Transitioning to midwifery models of care: Implementation insights from focus groups with Health leaders in two African countries
African Journal of Primary Health Care & Family Medicine
| Field | Value | |
| Title | Transitioning to midwifery models of care: Implementation insights from focus groups with Health leaders in two African countries | |
| Creator | Franklin Larsson, Lise-Lotte Hailemeskel, Solomon Lindgren, Helena Byrskog, Ulrika Wells, Michael B. Blomgren, Johanna Jebet Cheptum, Joyce Ceesay, Kaddy Erlandsson, Kerstin | |
| Description | Background: Midwifery models of care, endorsed by the World Health Organization (WHO), offer rights-based, person-centred care with proven benefits for safer maternal and newborn care worldwide. Despite these demonstrated benefits, the successful adoption of midwifery models of care depends on context-specific factors, making it essential to understand how healthcare leaders perceive and approach such transitions.Aim: To examine healthcare leaders’ perceptions of transitioning to midwifery models of care in Ethiopia and The Gambia, and to identify key barriers and facilitators influencing implementation.Setting: The study was conducted in Ethiopia and The Gambia within their respective maternal health system contexts, focusing on national and sub-national leadership perspectives.Methods: A qualitative study using open-ended, semi-structured interviews. An inductive thematic analysis was applied to explore leaders’ insights on midwifery models of care and system readiness for transition.Results: Facilitators included midwives’ active advocacy for women’s rights and strong community engagement in maternal health decision-making. Common barriers across both countries were workforce shortages, limited health system infrastructure, donor dependency, and persistent gaps in access for rural populations. Additional barriers included inadequate transport networks, geographic inaccessibility, financial challenges limiting women’s ability to reach skilled care, hierarchical governance structures that restrict midwives’ professional autonomy, insufficient facility readiness, and cultural resistance to evidence-based midwifery practices.Conclusion: Transitioning to midwifery-led models of care requires context-specific strategies aligned with the World Health Organization implementation guidance, with particular attention to strengthening infrastructure, financing, and workforce capacity.Contribution: The study underscores the need to integrate midwives more fully into policy and governance structures. Strengthening their leadership and advocacy roles may enhance the visibility, influence, and overall contribution of the midwifery profession within national health systems. | |
| Publisher | AOSIS | |
| Date | 2026-02-19 | |
| Identifier | 10.4102/phcfm.v18i1.5238 | |
| Source | African Journal of Primary Health Care & Family Medicine; Vol 18, No 1 (2026); 9 pages 2071-2936 2071-2928 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://phcfm.org/index.php/phcfm/article/view/5238/9091
https://phcfm.org/index.php/phcfm/article/view/5238/9092
https://phcfm.org/index.php/phcfm/article/view/5238/9093
https://phcfm.org/index.php/phcfm/article/view/5238/9094
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