BLOG: Transforming Maternal Health in the Middle East and North Africa: Expanding the Safe Delivery+ programme to Empower Midwives
By Julie Strøyer Rasmussen, Head of Programme Development
& Sonali Das, Monitoring Evaluation and Learning Manager
“I wasn’t even on call that day,” she says, smiling. “But when I heard my neighbour screaming, I ran.”
In a small Syrian town, a midwife recently trained to use the Safe Delivery App heard cries from a woman in labour. Complications were beginning, transport was unavailable and time was short. She opened the App’s Arabic module, followed the step-by-step guidance on managing complications, and stabilised the mother until help arrived. Both survived. The difference that day was not luck. It was the knowledge in her hands, ready when she needed it.
Stories like hers are becoming more common across the Middle East and North Africa. In a region where conflict, displacement and fragile health systems continue to limit access to skilled care, the Safe Delivery App helps midwives make faster, safer decisions, even in settings where electricity, staffing, equipment or referral options are limited.
The Safe Delivery App is a central part of Maternity Foundation’s Safe Delivery+ programme. While the programme delivers competency-based training, the App provides microlearning and serves as a practical job aid, ensuring midwives have evidence-based guidance both during training and in day-to-day practice. The App is free and works offline once downloaded, making it a valuable resource in low-resource, remote, and fragile settings.
The programme was introduced in 2022 across the Middle East and North Africa through a three-year initiative supported by the Novo Nordisk Foundation and implemented with UNFPA Jordan, the Jordan Health Aid Society – International, UNFPA Syria, the Danish Red Cross and the Iraqi Red Crescent Society. Across Jordan, Iraq and Syria, midwives have strengthened their skills through hands-on clinical training and Safe Delivery App-supported microlearning, enabling them to act with confidence during emergencies and routine care alike.
Building midwifery capacity across Jordan, Iraq and Syria
In 2023, six healthcare professionals from partner organisations took part in a regional Training of Trainers (ToT) workshop in Amman. After completing certification in emergency obstetric and newborn care, they returned to their homes (Jordan, Iraq and Syria) to deliver cascade training with the Safe Delivery App embedded as a learning and clinical decision-support tool.
As training continued, Maternity Foundation developed a new Modern Contraception module for the App in English to support preventative maternal health capacity building. It was then adapted to Arabic using locally relevant scenarios and culturally appropriate visuals. Because many healthcare professionals in Middle East and North Africa are accustomed to English medical terms, key terminology was intentionally retained in brackets to support clarity and user confidence. The programme later expanded further with a Postnatal Care module and an Arabic Safe Delivery App introduction video, increasing accessibility for both students and practising midwives.
Progress in Jordan
Training impact became visible early. Two certified Jordanian trainers led a three-week cascade training for 41 providers in Al Za’atari Camp, combining Safe Delivery App modules, simulation-based practice and WHO-aligned maternal and newborn care. Post-training assessments showed a rise in knowledge scores from 66 to 78 per cent, and participants reported immediate improvements in how they managed labour, bleeding, and newborn resuscitation.
To strengthen integration beyond the training room, UNFPA Jordan and JHASi hosted a workshop for 32 healthcare providers, supporting knowledge exchange and encouraging participants to complete Safe Delivery App’s certification as part of their continued professional development. The initiative was later presented at national Sexual Reproductive Health (SRH) coordination meetings, drawing strong interest from the Ministry of Health and partners who expressed intent to explore scale-up.
Progress in Syria
In Syria, training expanded despite power shortages, limited connectivity and the challenges of working across crisis-affected areas. By December 2024, 164 midwives across Aleppo, Hama and Deir Ez-Zor had received clinical training supported by the Safe Delivery App. Where internet access was scarce, UNFPA field teams enabled App usage on shared devices. This helped midwives access the App contents at their workstations while continuing to use it offline during births.
One of the most promising developments was the introduction of the Safe Delivery App into pre-service education, boosting the longer-term institutionalisation. Twenty-five midwifery students in Aleppo received training with the App embedded in their coursework, and ten public midwifery schools have since integrated it into simulation and clinical modules. Follow-up visits across Northeast and Northwest Syria confirmed improvements in early recognition of complications, labour monitoring and newborn resuscitation. Midwives frequently described the App as a tool they could “reach for in a moment of uncertainty”.
Community awareness efforts ran in parallel. More than 13,600 women, families and community members attended sessions, tailored from information on the App, and led by UNFPA and midwives on safe delivery, danger signs, psychosocial support and postnatal care thereby extending the impact far beyond facility doors.
Progress in Iraq
In Iraq, the Safe Delivery+ programme progressed in two phases. The first Training of Trainers session in 2023 equipped 35 doctors in Baghdad, but due to instability in the country, follow-up cascade training was paused. In 2025, implementation resumed with a new approach. A hybrid Training of Trainers session was delivered to 33 healthcare professionals from 14 governorates, with training facilitated jointly in person and remotely by Maternity Foundation’s clinical staff. The technical content now includes antenatal care, modern contraception and postnatal care effectively expanding the programme from emergency response into preventive maternal health.
From there, momentum grew quickly. Newly trained facilitators carried out 49 cascade training sessions reaching 400 healthcare professionals in primary facilities and hospitals. A WhatsApp-based community of practice allowed midwives to share cases, troubleshoot uncertainty and request clinical support. Meanwhile, 328 community awareness sessions reached 2,546 people, including 1,348 pregnant or postnatal women, and 84 women identified as highly vulnerable received financial support for delivery-related needs.
Crucially, the Iraqi Red Crescent Society has now integrated the Safe Delivery App into its maternal health programming, enabling its continued use in training, supervision and outreach beyond the project period.
Looking ahead
Across the Middle East and North Africa, interest in the Safe Delivery+ programme continues to expand. Ministries, colleges, professional associations and hospitals are increasingly viewing the SDA not only as an educational supplement but as a clinical companion to guide real-world decision-making.
Through more than two dozen outreach engagements, the Safe Delivery App has begun to shift from a learning tool to a trusted clinical companion used in everyday maternal and newborn care.
More than 3,646 healthcare professionals have been onboarded so far, a foundation for long-term scale and system strengthening. Over 2,807 midwives and nurses (77%) use the App for microlearning and are striving for certification, while 164 have already become Safe Delivery Champions.
Together, these developments show that the Safe Delivery+ programme has established a strong foothold in the region. The App is no longer an introduction; it is becoming a valued, trusted resource for midwives. Whether providing care in a refugee camp under pressure, studying in a classroom, or managing complex clinical scenarios in a busy hospital, midwives need timely, evidence-based guidance. With demand continuing to grow, this marks the beginning of a deeper and more sustained regional presence.
Safe Delivery+ is built for midwives, shaped with midwives, and grounded in the realities they face daily. Whether in a refugee camp, a rural health facility or a busy maternity clinic, midwives deserve the tools, knowledge and support to act with confidence. Together, we will keep working towards a future where it should never cost life to give life.
