Global Speeches

SPEECH FROM February 12th, 2024

With the goal of “Empowering Africa: Unveiling the Hidden Drivers Shaping Tomorrow,” I am honoured to have delivered my keynote address at the 10th Annual St Andrews Africa Summit, a commendable student-led and university-supported initiative dedicated to the challenges and opportunities we face on the continent.

I am particularly heartened by the summit’s focus on women and children’s health alongside science and technology, especially as we commemorated the United Nations International Day of Women and Girls in Science, yesterday, emphasising women’s leadership in science to foster a new era for sustainability, while driving socio-economic development.

From improving health to combating climate change, women and girls play a critical role in the science and technology communities, and it is essential that their participation is strengthened, especially since STEM is widely regarded as critical to national economies across Africa.

I urged each student to seize the opportunity to be inspired, to learn, and to commit to action, as we are reminded of the transformative impact that collective action can have. Through platforms like such, we can foster open and respectful political dialogue, inspire technical innovation, and mobilise sustainable resources, leading to the unveiling of the hidden drivers shaping tomorrow’s Africa, a future defined by hope, resilience, prosperity, and boundless opportunity.

Watch the Keynote:

 

Written Keynote:

Ladies and gentlemen, esteemed guests, and students of St. Andrews,

It is with immense pleasure that I join you today on this momentous occasion, as we gather for the 10th annual St. Andrews Africa Summit. For a decade now, the St. Andrews Africa Summit has served as a platform for dialogue, collaboration, and action on the pressing issues facing Africa—a testament to the unwavering commitment of this student-led initiative and university-supported endeavour towards a more empowered Africa.

As the Founder-President of the Wellbeing Foundation Africa, and Inaugural Global Health Ambassador for the World Health Organization, I am deeply honoured today to join you in exploring this year’s theme: “Empowering Africa: Unveiling the Hidden Drivers Shaping Tomorrow.” This theme resonates profoundly with the challenges and opportunities we face on the continent, and I commend the organisers for their foresight in selecting such a vital topic, especially as 18 African countries, a third of the population in Africa, head to the polls in 2024.

The importance of democratic governance cannot be overstated. Democracy empowers citizens, especially our youth to participate in the decision-making process, ensuring their voices are heard and their needs addressed. With a flourishing youth population, the voices and votes of young people have the power to drive meaningful change and pave the way for a more inclusive and prosperous Africa.

As we reflect on the journey of the St. Andrews Africa Summit over the past decade, we are reminded of the transformative impact that collective action can have on shaping the future of our continent. It is through platforms like this one today, in which we can foster open and respectful political dialogue, inspire technical innovation, and mobilise sustainable resources to ensure Africa prospers.

I am particularly heartened by the focus on women’s and children’s health, empowerment, and socio-economic development—a cause that lies at the very heart of the Wellbeing Foundation Africa’s mission. For too long, women and children have borne the brunt of inequality across Africa, while being denied access to essential and quality healthcare, education, and economic opportunities.

Yet, as we gather here, we stand on the cusp of change—a change that begins with each and every one of us. At the core of the Wellbeing Foundation Africa’’s initiatives lies a commitment to holistic healthcare, education, and advocacy. Through strategic programming, advocacy and global partnerships, WBFA tackles the root challenges of maternal, newborn and child health while uplifting and empowering communities to build a healthier, brighter future.

Beyond policies and programmes, it is our collective will and determination that will truly drive progress. It is the belief that every individual in Africa has inherent worth and potential—that no one should be left behind—that will propel us forward on this journey of empowerment and transformation.

As we embark on this summit, I urge each and every one of you to seize this opportunity to be inspired, to learn from one another, and to commit to action. For it is through our joint efforts that we will unveil the hidden drivers shaping tomorrow’s Africa—a future defined by hope, resilience, and boundless opportunity.

Together, let us empower Africa and unleash its full potential.

Thank you.

SPEECH FROM January 19th, 2024

From Davos, Switzerland at the 54th World Economic Forum:

The Wellbeing Foundation Africa Delegation was thrilled to join in launching forthcoming research by the McKinsey Health Institute and the World Economic Forum with leaders across the public, private, social, and philanthropic sectors for an action-oriented convening to explore the latest data powering the effort to draw awareness to the women’s health gap.

