Visa refusals have jeopardised strides in maternal and newborn health, global midwifery leaders warned, after experts from low‑resource countries were barred from a pivotal conference.
This week, politicians, donors and UN agencies gathered at the International Confederation of Midwives (ICM) congress in Lisbon, Portugal, to discuss the millions of preventable maternal and infant deaths worldwide.
However, last‑minute visa denials excluded prominent midwives from Africa and Asia, the regions that bear the highest burden of maternal and infant mortality.
Urgent appeals were filed on behalf of delegates from Nigeria, Ghana, Rwanda, Burundi, Uganda, Tunisia, Ethiopia, Sierra Leone, Bangladesh, India and Indonesia.
ICM advisor Kate Stringer said, “These midwives are leaders working in countries that bear the highest burden of deaths.”
“A mother dies every two minutes from pregnancy or childbirth. How can we intervene if the leading researchers and clinicians are barred?” she added.
This is illogical. It is a life‑and‑death situation, sustained by colonial bias, she continued.
In Uganda, midwife Harriet Akello runs a lifesaving initiative that has drawn the attention of the World Health Organization (WHO). She was due to speak in Lisbon about transforming fragmented, high‑risk maternity systems into a midwifery model of care—where a small team of skilled midwives keeps mothers safe.
Through her NGO Mother Health International, Akello helps overwhelmed public maternity centres align with WHO standards in a remote post‑conflict region near the South Sudan border, 95 km (60 miles) from a referral hospital.
“Policymakers are in Lisbon, yet here I am in Uganda, trying to convince an embassy that I should be allowed to travel. I am gutted and insulted. The WHO calls for midwifery models of care. I can demonstrate a rare example, but I have been silenced,” she said.
Having recently travelled to Sweden for work, she added, “I was in a Schengen country last year. I did not overstay—my work for Ugandan mothers is pressing.”
Two Bangladeshi midwifery union leaders were denied visas, even as a male government official flew to Lisbon to pledge 25,000 additional midwives for the country.
Similarly, Dr. Arthur Munkana of the Democratic Republic of the Congo expressed frustration over four midwives who could not attend: “Our country is devastated by mothers dying. Quality midwives are a key solution, yet only I obtained a visa.”
Stringer described this as “gender inequity laid bare.”
Alison Perry, a researcher at Imperial College London, said a Ugandan midwife she collaborates with was also excluded. “This represents overt discrimination against equitable participation in international conferences,” she observed.
Portugal’s Ministry of Foreign Affairs said visa assessments were performed “rigorously, objectively, and factually,” in line with Schengen rules.
Globally, about 260,000 women die each year in childbirth, 1.9 million babies are stillborn, and 2.3 million newborns die. Approximately 70 % of maternal deaths occur in sub‑Saharan Africa, with the remainder mainly in Asia.
The WHO has urged governments—including the UK—to make “midwifery models” a core service. The ICM reports the world is a million midwives short of safe staffing levels.
This week, the ICM also covered obstetric hemorrhage, which affects 27 million women annually, claims 43,000 lives, and costs countries more than £7 billion. New Lancet data highlighted six critical factors for survival, including accurate, timely diagnosis and access to blood transfusions.
