“Women still die…and they die preventable deaths,” said Address Malata, vice chancellor of the Malawi University of Science and Technology, at a recent Wilson Center event honoring the 30^th anniversary of the Safe Motherhood Initiative. Malata—a midwife and the former vice president of the International Confederation of Midwives—told the heart-wrenching story of a pregnant woman who, like so many others, died waiting for transportation.

“[Her mother] asked me…‘why was it that we waited for two days before my daughter was transferred to a decent hospital, but it only took a short time to take my daughter back home, and this time she was dead?’” said Malata. “My life has never been the same.”

Malawi’s government has started to build new maternity waiting homes, develop community-based interventions, and provide family planning, as well as other programs intended to improve health outcomes for women and mothers. “At the end of the day,” Malata said, “the question is: Is this good enough progress?”

Malawi still struggles with retaining an adequate health workforce, especially when it comes to midwives. Malawi needs to increase not only the quantity of midwives that stay in the country, but also the quality of their training and working conditions. “Do they have adequate time to practice when they are going through a midwifery program?” Malata asked. “As an advocate for midwifery, I would like to start protecting the profession,” she said.

 “There is so much money going to maternal health…but why are women still dying?” she asked, “We are not addressing the core issues that can change women’s lives.” By holding leaders accountable for fulfilling the needs of people on the ground, Malawi can address issues of quality, equity, and dignity for mothers.

 “If your dreams don’t scare you, they are not big enough.” Malata’s dream—that no woman dies while giving life—is big. “It is scary,” she said, “but it can be done.”