The report titled “Closing the Women’s Health Gap: A $1 Trillion Opportunity to Improve Lives and Economies,” emphasizes that investments addressing the women’s health gap would add years to life and life to years – while potentially boosting the global economy by $1 trillion annually by 2040.

When discussing the challenges in women’s health, a common rejoinder is that women, on average, live longer than men. But this neglects the fact that women spend 25% more of their lives in debilitating health. Closing the women’s health gap would allow 3.9 billion women to lead healthier, higher-quality lives.

The report identifies four primary areas that need addressing to close the health gap: Science, Data, Care Delivery, and Investment, and to move forward, the report suggests action on five fronts: investing in women-centric research, strengthening the collection of sex-and gender-specific data, increasing access to women-specific care, creating incentives for investment in women’s health innovation, and implementing policies supporting women’s health.

Closing the women’s health gap is a moral imperative, as addressing these gaps would reduce the time women spend in poor health by almost two-thirds, adding an average of seven days of healthy living for each woman annually.

Together, we have a chance to lift millions of women out of poverty, improve future generations’ health, and foster healthy aging. We cannot succeed when half of us are held back.

SPEECH FROM June 26th, 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 which amplified 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 that are 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 full-circle 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 reiterating the commission to this great call.

In 2017, we advocated the importance of midwives being qualified to administer safe single-use injectable contraceptives at the FP2020 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 midwives, 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. Indeed, in a world where racism has become a crisis, I appreciate, respect and applaud the courage of the ICM in choosing me, in 2014, a black African woman, as your first ever Global Ambassador – an organic action that speaks to the egalitarian inclusiveness of the International Confederation of Midwives, and the values of the midwifery profession, globally.

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 curriculae 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.

National Speeches

SPEECH FROM February 16th, 2024

Goodwill Speech:

Good Morning Honourable Ministers; Esteemed dignitaries; Distinguished Guests; Thank you to the Federal Ministry of Health and Social Welfare, Tropical Health & Education Trust and Ducit Blue Solutions for hosting the Global Health Workforce Programme Nigeria Launch Event today.

I am Toyin Saraki, the Founder and President of The Wellbeing Foundation Africa, an NGO which works to improve health and wellbeing outcomes for women, infants and children across Nigeria, prioritising frontline impact with global advocacy, in alignment with the United Nations Sustainable Development Goals and UNFPA ICPD Programme of Action and Three Zeros, in particular zero maternal deaths by 2030.

I am honoured to address you today as we launch pivotal partnerships to enhance and advance healthcare across the nation, including the the Wellbeing Foundation Africa partnership with the Liverpool School of Tropical Medicine in advancing Emergency Obstetric and Newborn Care competency-based curriculum for resident doctors in Obstetrics and Gynaecology at the National Postgraduate Medical College of Nigeria.

This partnership, supported by the Global Health Workforce Programme funded by the UK Department of Health and Social Care and managed by the Tropical Health and Education Trust and Ducit Blue, underscores our commitment to strengthening the healthcare workforce in Nigeria. Leveraging our previous partnership with the Liverpool School of Tropical Medicine, leaders in implementing and evaluating interventions and combining research with capacity strengthening in EmONC, we covered 51 HCFs in 16 LGAs in Kwara State between 2015-2020, establishing thirteen emergency obstetric and newborn care skill rooms comprising of ten main skill labs and three mini labs, benefiting over 700 healthcare providers directly, and reaching an estimated 62,900 women and their newborns, recording a 38% reduction in facility stillbirth rate, leading to the development of the Centre of Excellence. WBFA and LSTM aim to continue to collaboratively elevate healthcare delivery standards while advancing towards Universal Health Coverage for all, as fostering a more robust and sustainable healthcare workforce is paramount to ensuring the delivery of high-quality healthcare services and achieving UHC.

