Indigenous Midwives Gain Recognition for Protecting Mothers and Newborns

Comadronas assist around one-third of births in Guatemala and often take on wider roles as community healers, caregivers and trusted advisers to women and children.

Indigenous midwives, community facilitators and caregivers continue to play a central role in protecting the health of mothers, newborns and families, often working in remote communities where formal healthcare services are limited or difficult to reach.

Their work goes far beyond assisting with childbirth, since many also identify high-risk pregnancies, guide families through early childcare, share traditional knowledge and connect communities with clinics and hospitals when specialist care is needed. Much of this work remains outside formal health systems, leaving many caregivers without the recognition, resources or compensation that match the responsibility they carry.

This year's International Day of the World's Indigenous Peoples is highlighting that contribution under the theme "Honouring Indigenous Midwives: Safeguarding Life and Well-being," bringing greater attention to the need to value their skills and strengthen the systems around them.

Guatemala Brings Midwives Into the Health System

Guatemala has taken major steps to formally recognize comadronas, or traditional midwives, through its National Policy of Midwives, introduced in 2015 to strengthen culturally relevant maternal healthcare and build stronger links between Indigenous communities and the national health system.

Comadronas assist around one-third of births in Guatemala and often take on wider roles as community healers, caregivers and trusted advisers to women and children. Nearly 19,500 Indigenous midwives are now registered and carry official identification, helping them work more closely with health providers while keeping their own cultural practices and traditional knowledge.

The policy has also supported care in Indigenous languages, increased access to supplies and annual incentives, and raised public recognition through the creation of a National Day of the Guatemalan Comadrona.

Training Helps Reduce Risks During Pregnancy

Recognition alone does not solve the practical challenges facing community caregivers, which is why training, equipment and stronger referral systems have become another important part of maternal health programmes.

A small World Bank-supported grant in Guatemala's Lake Atitlán region trained comadronas to identify dangerous pregnancies and refer women to hospitals, while also supplying basic sanitary materials and delivering lessons in Indigenous languages. Following the training period, maternal deaths in the region fell from 18 to three, showing how focused support can make a significant difference when it is designed around local needs.

The World Bank-financed Crecer Sano Project has also trained 4,500 comadronas as "friends of breastfeeding," while involving them in the design of health facilities and regular knowledge exchanges with health workers.

Similar Models Expand Across Other Countries

Panama, Lao PDR and India are also using community-based approaches to strengthen maternal and child health in remote and Indigenous areas. In Panama, more than 196 traditional midwives have been trained through a World Bank-supported programme that also helped produce the country's first National Midwifery Training Manual. Lao PDR has trained 3,250 ethnic minority women as village facilitators, giving them practical skills in nutrition and maternal and child health so they can support families in hard-to-reach communities.

India has used targeted training programmes to improve healthcare access in tribal regions, including reserving places for tribal women in auxiliary nurse-midwife courses in Karnataka, allowing more women to serve communities where they share language, culture and local knowledge.

Stronger Health Systems Depend on Local Trust

The experiences across these countries point to the same lesson: health services work better when traditional knowledge is respected, community caregivers are included and formal medical systems build relationships with people who already hold the trust of families.

Supporting Indigenous midwives can improve maternal and newborn health while also creating stronger opportunities for women whose work has often gone unpaid or overlooked. Their role combines healthcare, education, cultural knowledge and leadership, making them an important part of community health systems rather than an informal service operating on the margins.

Recognizing that contribution gives countries a chance to build health systems that are more inclusive, culturally responsive and better equipped to reach mothers and children wherever they live.