PURPOSE:
To build an enabling ecosystem for midwifery in India, WRAI/C3 adopted a strategic advocacy approach that amplified midwives’ voices, built their leadership and advanced systemic change for midwifery in India, grounded in evidence and priorities set by midwives themselves.

DISCUSSION:
The advocacy approach adopted a four-step cycle: 1. Identifying Priority Issues: Through the ‘What Midwives Want’ campaign, over 10,500 midwives from across India shared insights. Their top Asks - better facilities and supplies, increased staffing and fair pay, greater autonomy formed the foundation of the midwifery Action Agenda. 2. Co-developing Advocacy Objectives and Recommendations: SMART Advocacy workshops conducted in collaboration with professional association, SOMI in states like Uttar Pradesh and Bihar brought midwives and key stakeholders together to define focused, time-bound advocacy objectives, such as creating posts for NPMs/MEs, functionalizing MLCUs for 24/7 care, and including midwives in policy-making roles. 3. Implementing the Action Agenda: The Midwives’ Charter of Asks and Action Agenda were disseminated in national and state forums. Midwives presented their demands and lived experiences directly to decision-makers, supported by champions and development partners. Advocacy meetings with high-level policymakers and State Midwifery Task Force convenings fast-tracked action on priority issues. 4. Institutionalizing Policy Change: Key midwifery Asks were embedded into state cadre rules and are informing regulatory changes under the National Nursing and Midwifery Commission Act 2023; advancing integration of midwifery into the health system.

EVIDENCE WHERE RELEVANT:
This evidence-based advocacy process combined participatory needs assessment and compelling narratives for strengthening advocacy platforms in aligning midwives’ voices with high-level policy influence for creating a joint midwifery action agenda.

KEY MESSAGE:
Midwife-led advocacy rooted in lived experience and strategic evidence can lead transformative systems change. This model demonstrates the power of leadership within the profession to shape policies, shift structures and secure the future of midwifery in India, ultimately ensuring midwives’ Asks and leadership is represented in decision-making spaces. Poster session 3 (Group B)