Midwives stand at the intersection of clinical skill, human care, and some of the most consequential moments in the lives of women and families.
Hosted by the Society of Midwives of South Africa under the banner #OneMillionMoreMidwives, the congress brought together midwives, researchers, healthcare practitioners, and sector leaders to consider the profession's future. The final day focused on the subtheme Building the movement for and with women.
For Prof Klopper, the call for one million more midwives is about more than workforce numbers. In her keynote address, she described it as both a workforce-planning statement and a moral one, pointing to evidence that skilled midwives can provide more than 80% of the essential care needed by women and newborns across the reproductive continuum.
However, increasing numbers alone will not be enough. Her address stressed the need to invest in the education, deployment, support, and sustainability of the midwifery workforce within health systems so they can provide safe and effective care.
Her first qualification in General Nursing Science and Midwifery grounded Prof Klopper’s early career in a profession that continues to shape her understanding of education, skilled care, and human well-being.
A profession of consequence
Prof Klopper also emphasised that investment in midwifery should be understood as central to stronger health systems and better maternal and neonatal outcomes.
“Investment in midwifery is not a soft line item. It is hard health-systems economics,” Prof Klopper said.
She highlighted the importance of translating evidence and guidelines into practice, arguing that implementation is ultimately what determines whether knowledge improves care.
“Guidelines do not save lives sitting in a drawer,” she said.
Prof Klopper reflected on the relational and rights-based dimensions of maternity care, including respectful care, communication, women’s autonomy, and the need to understand how institutional conditions shape both women's experiences and the professionals who care for them.
The challenge is not only to generate knowledge, but to strengthen the profession’s ability to interrogate practice, produce evidence in its own clinical context, and translate that evidence into better care and policy.
This places universities in an important position. They must prepare healthcare professionals who combine clinical competence with judgement, compassion, ethical responsibility, and the ability to use evidence effectively in changing healthcare environments.
Universities have a role beyond the classroom
Prof Klopper’s participation also highlighted the contribution universities can make to stronger healthcare systems.
She described universities as the “engine room of competence”, arguing that the quality of midwifery ultimately depends on how professionals are educated, supervised, and prepared for clinical practice.
She highlighted the importance of research-active academic staff, competency-based curricula, strong clinical supervision, and genuine partnerships between universities and healthcare services.
“You are not a support function to clinical practice. You are its origin point,” Prof Klopper told the academics and educators in the room, describing universities and their clinical partners as central to building the midwifery workforce the future requires.
The message was clear: One million more midwives is not only a workforce target. It requires investment in education, evidence, working conditions, professional support, and the well-being of the people delivering care.
“What remains is not more proof – it is the will to act on what we already know,” said Prof Klopper.