A chronic shortage of midwives will jeopardise progress on reducing child mortality, improving maternal health and fighting disease, a UN report said on Monday.

The The State of the World's Midwifery 2011 report, launched at a meeting of the international confederation of midwives in Durban, South Africa, confirms a significant gap between the number of midwives practising and those needed to save lives.

Each year, 358,000 women die while pregnant or giving birth, around 2 million newborns die within the first 24 hours of life, and there are 2.6 million stillbirths, because of inadequate or insufficient healthcare. Unless an additional 112,000 midwives are trained, deployed and retained, 38 of 58 countries surveyed might not meet their target to achieve 95% coverage of births by skilled attendants by 2015, as required by millennium development goal 5, on maternal health. Globally, 350,000 more midwives are needed, the report said.

"The report points to an urgent need to train more health workers with midwifery skills and ensure equitable access to their life-saving services in communities to improve the health of women and children," said Dr Babatunde Osotimehin, executive director of the UN Population Fund (UNFPA), which released the report.

The 58 countries surveyed together account for just under 60% of all births worldwide, but 91% of all maternal deaths. Among the 38 countries most in need of midwives, 22 need to double the workforce by 2015; seven need to triple or quadruple it; and nine (Cameroon, Chad, Ethiopia, Guinea, Haiti, Niger, Sierra Leone, Somalia and Sudan) need to scale up midwifery by a factor of between six and 15.

Increasing women's access to quality midwifery has become a focus of global efforts to give women the best possible healthcare during pregnancy and childbirth. It is also at the heart of three health-related millennium development goals – cuting child deaths, improving maternal health and combating disease.

If adequate facilities were available to deal with complications during pregnancy and childbirth at their onset, many deaths could be averted – nearly two-thirds of all maternal deaths, almost half of stillbirths and three in five newborn deaths.

"Ensuring that every woman and her newborn have access to quality midwifery services demands that we take bold steps to build on what we have achieved so far across communities, countries, regions and the world," said the UN secretary general, Ban Ki-moon, in his foreword to the report.