Last month in Goalanda upazila of Rajbari, a newborn died and a first-time mother was left critically ill following a delivery that was allegedly handled by a village animal doctor and a pharmacist who possessed 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, followed by 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 currently in critical condition at Faridpur Medical College Hospital.
The news spread on social media, prompting public outrage.
Dr Maruf Hasan, the upazila health and family planning officer of Goalanda, formed an inquiry committee and stated that action would be taken against those found responsible, even if the family files no case.
The Goalanda case is not an isolated incident. A government health official told the Dhaka Tribune that three midwives are currently working against four approved government posts in the area, which serves a population of approximately 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.
However, the current workforce figures raise questions about how the government will manage to reach that target in the time that remains.
In response to queries from the Dhaka Tribune, the UNFPA Bangladesh office stated that 2,557 midwives had been recruited and deployed within the public health system out of a total of 4,488 government-approved midwifery posts.
Dil Afroza, Director General of the Directorate General of Nursing and Midwifery (DGNM), acknowledged the shortage and stated that the directorate is working to improve the situation by accelerating recruitment efforts.
“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 head of the DGNM also stated that posting midwives to remote areas was not turning out to be a significant problem, because the majority of midwives felt comfortable working within their local regions.
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?
The commitment involves the creation and deployment of 25,000 permanent government midwifery posts across public health facilities, according to the United Nations Population Fund (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 took into account facility types, bed numbers, and current or proposed midwifery posts. The objective was to provide round-the-clock, midwife-led sexual and reproductive health services spanning from the primary to the tertiary level.
According to the UNFPA, Bangladesh features 62 public midwifery education institutions alongside 110 private ones, which together maintain a combined annual intake exceeding 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.
The UNFPA states, 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.
The United Nations Population Fund (UNFPA) has identified administrative bottlenecks in post creation and budget approval as a primary risk. The organization warns that such delays could leave newly trained midwives without employment.
Since 2010, UNFPA has supported the development of midwifery education and the professional workforce. This support includes faculty development, educational materials, clinical teaching equipment, accreditation, and quality improvement initiatives.
The agency says it has invested approximately $25 million in the programme over the years.
With support from development partners, it has also supported the phased deployment of more than 500 midwives in public health facilities, including within Rohingya refugee camps.
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 stated that a strategic roadmap, which establishes year-by-year targets spanning from 2026 to 2030, is currently being developed in collaboration with DGNM.
The roadmap will be crucial in demonstrating how the government intends to transition from the current workforce to the promised total of 25,000.
However, the roadmap was not available at the time of reporting.
According to the UNFPA, midwives will be deployed across medical colleges, district hospitals, upazila health complexes, and union-level facilities under both the Directorate General of Health Services (DGHS) and the Directorate General of Family Planning (DGFP).
The agency stated that it strongly advocates prioritizing union-level postings to ensure 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 currently awaiting approval from the Ministry of Health and Family Welfare, according to the United Nations Population Fund (UNFPA).
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.
The UNFPA stated that 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.
The organization also emphasized the necessity of functioning referral systems equipped with transportation to ensure that women experiencing complications can reach higher-level hospitals in a timely manner.
International evidence cited by the UNFPA supports this view, indicating that increasing the number of midwives is important but remains insufficient on its own without an enabling environment, supportive supervision, and mentoring.
The UNFPA identifies the deployment of 25,000 midwives as the primary route to achieving the Sustainable Development Goal target, which aims to reduce the maternal mortality ratio to 70 deaths per 100,000 live births by the year 2030.
The text 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 involves not only determining how many midwives can be recruited, but also whether the health system can create the positions, 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.
Why it matters
Meeting the 2030 midwife deployment target is critical for Bangladesh to improve rural maternal healthcare and reduce preventable childbirth mortality.