Global Health Focus Shifts to Systems
Experts are arguing that a focus on "effective charity" like distributing vitamins has overshadowed the more critical, long-term work of strengthening health systems. Building resilient, locally-funded systems in countries like Rwanda and Thailand is being presented as a more sustainable path to improving global health outcomes.
A worldwide shortage of 900,000 midwives is a critical barrier to strengthening health systems, particularly in lower-income countries. Investing in midwives is recognized as a cost-effective strategy that yields a significant return by saving lives and increasing health system efficiency. Universal access to midwife-led care could prevent over 80% of all maternal and newborn deaths, potentially saving 4.3 million lives annually by 2035. The American College of Nurse-Midwives (ACNM) actively promotes midwifery globally as a key to improving maternal and newborn health. For over three decades, the ACNM's Department of Global Outreach has mentored midwives in more than 30 countries, focusing on building local capacity through training, education, and professional association strengthening. In Virginia, 47% of counties are classified as "maternity care deserts" with limited or no access to maternal health services. In response, legislation signed in 2025 aims to increase access to midwifery care by allowing independent practice for experienced Certified Nurse-Midwives (CNMs) and Licensed Certified Midwives (LCMs) and mandating insurance reimbursement parity. Advocacy groups like Virginia Families for Access to Midwifery continue to push for the full integration of midwives to improve outcomes. Digital health platforms are emerging as a key tool to strengthen maternal health systems. Innovations like AI-powered chatbots for patient education, remote monitoring devices, and virtual doula care are being used to improve access to care, especially in underserved areas. Platforms like PowerMom and Mae Health focus on recruiting diverse participants for maternal health research to address disparities and build trust with communities.
