Freetown, Sierra Leone – 5 May 2025 – Sierra Leone joined the global community in marking the International Day of the Midwife (IDM) 2025, honoring the critical role midwives play in advancing maternal and newborn health, particularly during times of crisis. Commemorated under the global theme “Midwives: Critical in Every Crisis,” the event served as a platform to celebrate the achievements of midwives and emphasize their crucial role as first responders in times of crisis. The event also provided an opportunity to advocate for the development of crisis-ready midwifery systems, the importance of dignified working conditions for midwives, and the need for sustained investments in maternal health, while highlighting the challenges that still need to be addressed.

Organized by the Sierra Leone Midwives Association (SLMA) in partnership with the Ministry of Health, UNFPA, and other partners, the week-long observance included a scientific symposium, a community advocacy walk aimed at raising awareness of the vital role midwives play in maternal and newborn health, media engagements, essay competition for midwifery students from the country’s four midwifery schools, and a national commemoration and awards ceremony, with a strong emphasis on inclusivity, capacity development, and accountability.

Progress in reducing maternal mortality and expanding midwifery coverage

Over the past two decades, Sierra Leone has made significant strides in reducing maternal mortality and expanding access to skilled care during pregnancy and childbirth. The maternal mortality ratio (MMR) has declined by 79 per cent, from 1,682 deaths per 100,000 live births in 2000 to 354 per 100,000 in 2023. This achievement reflects the government’s commitment to improving maternal health, alongside technical and financial support from development partners.

Crucial to this progress has been the investment in midwifery education and deployment. The number of trained and practicing midwives in Sierra Leone has increased from fewer than 100 in 2010 to approximately 1,800 in 2024, helping to expand coverage in rural and underserved communities.

''Midwives are the backbone of maternal and newborn healthcare, " said Sibeso Mululuma, UNFPA Sierra Leone Officer in Charge. “They provide essential care, from pre-natal check-ups, safe delivery to post-natal support and family planning. Their expertise not only ensures the health and well-being of women and newborns but also strengthens entire communities.''

Elevating Knowledge: National Scientific Symposium

The IDM commemorations began on 2 May with a National Scientific Symposium which was hosted by the SLMA and supported by UNFPA, and  brought together midwives, clinicians, academia, and development partners to share evidence, innovations, and best practices in maternal and newborn care.

Key deliberations focused on:

• Midwifery-led care models and their impact on maternal and newborn outcomes
• Integration of the Maternal and Child Health Handbook as a continuity-of-care tool
• Innovations in community outreach and service delivery
• Prevention and management of obstetric fistula
• Maternal mental health and impaired maternal-infant bonding.  

Community Engagement: Walk for Inclusion

On 3 May, midwives took their advocacy to the streets through a “Walk for Inclusion”, aimed at engaging communities on the importance of early antenatal care, skilled birth attendance, and respectful maternity care. 

The walk emphasized the role of midwives as trusted health professionals who bridge the gap between health systems and communities.

"Midwives are essential not just in the delivery rooms, but also in our communities," said Umu Fye, SLMA Secretary General. “We help women understand their bodies, their choices, and the services available to them. Our presence changes lives.”

Amplifying Voices: Strategic Media Engagements

To broaden the reach of the IDM message, UNFPA and SLMA engaged with national media platforms in the lead-up to and during the commemoration. Radio and television discussions featured midwives sharing real-world experiences and challenges, while UNFPA’s Maternal and Reproductive Health Specialist, Yatta Musa, reinforced the need for continued investment in the profession and emphasized the progress made through partnerships. These appearances helped spotlight the lived realities of midwifery in Sierra Leone and brought the conversation to households across the country.

Youth Leadership: Midwifery Student Essay Competition

To nurture leadership among the next generation of midwives, UNFPA supported a national essay competition among students from the four midwifery schools in Sierra Leone. Participants were invited to creatively write on the IDM 2025 theme. Winning entries were recognized and awarded at the main commemoration event. This not only demonstrated the relevance of IDM to the budding midwives but also sought to inculcate in them a culture of being advocates for midwifery at national and sub-national levels. 