A well-trained and adequately supported healthcare workforce forms the backbone of all healthcare systems, serving as the frontline in addressing the diverse healthcare needs of populations. By investing in continuous professional development and training programmes, particularly in critical areas such as Emergency Obstetric and Newborn Care, we not only equip healthcare professionals with the necessary skills and competencies to provide timely and effective care but also contribute to reducing maternal and neonatal mortality rates, as according to the World Health Organization, the lifetime risk of a Nigerian woman dying during pregnancy, childbirth, postpartum or post-abortion is 1 in 22, in contrast to the lifetime risk in developed countries estimated at 1 in 4900.

Our objectives are clear and resolute. We aim to engage OBGYN students in post-graduate medical education, adapt training packages for revision courses and examination OSCE, establish advanced EmONC Centers of Excellence in Abuja and Lagos, and ensure the sustainability of these centres for postgraduate OBGYN revision courses. Furthermore, we are committed to supporting the NPMCN in providing training to residents, ensuring quality assurance, and rigorously evaluating the programme for maximum impact and effectiveness.

Central to the success of this programme are the esteemed experts from the Royal College of Obstetricians and Gynaecologists (Nigeria Liaison Group) and the experienced master trainers in advanced EmONC provided by LSTM. Their invaluable insights and guidance will undoubtedly contribute to the robustness and efficacy of our initiative, ultimately benefiting the healthcare landscape of our nation.

I extend my heartfelt gratitude to all our partners, stakeholders, government officials, dignitaries, and supporters who have joined us today. Your unwavering commitment and steadfast support will ensure we reach our mission of providing quality health and wellbeing for mothers and newborns across Nigeria.

SPEECH FROM April 8th, 2022

Good morning, my name is Toyin Saraki and I am the Founder, President, of the Wellbeing Foundation Africa and Inaugural Global Health Ambassador for the WHO Foundation. My Foundation works across Africa to improve health and social outcomes for women and their children, a cause I have dedicated much of my life to.

I am delighted to join you all here today, to celebrate the launch and mark of the Smiles for Mothers Program First Use of Heat-Stable Carbetocin in Nigeria and Sub-Saharan Africa. Today is a life changing moment for women around the world, and the global health community as we will actively witness in real-time the vital impact of heat-stable carbetocin, a new formula which does not need refrigeration or cold-chain transportation, challenges we have faced time and time again in Nigeria.

I personally have been awaiting this major maternal health milestone since the publication of the CHAMPION (Carbetocin hemorrhage PreventION) trial results in 2018 – a study led by the World Health Organization (WHO) as part of a collaboration with MSD for Mothers and Ferring Pharmaceuticals. That data then contributed to heat-stable carbetocin being added to the WHO Model List of Essential Medicines (EML), as well as an update in the WHO’s recommendations on uterotonics for the prevention of excessive bleeding after birth.

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality, morbidity and long term disability related to pregnancy and childbirth in not just low-resource countries, but globally, accounting for nearly one quarter of maternal deaths worldwide. In Nigeria, low use of antenatal care (ANC) and delivery services contribute to PPH, with PPH observed to be the most frequently diagnosed obstetric hemorrhage complication, and majority of women who experience PPH complications have no identifiable clinical or historical risk factors prior to.

While improving overall quality of healthcare is crucial to addressing the high maternal deaths, the use of Heat-Stable Carbetocin will be revolutionary. Maternal health, with thriving mothers and children, is the first and most vital component of healthy societies, economies and nations. Healthy mothers lead to healthy families and strong health systems. It has a direct impact on the welfare of society especially in many developing countries, as a mother’s death is much more than an emotional crisis, it often leads to long-term social and economic breakdown, both for her immediate family and the wider community.

Throughout my years advocating for improved maternal health in Nigeria, one thing has always been clear – effective interventions to prevent and treat PPH do exist and can largely reduce the burden of this life-threatening condition.

I personally have addressed the challenges associated with a lack of access to PPH medication and training, and adequate timely maternal health care ,by developing and then implementing programming through my Wellbeing Foundation Africa to improve access to skilled birth attendance, particularly better quality primary health care at a grassroot community level.

