"Both would be valued in Africa; if you can do both, then that would be best."
In the part of Africa that I'm familiar with, both a nurse midwife and nurse practitioner are extremely valuable professions - if you don't mind how you are licensed. Nurse Training Schools in Africa most frequently triple qualify their registered nurses. When they complete their training they are qualified as a general nurse, a community nurse, and a midwife. Diagnosing and treating is included in their basic training so they can be posted to work on their own or with a clinical officer (similar to a PA) to run outlying clinics or even a health center (better equipped than a clinic, and do bigger things like deliveries).
In my opinion, either qualification would be valued but I might place midwifery a little ahead in importance. Your personal preference would be important as I truly mean that both would be valued in Africa. If you are ambivalent, then lean towards midwifery, as pregnancy and all that surrounds it is a huge healthcare issue for Africans. If you can do both, then that would be best.
While I realize that spending more years in training keeps you from sharing your knowledge and skills with people who desperately need them, healthcare in Africa is just so much more challenging - usually because disease/care issues are so much more advanced when they present at the clinic. I personally do not know any medical missionary who would say they had over-trained. I can name many who wish they had more training.
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