National Celebration and Recognition

The week of commemoration culminated on 5 May with a national event held in Freetown. Attended by government officials, development partners, midwives, and community representatives, the event featured:

• An awards ceremony supported by SEED Global recognizing 60 exceptional midwives across Sierra Leone’s 16 districts for outstanding service and leadership
• The distribution of baby packs to 60 pregnant and lactating women, supported by UNFPA, to provide essential items for mothers and newborns
• Statements  and testimonials celebrating the impact of midwifery in improving health outcomes
• Presentation and demonstration on pre-eclampsia led by Welbodi Partnership. 

In her keynote address, Dr. Joan H. Shepherd, Former Principal of National School of Midwifery, paid tribute to the relentless dedication of midwives in Sierra Leone, particularly in times of crisis. Reflecting on the theme "Midwives: Critical in Every Crisis," she acknowledged their consistent commitment to maternal and newborn health, even under challenging circumstances. "They are the ones helping mothers through the most vulnerable moments. They are the ones ensuring babies come into this world safely," Dr. Joan stated, emphasizing their indispensable role in safeguarding lives. She further highlighted the resilience displayed by midwives during various crises such as Ebola and COVID-19, noting their courage and compassion in delivering care, often with limited resources. 

“We are not just service providers—we are educators, advocates, and protectors of life,” said Edwina Conteh, President of the Sierra Leone Midwives Association. “This day is a celebration of our contribution and a reminder of the urgent need for investment in midwives and the systems that support them. Whether during Ebola, COVID-19, natural disasters, or ongoing humanitarian challenges, midwives have been at the frontlines often under-resourced but never defeated. We have worked without adequate personal protective equipment, walked long distances when transportation failed, stayed awake for nights on end, and even put our own lives at risk to ensure that no woman gives birth without a midwife, and no baby enters this world without a skilled hand to receive them.’’ We have not only delivered babies we have delivered hope.’’ 

UNFPA’s Commitment and the Midwifery Accelerator

 Sierra Leone's International Day of the Midwife celebrations in 2025 coincided with a significant global initiative: the launch of the Midwifery Accelerator on April 7, World Health Day, at the 58th Session of the Commission on Population and Development (CPD58) in New York. This global roadmap, co-led by UNFPA, WHO, UNICEF, ICM, and Jhpiego, aims to strengthen midwifery services worldwide by focusing on training, deploying, equipping, and retaining midwives, particularly in underserved communities. The initiative was informed by country consultations in six high-burden countries, including Sierra Leone, and reflects key priority areas that need to be addressed through accelerated actions to improve global availability of and access to quality midwifery care.

“We can and must end preventable maternal deaths,” said Dr. Natalia Kanem, Executive Director of UNFPA. “We have the knowledge and tools to ensure safe births. We now need to step up what works: skilled midwives, quality care, and strong political commitment. This new initiative is about delivering on all three with the urgency they deserve.”

In Sierra Leone, UNFPA’s support, including through previous funding from the UK Government’s Foreign, Commonwealth and Development Office (FCDO), has been instrumental in strengthening the midwifery sector. This includes:

• Enhancing midwifery school infrastructure and curricula in Freetown, Bo, and Makeni
• Increasing the number of midwives through pre-service training
• Providing clinical and learning equipment
• Supporting on-the-job mentorship and continuous professional development
• Advocating for midwifery leadership in national health planning

UNFPA, through its flagship programme - maternal and newborn health fund (MNHF), is also supporting the digital modernization of the Sierra Leone Nursing and Midwifery Council (SLNMC). In collaboration with the Directorate of Science, Technology, and Innovation (DSTI), this initiative will develop a centralized digital database to enhance regulatory oversight, improve data accuracy, and streamline certification processes. By ensuring that only qualified and accredited professionals are licensed to practice, this transformation will bolster public trust, improve workforce management, and contribute to higher standards of care across the country.

Despite the progress made, Sierra Leone continues to face challenges, particularly in the equitable distribution of midwives, resource constraints, and systemic barriers to care. However, the country's journey demonstrates that with political will, strategic investment, and community engagement, maternal deaths can be prevented.

“Midwives are not only lifesavers; they are also a vital force for promoting the health, well-being, and dignity of women and their families. They are, indeed, critical in every crisis, and they deserve our utmost respect, gratitude, and support” underscored Sibeso Mululuma UNFPA Sierra Leone Officer in Charge. “