MIDWIFERY CARE MANAGEMENT IN SEXUAL AND REPRODUCTIVE HEALTH: EVIDENCE AND A RIGHTS-BASED APPROACH

Abstract

The World Health Organization (WHO) indicates that midwives can meet up to 87% of essential sexual and reproductive health needs [1]. Furthermore, international studies have demonstrated that midwife-led care models improve maternal and neonatal outcomes and reduce unnecessary interventions [2,4,9]. However, their participation in national governance remains limited, creating gaps between available evidence and health decision-making [3].

Scientific evidence supports that midwifery has a direct impact on reducing maternal and neonatal morbidity and mortality [2,4], while also contributing to enhancing patient experience and decreasing unnecessary interventions in healthcare processes [9].

The integrated health services networks model promotes continuity of care, coordination across healthcare levels, and people-centered care [6]. Midwifery care management, being present across all levels of the healthcare network in Chile, plays a key role in articulating these processes, thereby preventing fragmentation of care [6,7].

On the other hand, the health rights approach has highlighted the need to advance toward more humanized care models. Various studies have documented the existence of mistreatment during childbirth care, which constitutes a violation of rights [5,8]. Nonetheless, midwife-led models have been shown to reduce these practices and promote respectful care [5].

Despite this evidence, structural barriers persist that limit the participation of midwifery at decision-making levels, which impacts the quality and efficiency of the healthcare system [3].

Leadership in national-level Midwifery Care Management is essential to strengthen health systems, improve clinical outcomes, and guarantee respect for sexual and reproductive health rights [1,2,8]. Integrating this discipline into governance spaces constitutes a technical, ethical, and sanitary necessity to advance toward a more equitable, people-centered care model with a human rights approach.