The WBFA, in partnership with the Liverpool School of Tropical Medicine and Johnson and Johnson has successfully introduced, implemented and championed Emergency Obstetric and Newborn Care (EmONC) Skills and Drills training in Nigeria which takes place in-house and equips doctors, nurses and midwives, as a collective team, with the skills needed to overcome obstetric emergencies. The training uses lifelike anatomical models and simulation case scenarios to enable health workers to develop expert first-hand experience – which is often not common in the developing world. At implementing facilities, there’s been a 15% reduction in maternal fatality & 38% reduction in the stillbirth rates – validating our push to scale these lifesaving innovative capacitation to the pre-service curriculum with the denomination of the Kwara State School of Nursing and Midwifery as Nigeria’s First National Centre of Excellence.

As the Inaugural and Emeritus Global Goodwill Ambassador to the International Confederation of Midwives, since 2014, the WBFA has recognised the role of midwives as primary educators and health carers for chilbearing women in our frontline programmes towards safer births and healthy futures through our flagship Mamacare360 Antenatal and Postnatal programme, which covers the mother’s nutritional status, mental wellbeing, and lifestyle choices, before, during and after pregnancy; profoundly affecting the future health and wellbeing of the mother and child. Antenatal education forms part of the early intervention and promotes positive perinatal outcomes and should be viewed as part of a life-long journey. My Foundation promotes respectful care and the involvement of pregnant women and their families by making the mother a premium partner in her own outcome, through education and awareness in birth preparedness.

The quest for real and practical solutions to improve PPH outcomes in Nigeria has seen us walk the daily path from research bench to hospital bedsides and birthing stools in huts over decades, from a simple mat placed under the mother to measure the flow of blood as a practical signal in 2008, and the oxytocin shot for life, to misoprostol with DFID PATHS2 in 2010, to fighting alongside with Flight For Every Mother for hands-on training across Africa in 2013, to our 6-Year WBFA-LSTM-JNJ Program To Improve The Availability and Quality Of Maternal And Neonatal Health Care In Nigeria through the EmONC Skills and Drills Program pioneered from 2015 to 2021 throughout Kwara State, to the London School of Tropical Medicine’s WOMAN Trial of tranexamic acid in 2018, to advocating to the Global Board of Ferrings in January of 2020, and an ongoing working partnership with Laerdal Global Health to improve community midwives access to modern tools and training in the 670 community HCF we have engaged with across Lagos, Kwara, Osun, Cross River, Kaduna, Kano, Sokoto and the FCT Abuja.

Now, with accessible treatment of PPH through heat-stable carbetocin, we will be much closer to reaching the Sustainable Development Goal 3, with our healthcare workers given timely access to appropriate medications and support in procedures relevant to the management of PPH, and our mothers being aware and knowledgeable on advocating for heat-stable carbetocin.

The fact remains that despite significant statistical improvements, becoming pregnant is still one of the most dangerous things a woman can do in her lifetime in Nigeria where there is a 20-fold higher risk of death than in better resourced regions of the world – but today, with the entry of heat-stable carbetocin into the arsenal, we are a quantum leap closer to tackling and ending PPH, demonstrating first-hand how work across both the public and private sectors can help achieve development goals in global health.

It is my hope that the ground-breaking progress we have made today will also mark a new era in strengthening the Essential Medicines Supply Chain and Drug Revolving Fund Management at the Primary Health Care frontline where this matters most, and to transforming maternal care around the globe with positive impact that will be implemented and accessible everywhere through heightened investment and commitment to the cause. When we save the lives of mothers, we are also saving families and communities from tragic emotional, mental and socio-economic costs of irreplaceable losses, but also realizing and potentiating an enormous opportunity for human development and a healthy future for all.

Thank you.

SPEECH FROM February 27th, 2020

Thank you to the Independent Midwives Association of Namibia and the ICM Board Members for the Africa region, who as our hosts have accorded us the warmest welcome here in Namibia.

I am delighted to offer my own welcome to you all, as ICM’s inaugural Global Goodwill Ambassador, to the Africa Regional Conference of the International Confederation of Midwives (ICM).

I would like to pay tribute to the work done by my dear friends Sally and Franka, at the leadership of level of ICM, who along with their team, work tirelessly with and for midwives all around the world.

