Future Trends and Challenges in International Midwifery

upon or within nursing, and (2) midwifery education entered directly without a health background.

In each of these two pathways, there are a variety of educational levels that are prerequisite to entering midwifery education. Within developed nations, the majority of midwifery education is built upon a minimum of a high school education, although the actual midwifery education may or may not lead to a college degree. In developing nations, midwifery education is generally built upon a minimum of a tenth grade secondary education.

It is estimated that approximately one-half of the world’s professional midwives are also nurses, constituting dual professional qualification. Many nations require dual qualification in nursing and midwifery to meet the growing need for professional health workers working in community-based primary care facilities. In other areas of the world, direct-entry midwifery is encouraged to meet the demand for childbearing services of high quality.

And in several nations, both types of professional midwives are prepared. Whatever the pathway to midwifery education, it is the competencies of the individual midwife that are most important.

5. How can I become active in the International Confederation of Midwives? Any individual midwife who is a member of a midwifery association that is a member of the International Confederation of Midwives (ICM) is considered an active member of the ICM. As noted earlier in this chapter, ICM depends on the volunteer efforts of midwives throughout the world to carry out its mission, vision, and global strategy. Midwifery students, new graduates, and experienced midwives are encouraged to take an active role within the ICM. This role may be working with officers of the Confederation on individual projects, such as the evolving international midwifery competencies and standards of practice, the development of the ICM Web site, or on mid-triennium conferences and Triennial Congresses held in their area of the world.

Anyone interested in becoming active in the ICM should contact the Secretary General at ICM head- quarters to volunteer their time and talents.

Future Trends and Challenges in

(communication, emergency transportation, emergency funds, permission to seek medical care, etc.) and development of community solutions to community problems. This local solution means that solutions are within the means of the community and therefore have potential for sustainability.

Participatory learning activities (PLA) are tech- niques developed by agricultural workers to in- volve community members in examining all sides of an issue and seeing how multiple inputs can help bring a solution. The goal is to encourage various levels and groupings of stakeholders to contribute in practical ways. Positive deviance is a strategy that analyzes how positive behavior has survived in the face of cultural and family pressures. For ex- ample, if a few families in a village have resisted the pressure to have their daughters circumcised, studying how they have succeeded in a pressured environment yields helpful information in developing a strategy to eliminate female genital mutila- tion. Applying strategies such as PLA and positive deviance helps bring about profound changes at the community level.

As a midwife, you will have the power to make a profound impact on the survival of mothers and infants globally. Begin with the best educational preparation, maintain competence, listen to women and respond to their needs, and never become complacent about maternal mortality and morbidity. Women and families are counting on you!

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