The world is facing an unprecedented number of compounding crises - disasters, conflicts, and the ongoing impacts of climate change. These emergencies disproportionately affect women, girls in all their diversity, exposing them to heightened risks and delays in seeking life saving maternal healthcare for pregnancy and birth complications and gender-based violence, while also limiting their access to essential health services.
Midwives are trusted first responders within their communities, playing a vital role in strengthening health systems to be resilient to crises. They can provide up to 90% of sexual, reproductive, maternal, newborn, and adolescent health services, even in the most complex humanitarian settings.
A global shortage of nearly 1 million midwives, a regional shortage of over 200,000 in Asia Pacific, and a lack of international commitment to invest in their training, development, deployment and support, limits their reach and endangers women and girls who rely on them for care.
This collection of profiles from around the region presents a snapshot of a few of the millions of midwife heroes who stand on the frontlines of climate impacts and humanitarian emergencies, coping with daily crises that affect women’s health and dignity.
”Whenever there is conflict, families flee,” says Rayhana. “They go to evacuation centers or go stay with extended family and some people stay in their vehicles.”
As a midwife in the conflict-affected province of Mindanao, Rayhana is familiar with the cycles of insecurity and recovery that mothers are struggling with. Her own experience with displacement has shaped her compassion: “When we came back to our house everything was destroyed,” she recalls. “Our savings were taken, we had nothing left.”
Rayhana's education has been marred by the conflict that has endured for decades in Mindanao. “There was a time when I couldn’t even go to school because I couldn’t cross the conflict zone.”
Rayhana began her journey as a volunteer facilitator at a Women-friendly Space supported by UNFPA and the Government of Australia. The spaces are a refuge for women to connect with other women and get support. She was trained in how to be an effective frontline advocate for women affected by the protracted crisis. The modest stipend she received helped her pursue her studies to become a midwife.
Rayhana is now a fully qualified midwife and works at a birthing clinic with local health officials. As a midwife she has to operate in dangerous situations, frequently traveling to remote forest camps where she provides care to adolescent mothers whose partners are affiliated with armed groups.
“It’s definitely difficult to reach these young mothers, but they need a midwife,” she says. “If I'm visiting a patient in a secluded area, my mother or my husband comes with me.”
She says many patients have a difficult time getting to the rural clinic. ”There are armed groups along the road that intimidate women from coming to health appointments. Women say they are in a conflict area and they can’t get to the clinic.”
Rayhana continues to go out into the community, advocating for family planning and safe motherhood with the local health teams. “Even in a conflict, women still give birth,” she says. “We need to have a safe place for them to give birth.”
Apart from armed violence, natural hazards like floods are another barrier women in Maguindanao frequently face in accessing quality sexual and reproductive health services. “Flooding is a disaster that we often experience in Mindanao. I regularly have to cross a flooded river to get to patients.“
Despite the challenges, Rayhana says she is seeing real progress. “There have been a lot of changes in my community since I joined. Women are much more aware of how we can support each other to get through this crisis.”
Anita is a midwife-nurse in the suburb of Sta. Rosa, on the sprawling outskirts of Metro Manila. In 2021, at the height of the COVID-19 pandemic, the city's birthing clinic received an electric Reproductive Health Bike (RH Bike) from UNFPA, through the support of the Government of Canada. The bike was introduced to bridge critical gaps in maternal care, especially when it made it nearly impossible for pregnant women to visit health centers for prenatal care. She says the electric bike has changed the way she delivers sexual and reproductive health services —from maternal care to family planning—especially in emergency situations.
“The streets are small and narrow so it allows us to get into communities to host talks with young people,” Anita says. “When we turn up, we have conversations about teenage pregnancy, sexual reproductive health, safe births, gender-based violence. So many more people come because we are in their neighborhood, and they don’t have to come to see us at the clinic."
The electric bike is easy to operate, doesn’t require additional drivers or fuel, and can be deployed on short notice. Powered by a battery that lasts about two years- some models are being tested with solar panels- it is a practical energy-efficient tool for emergencies and outreach. "When women say they can’t make it to their prenatal check-ups due to transportation issues, the bike even allows us to fetch women to and from their appointments, ensuring they get the care they need for healthy outcomes for their children."
The electric bike can carry family planning commodities, bringing both information and essential services closer to the community.
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Read the full collection from UNFPA Asia and the Pacific
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Learn more
Ending preventable maternal deaths in Asia and the Pacific
The State of the World’s Midwifery Report - 2021
Global Standards for Midwifery Regulation
Policy Brief: Quality Midwifery Education needs to address Minimum Global Standards
