Statement of Commitments for Advancing Midwifery in the European Region

Statement of Commitments for Advancing Midwifery in the European Region

On the occasion of the launch of The State of the Midwifery Workforce in Eastern Europe and Central Asia, and gathered by the European Forum of National Nursing and Midwifery Associations (EFNNMA), the WHO Regional Office for Europe and the UNFPA Regional Office for Eastern Europe and Central Asia, representatives of governments, inter-governmental and non-governmental organizations, researchers and academics, networks of health care professionals, civil society and women activists have pledged to undertake as a matter of priority the necessary measures to advance the midwifery agenda in the European Region.

  • We are guided by Sustainable Development Goals related to health, the 1994 International Conference on Population and Development (ICPD) Programme of Action, WHO and UNFPA policies and strategies and countries’ priorities to advance midwifery in the European Region.
  • We are inspired by the Bucharest Declaration on Health and Care Workforce and the Global Strategic Directions for Strengthening Nursing and Midwifery to ensure the sustainable protection and enablement of our health and care workforce.
  • We recognize that our efforts to support midwifery will have positive outcomes for the health and well-being of populations, in particular by reducing preventable deaths of mothers and newborns and by accelerating progress towards achieving universal access to sexual and reproductive health services in line with Sustainable Development Goals and the ICPD agenda.
  • We recognize the important role that governments, academia, civil society, development partners, and the private sector can play in advancing midwifery education, competencies and regulation in line with international standards and practices.
  • We welcome the recommendations included in the State of the World’s Midwifery 2021 and the State of the Midwifery Workforce in Eastern Europe and Central Asia reports, as well as in strategies and best practices developed by WHO, UNFPA and other partners in the respective area.
  • We recognize that a comprehensive response to the challenges and gaps in midwifery practice in the European Region requires intersectoral and international cooperation.
  • We will cooperate with and support international, regional and national efforts to strengthen midwifery associations and promote midwifery practice in the European Region

and follow the implementation of the recommendations of the State of the Midwifery Workforce in Eastern Europe and Central Asia report.

  • We will support measures and structures to institutionalize meaningful participation of midwives and midwifery associations in developing and implementing national policies, strategies and action plans aimed at improving SRH and health outcomes of the population in general.

We call on Member States, with the support of international organizations, academia, private sector and civil society, including NGOs, to:

Improve midwifery education by

  • ensuring it is delivered and led by midwives;
    • ensuring midwives have the requisite knowledge, competencies and attitudes to meet international standards and national health priorities;
    • enabling midwives to exercise their full scope of practice to ensure the needs of the population are met and to foster safe and patient-centred reproductive health services;
    • ensuring midwives have access to continuing life-long learning to upscale skills and competencies as their practice environment changes.
    • ensuring that midwifery education standards in public and private sectors are based on the latest evidence-based standards and practices.

Advance the midwifery profession by

  • sustainably creating midwifery jobs, effectively recruiting and retaining midwives, and ethically managing their international mobility and migration;
    • ensuring effective and fit-for-purpose regulatory systems that reflect the autonomy and professional scope of midwives;
    • investing in their skills and competencies and enabling their autonomy and integration into available interprofessional teams;
    • protecting the professional scope of midwifery practice that provides safe and high- quality care from the advancements of non-professional groups.

Improve service delivery by

  • ensuring midwives are appropriately educated, trained and able to work to their full scope of practice in safe and supportive service delivery environments
    • strengthening national policies and regulations, enabling midwives to provide a woman- centred, client-oriented respectful continuum of care for women, adolescents and communities, preventing complications and fragmentation of care.
  • reconsidering the available models of service delivery, especially primary health maternity services, and optimizing them for greater efficiency and higher quality of care by granting midwives responsibility for managing normal births and granting them greater involvement in the design of services;
    • advancing midwifery education and regulations to enable midwives to be a primary point of contact for the community for a wider spectrum of sexual and reproductive health services and information, including self-care interventions, responding to violence against women and addressing sexual and reproductive rights, promoting women’s empowerment and behaviour change on family planning, as well as in addressing harmful social and gender norms and practices such as child and early forced marriage;

Promote midwifery leadership by

  • recognizing that by appointing them to strategic leadership positions within organizations responsible for sexual, reproductive, maternal, newborn and adolescent health care systems, midwives can contribute vital insights into improving the safety of mothers, newborns, families and communities;
    • supporting national midwifery initiatives and midwives’ associations and encouraging networking within and beyond the Region;
    • engaging midwives’ associations in national health policies and strategies development and implementation processes.


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United Nations Population Fund, World Health Organization. The State of the Midwifery Workforce in Eastern Europe and Central Asia. (ttps:// midwifery-workforce-eastern-europe-and-central-asia, accessed 25 April 2023

Statement by UNFPA Executive Director Dr. Natalia Kanem on the International Day of the Midwife 5 May 2023:

natalia-kanem-international-day-midwife-2023 (accessed 1 May 2023)

United Nations Population Fund and International Confederation of Midwives. Comprehensive Midwifery Programme Guidance: pdf/Midwifery%20Programme%20Guidance.pdf

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United Nations Population Fund Eastern Europe and Central Asia Regional Office: Child marriage. 2022 (, accessed 29 July 2022).

WHO Europe, 2022 Health and care workforce: time to act accessed 25 April 2023

WHO Europe, 2023 Bucharest Declaration on the Health and Care Workforce:

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