BACKGROUND:
The Global Midwifery Strategy 2018–2030, led by the United Nations Population Fund (UNFPA), has guided the strengthening of midwifery in Latin America and the Caribbean (LAC), promoting its integration into sexual, reproductive, maternal, and newborn health systems. Five years into its implementation, a regional midterm evaluation was conducted to assess progress and challenges across its six pillars: education, regulation, workforce, associations, enabling environments, and professional recognition.

OBJECTIVES:
The objective was to assess the progress of the Strategy between 2018 and 2023, identifying areas for improvement toward 2030.

METHODS:
In 2024, an ex-durante (mid-implementation), mixed-methods evaluation was carried out. With no conflicts of interest, the methodology included a document review of 65 strategic sources, surveys with 43 key stakeholders across 14 countries (analyzed using descriptive statistics), 12 semi-structured interviews, and a participatory workshop with 38 decision-makers (all inductively coded). Ethical principles of confidentiality and informed consent were applied.

RESULTS:
Quantitative results show progress in education (91%), professional associations (73%), and participation in public policy (67%), while regulation remains a critical gap (36%). UNFPA-promoted partnerships were positively rated by 85% of respondents. These findings were enriched by qualitative analysis, which captured diverse national experiences and showed how the Strategy has catalyzed coordination, emerging leadership among midwives, and increased institutional and social visibility. Narratives also highlighted political barriers, regulatory fragmentation, and the need for stronger evidence to sustain progress.

CONCLUSIONS:
The Strategy is proving transformative in LAC, but its sustainability requires solid regulation, active leadership, and strong information systems. The evaluation methodology is replicable and provides key midterm baseline evidence for the upcoming State of the World’s Midwifery 2028 report.

KEY MESSAGE:
Evaluating is transforming. A global strategy gains strength when it is adapted to local contexts and supported by active partnerships. Midwifery in LAC is ready to lead the progress in sexual, reproductive, maternal, and newborn health. Spanish - policy (including three-minute presentation competition)