Midwives in Morocco: seeking recognition as skilled partners in women-centred maternity care.

Around the world, midwives are increasingly being called upon to provide skilled care for pregnant women and newborns. In Morocco, there is a persistent lack of professional recognition of midwifery, which is consistent with widespread gender inequality and women's low status. Midwifery training in Morocco has evolved since the 1960s into a three-year undergraduate programme. Despite this, there is currently a shortfall of midwives to attend the large number of births in Morocco. Midwives have only partially replaced traditional birth attendants, especially in rural areas. Maternal mortality remains high. However, several recent government policies reflect increased attention to women's needs, e.g. since February 2006, midwives may be eligible for reimbursement should a medical doctor be unavailable. Since 1990, the Moroccan Midwives Association has been actively encouraging midwifery curriculum review, improvements in training and the professional status of midwifery. Partnerships with international midwifery associations have revealed challenges encountered elsewhere and helped us to establish specific strategies for promoting the professional recognition, autonomy and visibility of midwifery in Morocco. In a cultural context such as Morocco's, a disciplinary link between midwives and the medical community seems crucial. However, only with recognition of midwives as competent, skilled and valued partners can midwifery practice in Morocco progressively evolve into women-centred maternity care.