Midwives and Maternal Health

Today, The Guardian ran a feature article about Collette Botchomoli, a trained midwife in Maniema Province, D.R. Congo. This is a remarkable story of one woman who has dedicated her life to helping others. As the article reports, she sometimes tends to 20 patients in a week, with no doctor. For 33 years, she has been the only midwife for over 5000 women, and only recently began receiving a salary.


Midwives and traditional birthing agents still perform most of the antenatal care for women in the developing world, particularly Africa. Attendance at antenatal clinics has been on the rise in Africa since the 1990s, up from 64 percent to 79 percent in 2007. But less than half the women in Africa attend the WHO/UNICEF recommended threshold of four visits. Only 44 percent of African women deliver with a skilled health worker present (World Bank, 2010).

Yet while there is an issue of tradition, other factors come into play as well. HIV/AIDS testing at antenatal clinics (even when not mandatory) could scare off women due to stigma.

Does anyone know of a study that has been conducted to investigate the correlation between antenatal attendance and HIV testing uptake in Africa?

In addition, there are still too few skilled health workers on the continent, despite the positive effects that HIV/AIDS programming have had on training health workers.



In brief, Africa desperately needs individuals like Ms. Botchomoli. They do a good job and with little to no pay. They do it without help from outside most of the time. And guess what? It works. So why aren’t we working with them instead of against them?

H/T Kaiser Family Foundation for graphics

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