and re-assigned unattributed affiliations. The profession must continue to move forward in order to maintain the recognition it deserves for its contributions in improving sexual and reproductive health beyond just the physiological joining of mother and child. At different points along this momentous journey, midwifery has taken pride of place in reigniting and exemplifying a plethora of best practices for essential frontline Health workers, and has likewise birthed a series of incredibly poignant and monumental experiences within a space I am so truly proud to be advocating for.

Every victory counts, and I have rejoiced as nation-states begin appointing Chief Midwifery Officers. This call to action further reiterates the level of excellence and accountability implored by so many within this incredible profession. Regarding our original goal of Midwifery Education, I was particularly pleased to see the WHO AFRO launch a comprehensive curriculum setting a new standard for the training of midwives back in 2018.

To be crowning six years of ambassadorial achievements with the ICM in this 2020 Year of the Midwife and Nurse, is truly an unprecedented achievement. I remain hopeful that these years have been a catalytic culmination of intentional, educational and strategic efforts that offer a glimpse at centuries of quality advocacy, advancements and assistance. The call to midwifery is patience and perseverance personified. To safely nurture, be the first set of clean hands to touch and guide new life and initiate the first nourishing embrace between a celebratory woman and child is priceless. To do this on rotation, routinely, day in day out is heroic.

We have walked together and achieved the amplification of a vibrant and much-needed platform to celebrate, demonstrate and mobilise the heroic and admirable profession worldwide. The ICM’s leadership in representing, reconfiguring and increasing awareness of Midwifery globally is remarkable and unmatched.

This new decade started with the unique challenge of the Sars-Cov2 virus pandemic that has affected us all, yet pregnancy and childbirth wait for no-one, and front-liners continue to remain ever-ready for battle. The days ahead will require the intensification of resources, courage and commitment. Midwives have proven their mettle in the most daunting of circumstances, and it is time for the world, and the global health community to redeem the centuries of contributions that midwives have made to all our lives, and to community health.

In the vein of supporting the ICM as its midwives continue to stand with women, on the International Day of the Midwife, I joined the WHO, the Global Handwashing Partnership and Hygiene In Health Care Facilities Stakeholders in a resounding new commitment to “Applaud With WASH.”

We will, over this decade, mobilise and reinforce the key resources of water, sanitation and hygiene in health care facilities, to ensure that midwives and nurses clean hands can save more lives. We are confident that an internal approach to education will influence a more widely societal one.

As I bid farewell to the honorary role of Inaugural Global Goodwill Ambassador, I recall that we started our journey to claim the respect, recognition and resources for midwives with an African proverb, of ‘walking together, far and fast’ - in a succession of constant elevations; working authentically to strategize, take action and liberate women and girls from the constraints of family planning, child birth, and the other gender specific limitations they very often face. Our concepts of preparation and delivery have been very much centred around understanding, championing and reiterating the indelible bravery, resilience and selflessness of the millions of midwives who answer the ‘great call’ around the world each day. These particular efforts have been all the more powerful and pertinent because they have been achieved, with honourable dedication, repeatedly, and together.

Together, we have made great strides in authentically hailing a profession which charges each of us to wholeheartedly and strategically contribute to ensuring many more meaningful tomorrows. Our monumental six-year term of collaborative efforts and support for midwives alongside the ICM team has been invaluable. To work in close proximity with likeminded and driven people with an assurance of ‘togetherness’ in this profession as the word is defined, leaves me parting on an empowered, encouraged and excited note.

To all the incredible ICM Leaders, Council, Board and Teams; thank you for facilitating so many memories, key breakthroughs and positive affirmations along the way. Advocacy in itself is an unending journey. I am incredibly proud to be able to say that being the Inaugural Global Goodwill Ambassador for the ICM, will remain an unforgettable part of mine, and I am excited by the thought of new plans, possibilities and partnerships for healthy futures for women, girls and families - all with the midwives’ hands at my heart.

In this most wonderful Year of the Midwife and Nurse, as I appreciate the singular honour of serving the ICM for the last six years as its Inaugural Global Goodwill Ambassador, may I crown our collaborative advocacy efforts with one final African proverb, ‘a friend today is a friend for life.’

I assure the ICM, and every world midwife, that throughout this decade of action and delivery, I have pledged to mobilise resources in parallel to all your goals. At the ICM, you will always have a friend, supporter and partner in me, and in the Wellbeing Foundation Africa. Thank you ICM, and thank you world midwives, again and again, and again.

---

---