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May 5, 2022, at 3:00 p.m., baby Noelia with a birthweight of 2.5kgs let out her first cry inside the UNFPA tent, serving as temporary maternity ward at the regional referral hospital in Mananjary, Vatovavy region - the main structure having been destroyed during the passage of the Batsirai and Emnati cyclones at the beginning of the year. The birth of this baby girl was assisted by midwife Marie Nancy Christiane, who was on duty during this International Day of Midwives.

For midwife Nancy, the day not only demonstrated the importance of midwifery but also reaffirmed her worth and responsibility in the society. "I am so proud to be a midwife and happy to have helped this 17-year-old girl give birth safely today. She is still very young and this is the very first child of this couple to whom we proposed post-partum contraception" she informed us. In effect, 18 is the legal age for marriage in Madagascar according to law n° 2007-022 of August 20, 2007 relating to marriage and matrimonial regimes, however a majority of girls (40%) are married off before the age of 18. As a part of its gender-based violence programme, UNFPA works in Madagascar with authorities, the police, local communities and traditional leaders in order to raise awareness on gender-based violence, including teenage pregnancies and child marriage.

Working to save her community

"More and more, women are turning out for medical assistance at the very first sign of labour," Nancy added. Educating women and community workers on the importance of giving birth to their babies in health facilities is part of her everyday efforts. The positive impacts of such efforts in the community constitute a victory for her.

Nancy counts herself among the midwives who are passionate about their profession and convinced that her priority is to save lives. "Ever since I was a teenager, I was determined to become a midwife. I wanted not only to help women in my native Mananjary but to save my community and region." Upon graduation, she volunteered as a midwife for one year in Amboanato, a rural community in the Vatovavy region. She was later recruited as a midwife in Mananjary within the framework of UNFPA's support programme to the Ministry of Public Health from 2020 to 2021. Owing to her exceptional performance, she was integrated into the public service and she currently heads the team of midwives who are committed to ensure safe births at the Mananjary maternity ward.

"I really like this tent. It’s well-equipped, so much so that it looks like the usual maternity ward. Here, we help deliver babies in very hygienic conditions while ensuring that pregnant women are treated with dignity and that they receive the quality care they need," Nancy added.

While it is true that being a midwife is not an easy job, Nancy knows how to keep her motivation on the high, because she fully understands that it is thanks to her, that women are able to give birth and return home with their babies without any worries.

"Ever since I was a teenager, I was determined to become a midwife

Accelerating progress towards universal access to reproductive health

UNFPA is supporting the Government in the implementation of in-country midwife Programme through delivery of safe birth supplies, family planning services and other lifesaving materials.

The temporary maternity ward in Mananjary has been operational since February 2022, enabling women to have their babies in all safety. Between February and start of May, 58 safe deliveries have so far been carried out thanks to the highly-skilled and competent midwives, and nursing staff assigned here.

Recently, the percentage of births attended by skilled health personnel has improved in this region, with an increase from 20.4% in 2018 to 37.8% in 2021 according to the Demographic and Health Survey 2021.