A newborn died, and a first-time mother was left critically ill in Goalanda upazila of Rajbari last month after a delivery allegedly handled by a village animal doctor and a pharmacist with only a short health-assistant course.
The incident has once again drawn attention to the realities of maternity care outside major cities, as Bangladesh faces a major challenge in fulfilling its pledge to recruit and deploy 25,000 government midwives by 2030.
According to the family, labour began on October 8 at Daulatdia union, and a local traditional birth attendant, then an animal doctor, tried for hours to deliver the baby without success.
A pharmacist was then called in, who removed the baby, already dead.
The woman suffered severe bleeding and an infection, and she was now in critical condition at Faridpur Medical College Hospital.
The news spread on social media, prompting public outrage.
Goalanda’s upazila health and family planning officer, Dr Maruf Hasan, formed an inquiry committee and said it would take action against those found responsible, even if the family files no case.
The Goalanda case is not an isolated case, as a government health official told Dhaka Tribune that three midwives are working against four approved government posts in the area, which serves around 120,000 people.
The staffing situation in Goalanda reflects a wider challenge: turning an ambitious national commitment into midwives available to women when and where they need them.
Bangladesh announced the pledge at the 34th International Confederation of Midwives Congress in Lisbon on June 14, 2026, committing to create and deploy 25,000 midwives across public health facilities by 2030.
But the current workforce figures raise questions about how the government will reach that target in the time left.
In response to queries from Dhaka Tribune, the UNFPA Bangladesh office said 2,557 midwives had been recruited and deployed in the public health system, against 4,488 government-approved midwifery posts.
Dil Afroza, Director General of the Directorate General of Nursing and Midwifery (DGNM), acknowledged the shortage and said the directorate is trying to improve the situation through faster recruitment.
“There is a crisis of midwives,” she said.
She said that, given the institutional capacity currently available, the directorate is hopeful of recruiting 25,000 midwives by 2030.
Recruitment examinations are conducted by the Public Service Commission (PSC), and the process usually takes around three months to complete, she said.
The DGNM chief also said posting midwives in remote areas was not proving to be a major problem, as most midwives were comfortable working in their local areas.
Her remarks, however, leave a critical question unanswered: how will the government bridge the gap between the current workforce and its target, and what recruitment schedule will make that possible?
Posts, not just people
The commitment refers to the creation and deployment of 25,000 permanent government midwifery posts across public health facilities, according to UNFPA.
It is meant as a long-term expansion of the national health workforce, not a temporary recruitment drive.
By that measure, the distance to travel is considerable.
With 4,488 posts approved so far, more than 20,000 additional posts would need to be created, financed and filled within the next few years, as only 2,557 midwives are currently in position.
The target was developed using facility-level requirements collected by DGNM from the Directorate General of Health Services (DGHS) and the Directorate General of Family Planning (DGFP).
The assessment considered facility types, bed numbers, and existing or proposed midwifery posts, with the aim of covering round-the-clock, midwife-led sexual and reproductive health services from primary to tertiary level.
A training base, but a hiring bottleneck
According to UNFPA, Bangladesh has 62 public and 110 private midwifery education institutions, with a combined annual intake of more than 5,000 students.
The country currently has just over 12,000 licensed midwives, and about 5,000 graduate each year.
This suggests that the country has an existing training base from which to expand its workforce.
UNFPA says, however, that faculty recruitment and better clinical simulation facilities will be crucial to meeting the 2030 goal.
But producing graduates does not automatically translate into government appointments.
Recruitment examinations, approval of posts, budget allocations and deployment all need to move forward in a coordinated way.
UNFPA itself lists administrative bottlenecks in post creation and budget approval as a primary risk, warning that delays could leave newly trained midwives without jobs.
Who pays
UNFPA has supported the development of midwifery education and the professional workforce since 2010, including faculty development, educational materials, clinical teaching equipment, accreditation and quality improvement.
The agency says it has invested approximately $25 million in the programme over the years.
It has also supported the deployment of more than 500 midwives in public health facilities in phases, including in Rohingya refugee camps, with support from development partners.
The government’s permanent midwifery positions, however, will be financed entirely through the national revenue budget, UNFPA said.
The agency covers the salaries of only a limited, designated group of project midwives.
This makes the pace of recruitment and deployment dependent on government planning and sustained public funding.
UNFPA said a strategic roadmap setting out year-by-year targets for 2026 to 2030 is being developed with DGNM.
The roadmap will be crucial in showing how the government intends to move from the existing workforce to the promised 25,000.
However, the roadmap was not available at the time of reporting.
Where midwives will go
According to UNFPA, midwives will be deployed across medical colleges, district hospitals, upazila health complexes and union-level facilities under both DGHS and DGFP.
The agency said it strongly advocates prioritizing union-level postings so that care reaches closer to communities, including coastal areas, haors, chars, hill tracts and other remote locations.
To discourage early transfers to urban areas, the government has approved a minimum two-year retention period at the initial posting.
Career pathways and continuous professional development opportunities are awaiting approval from the Ministry of Health and Family Welfare, UNFPA said.
Posts alone will not ensure safe deliveries
Even if the recruitment target is achieved, the quality of maternity care will depend on whether midwives can work in properly equipped facilities.
In rural and hard-to-reach areas, women may have to travel long distances to access emergency obstetric care.
Midwives can provide essential maternal and newborn services, support normal deliveries, identify complications and arrange referrals.
But they cannot independently manage every emergency.
UNFPA said union-level postings will fail to reduce deaths if facilities lack reliable water and electricity, on-campus accommodation for round-the-clock service, security, supporting staff, and essential emergency obstetric drugs and equipment.
It also pointed to the need for functioning referral systems with transport, so women with complications can reach higher-level hospitals in time.
International evidence cited by UNFPA supports this view: increasing the number of midwives is important but insufficient on its own without an enabling environment, supportive supervision and mentoring.
What is at stake
UNFPA identifies the deployment of 25,000 midwives as the main route to meeting the Sustainable Development Goal target of reducing the maternal mortality ratio to 70 deaths per 100,000 live births by 2030.
It describes midwifery as a “best buy” in health spending, projecting up to $9 in social and economic returns for every $1 invested.
The agency did not give a specific projection of how many deaths the expansion could prevent.
The challenge is therefore not only how many midwives can be recruited, but whether the health system can create the posts, fund them, retain the midwives and equip the facilities where they work.
For women in places like Goalanda, where three midwives serve a population of about 120,000, the answer will be felt long before 2030.