In fact, the numbers increase every time I give a speech for ICM. I believe that ICM now supports and represents an incredible 140 Members Associations, representing 121 countries. Thank you for all that you do, and for bringing us here together, with the support of generous partners and sponsors.

Most of all, of course, welcome and thank you to our midwives. It is a real pleasure to see many familiar faces here today, and I look forward to meeting more of you over the duration of this conference.

The theme here today, ‘midwives leading the way for quality and equity in Africa,’ is striking in its simplicity and accuracy. As we share our experiences and knowledge here in Namibia,
I know that we will focus on how midwives already lead the way across Africa in so many different respects. I look forward to strategizing how we overcome barriers that prevent midwives from providing the very best of care to women, newborns, families and communities wherever they may be – from a small village in Namibia to the bustling streets of Lagos.

I have always operated according to the central belief that a women-centred, midwife-led model of care – one that follows normal physiologic labour and childbirth with no unnecessary or excessive interventions – saves lives and allows women and their infants to stay alive and thrive. That is, of course, essential. But midwife-led care is also transformative beyond the labour room.

At the World Health Assembly in Geneva earlier this year, I welcomed the launch of the report ‘Strengthening quality midwifery education for Universal Health Coverage 2030: A transformative approach to improving quality of care,’ produced by ICM, alongside WHO, UNFPA and UNICEF.

Wherever they work, midwives are the community leaders and interlocutors who are best placed to advocate for and ensure safe environments including, but also beyond, pregnancy, birth and breastfeeding. In many instances rural midwives represent the sole point of access to health care in remote and under-served areas. When midwives are safe and able to carry out their full range of services, we will have a real opportunity to drive forward Universal Health Coverage.

That means providing whole-system support for midwives, including the adequate tools, equipment, and medicine to provide the full scope of timely, high-quality care; and the capacity to carry out the WHO-recommended 8 antenatal visits.

That can only be achieved through effective supply chain management and procurement. By that I mean we must overcome challenges related to drug selection, registration, quantification, procurement, storage and distribution, quality assurance, and information systems.

Where midwives’ human resources metrics are not tracked, they cannot be managed. Thus, more data on midwives is needed: from midwifery schools on graduate profiles; to professional associations on licensure, registration, and continuing professional development. We need routine, robust, and up-to-date human resource information systems.

Midwife-generated data streams can provide valuable feedback on how services are delivered. With accurate information we can advocate for service improvements. A comprehensive civil registration and vital statistics system must form the foundation of health services and personnel decision making. Metrics provide the evidence needed to understand and advocate for how midwives’ enhanced leadership roles can optimize health systems.

We also know, and demand that a midwife’s workplace must be free from sexual harassment and gender discrimination. This as an absolute essential element of a functioning, decent and dignified health system. According to a global survey conducted by the ICM and the WHO, 37% of midwives reported that they have experienced harassment at work, whether from colleagues or patients. Effective interprofessional collaboration is important to keeping midwives’ workplaces safe. Midwifery must have its own ‘MeToo’ moment – and the harassment must end. Respect for both Midwives and their work in maternity care is a non-negotiable necessity.

At the Wellbeing Foundation Africa, of which I am the Founder-President, I have seen the remarkable effect that midwifery-led care has on equity in relationships and communities. Our ‘MamaCare’ midwives deliver their antenatal classes to women, but are also counsellors on issues as diverse as domestic violence and financial access. Men may attend some classes, and I have seen them sit quietly at the back of the room taking notes. Quite right too. I know that this is an experience mirrored by midwives across Africa, who act as strong role models and champions for women.

I am delighted to be here with you all in Namibia and I look forward to our shared learning and growth. Next year the Year of the Nurse and Midwife will be upon us. The Africa Regional Conference is going to be an important event for midwifery, it is an opportunity for us to lay the groundwork to drive progress forward. It is a space that allows us not only to share the latest developments in midwifery knowledge but also to build new partnerships that strengthen our networks within the region. A space we can exchange learning experiences and professional realities, and work together on solutions to the challenges we must overcome.
Thank you.