As COVID-19 rages on, midwives continue to provide quality care in Somalia

Zahra Abdirisak, 24, qualified as a midwife in 2017 from Mogadishu Midwifery School which receives technical and financial support from UNFPA. She has since been playing her role as a midwife; being the primary caregiver for women and their newborns during pregnancy, labour, childbirth and in the post-delivery period.

"My role mainly focuses on contributing to saving the lives of mothers, and they're newborn. I also work on providing comprehensive sexual and reproductive health information and services, including antenatal care, safe delivery care, and postpartum and post-natal care," Zahra explained.

Zahra works at De Martino Hospital, a central public health facility located in Mogadishu, the capital of Somalia. It is managed by the Ministry of Health and Human Services of the Federal Government of Somalia and funded mostly by the Government of Italy through the Italian Agency for Development Cooperation. UNFPA Somalia also partners with the governments of Somalia and Italy in providing support to the hospital.

 The De Martino Hospital is the main referral hospital in Somalia for treating COVID-19 patients, and Zahra continues to provide midwifery services in the hospital amidst response to the pandemic.

"My workload has increased since the outbreak of COVID-19 in Somalia in March 2020. I just had to double my efforts to provide health care services exceeding my normal midwifery tasks. I now have to ensure that I take care of myself first by following appropriate health measures before providing care to my clients so that I don't catch the virus," said Zahra.

Several health workers at the hospital have tested positive to COVID-19. As of 6 September 2020, Somalia had recorded 3,362 cases with 97 deaths and 2,738 recoveries.

Zahra also provides community awareness on the risks of COVID-19 and how to stem its spread. "I have to counsel mothers on what measures they should take to avoid the spread of the virus in addition to my role of providing midwifery services," she said.

At the hospital, Zahra helps patients practice social distancing. "I do not allow mothers to sit close to one another since COVID-19 can spread through physical contact," she explained.

UNFPA Somalia Midwifery Specialist Hawa Abdullahi Elmi said just like Zahra, many midwives continue to work tirelessly on the front line in maternity wards, health centres and women's homes, risking their own lives and wellbeing to save the lives of women and newborns.

"It is an act of bravery. Preparedness for COVID-19 was not fully in place when the pandemic was first reported in Somalia, but Zahra and other midwives continued to provide care," said Elmi.

She said that midwives are a crucial factor when it comes reducing maternal mortality and wellbeing of mothers and newborn and that they are the closest health care providers to the communities because they operate in remote areas across Somalia including where other health services are not available. Millions of women and girls in Somalia remain at significant risk of maternal mortality which remains high, with 1 in 20 women aged 15 expected to die of pregnancy or birth-related complications by age 49. 

"There is a great need to invest more in midwifery by training more midwives and establishing continuous professional. Creating employment opportunities, enabling a good working environment for midwives and providing motivation is also important to absorb more midwives to reach vast areas," said Elmi.

UNFPA Somalia has since supported the training of around 1500 midwives including Zahra. It is estimated that approximately 3,000 midwives are available across the country, including those who graduated from unregulated private schools and those who have since retired. Somalia needs 20,000 more midwives to meet population needs to midwifery services, according to the World Health Organisation.

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