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Contextual factors influencing the implementation of midwifery-led care units in India
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg.
Foundation for Research in Health Systems, Bangalore, Karnataka, India.
Indian Institute of Public Health Gandhinagar, Gujarat, India.
Dalarna University, School of Health and Welfare, Caring Science/Nursing. Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg.ORCID iD: 0000-0002-6910-7047
2023 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 36, no 1, p. e134-e141Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The Government of India has committed to educate 90,000 midwives functioning in midwifery-led care units (MLCUs) to care for women during labour and birth. There is a need to consider local circumstances in India, as there is no 'one size fits all' prescription for MLCUs.

AIM: To explore contextual factors influencing the implementation of MLCUs across India.

METHOD: Data were collected through six focus group interviews with 16 nurses, midwives, public health experts and physicians, representing six national and international organisations supporting the Indian Government in its midwifery initiative. Transcribed interviews were analysed using content analysis.

FINDINGS: Four generic categories describe the contextual factors which influence the implementation of MLCUs in India: (i) Perceptions of the Nurse Practitioner in Midwifery and MLCUs and their acceptance, (ii) Reversing the medicalization of childbirth, (iii) Engagement with the community, and (iv) The need for legal frameworks and standards.

CONCLUSION: Based on the identified contextual factors in this study, we recommend that in India and other similar contexts the following should be in place when designing and implementing MLCUs: legal frameworks to enable midwives to provide full scope of practice in line with the midwifery philosophy and informed by global standards; pre- and in-service training to optimize interdisciplinary teamwork and the knowledge and skills required for the implementation of the midwifery philosophy; midwifery leadership acknowledged as key to the planning and implementation of midwifery-led care at the MLCUs; and a demand among women created through effective midwifery-led care and advocacy messages.

Place, publisher, year, edition, pages
2023. Vol. 36, no 1, p. e134-e141
Keywords [en]
Hospital setting, Implementation research, India, Low- and middle-income countries, Maternal and new-born health, Midwifery-led care
National Category
Nursing
Identifiers
URN: urn:nbn:se:du-41671DOI: 10.1016/j.wombi.2022.05.006ISI: 000923976000001PubMedID: 35641395Scopus ID: 2-s2.0-85131140838OAI: oai:DiVA.org:du-41671DiVA, id: diva2:1673111
Available from: 2022-06-20 Created: 2022-06-20 Last updated: 2023-03-17Bibliographically approved

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Erlandsson, Kerstin

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CiteExportLink to record
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Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
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Language
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More languages
Output format
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