WASHINGTON, United States (CMC) — The Pan American Health Organization (PAHO) Monday said that only 60 per cent of countries in the Americas, including the Caribbean, have a regulatory authority that clearly defines the scope of midwifery practice, and just half have systems in place for periodic license renewal and quality assurance.

“These gaps limit the ability of health systems to fully harness the contribution of midwives and ensure high-quality, safe and respectful care,” PAHO said in a statement ahead of the observance of International Day of the Midwife on Tuesday.

The United Nations (UN) organisation said that it is working closely with member states to strengthen midwifery and the broader health workforce and that it supports workforce planning using national data, the development and modernisation of education and training programmes, and the advancement of regulation and professional recognition.

PAHO said it is also promoting the integration of midwives into interprofessional teams and supports the use of evidence-based guidelines to improve quality of care, including respectful maternity care.

It said currently, the region has 160 professional midwifery training programmes, many incorporating digital tools, interprofessional education and diverse clinical training settings. Encouragingly, 88 per cent of graduates achieve core midwifery competencies, preparing them to deliver comprehensive care from sexual and reproductive health through pregnancy, childbirth and the postnatal period.

PAHO said it is urging countries to invest in midwifery as a cornerstone of resilient, equitable and people centered health systems.

“Midwives play a critical role in delivering comprehensive, essential care to women, newborns, families, and communities across the life course. When adequately trained, supported and integrated into health systems, midwifery personnel can provide up to 90 per  cent of essential sexual, reproductive, maternal, newborn, and adolescent health interventions.”

PAHO said data from the National Health Workforce Accounts (NHWA) platform show that there are more than 78,000 midwifery professionals in the region, with an average density of 3.5 per 10,000 population.

“Subregions such as Central America and parts of the Caribbean report critically low densities, ranging from as few as 0.1 to 13.5 per 10,000 population. These inequities underscore the need to scale up the production, equitable distribution and retention of midwives where they are most needed,” PAHO said.

The Unit Chief of Human Resources for Health at PAHO, Benjamín Puertas, said strengthening the health workforce is a strategic priority for the region.

“Midwives are essential to expanding access to care, particularly in rural and underserved areas, and to ensuring continuity of high-quality services for women and newborns,”  he added.

PAHO said that midwives play a vital role within interprofessional health teams, particularly in primary health care. Their practice is grounded in respectful, culturally sensitive care that recognises the social, cultural, and community contexts in which women and families live. Through continuity of care and close links with communities, midwives contribute to improved health outcomes, social equity and community trust in health services.

In the Americas, three out of every four countries formally recognise midwifery as a profession distinct from nursing, a key step toward advancing specialised education, professional autonomy and regulatory frameworks that enable midwives to practice to the full scope of their competencies.

“Where midwifery is well integrated, midwives contribute not only to safer pregnancies and births, but also to sexual and reproductive health, newborn care, adolescent health, disease prevention, and health promotion,” PAHO  added.