PURPOSE:
To highlight the process and impact of a structured Community Midwifery (CMW) program in Sindh, Pakistan, on improving maternal and newborn health outcomes in underserved areas.

DISCUSSION:
In Sindh, where access to skilled maternal care is often limited, young women are stepping forward to transform the health of their communities. Following is the process of recruitment, training and deployment of Community Midwives in Sindh. Admission and Commitment: The program involves a robust selection process involving a contextual eligibility criteria. Two Years of Professional Midwifery Training: After admission, CMW students undergo two-year comprehensive classroom, clinical and community field experience. The curriculum aligns with International Confederation of Midwives (ICM) competencies. Two Years of Community Deployment: After graduation and registration, CMWs are deployed for two years in their assigned catchment areas, equipped with basic birthing stations’ necessities. They serve as the primary point of skilled maternal and newborn care in their communities, addressing critical gaps in healthcare access. The program ensures timely interventions, early detection of complications, and strengthened referral pathways. CMWs become trusted community figures, educating and empowering women and families.

EVIDENCE WHERE RELEVANT:
Khowaja, B. M. H., Feroz, A. S., Rani, M., Khowaja, Q., Khowaja, M. A. A., Abrejo, F., & Saleem, S. (2023). Acceptability of Community Midwives in rural communities of Pakistan: A qualitative exploratory study. medRxiv, 2023-02. Khowaja, B. M. H., Feroz, A., Abrejo, F., & Saleem, S. (2022). SWOT analysis of community midwifery program in Pakistan. Journal of Asian Midwives (JAM), 9(1), 2-14.

KEY MESSAGE:
Structured CMW programs significantly improve maternal and newborn health outcomes by bringing essential care directly to underserved communities, demonstrating a sustainable model for reducing maternal mortality and morbidity in a low-resource setting of Pakistan. As a way forward – a follow up two-year midwifery program can be offered to them to align with ICM standards of midwifery education. Professional development - training (including three-minute presentation competition)