A critical crisis persists: Updated estimate of global midwife shortage requires urgent action

INTRODUCTION: Midwives are widely recognised as an integral element of the strategy to achieve the health-related Sustainable Development Goals. This article provides updated global and regional midwife shortage estimates and future projections. METHODS: This study estimates the global midwife shortage as the difference between the number of midwives needed globally to provide universal coverage of essential midwifery interventions and the number of midwives currently in the workforce. Two scenarios are presented: Scenario 1 uses the most recent data in the World Health Organization's National Health Workforce Accounts platform, and Scenario 2 adds data from United Nations Population Fund regional midwifery workforce reports. RESULTS: Scenario 1 includes 135 countries (45 % of the world's women of reproductive age (wra)) and estimates a global shortage of 710,000 midwives. Scenario 2 includes 181 countries (82 % of wra) and estimates a global shortage of 980,000 midwives. Under both scenarios, a small reduction is forecast by 2030 but strong inequities remain, with most of the shortage in the African region and in low-resource settings. CONCLUSIONS: Significant population growth in Africa and Eastern Mediterranean regions will bring extra need for midwifery services. The current estimate and projections indicate that the production of new midwife graduates in these regions has increased, but is only just keeping pace with the increased need, so the large shortages will not decrease by much before 2030. Further substantial increases in midwife availability are required to ensure that all mothers and newborns have access to midwives who can provide essential care.