Challenges of midwifery staff at Tehran hospitals: A qualitative study from the midwifery managers perspective.

AIM: This study aimed to investigate the challenges faced by midwifery staff working in hospitals from midwifery manager's perspectives and provide suggestions to solve them. DESIGN: Descriptive qualitative study. METHODS: The study was conducted in Tehran in 2021. Data were collected using fifteen semi-structured interviews conducted with hospitals' clinical midwifery managers over 7 months. The interview data were grouped into three themes: recruitment, development, and maintenance. RESULTS: The midwifery workforce would face significant challenges in training hospitals. Lack of suitable patterns of midwifery workforce management, the non-optimal midwives' utilization and deployment, unclear job boundaries, weak training programs for the midwives' professional development, and unpleasant working atmosphere were the main challenges. A well-defined task description for midwives to determine their position in all spheres of reproductive health service provision, create training courses based on skill gaps, and focus on improving labour relations and organizational culture are suggested. PATIENT OR PUBLIC CONTRIBUTION: Midwifery managers were interviewed. They talked about their experience with midwifery workforce challenges.

The role of midwives in implementing reproductive health services in Islamic Republic of Iran

Background: It is essential to study the availability of reproductive health services and the capacities of providers, to provide evidence for improving service quality. Aims: To identify the role of midwives in the provision of reproductive health services and recommend improvements. Methods: A national review of government health resources in the Islamic Republic of Iran was conducted to explore available reproductive health services. Through semi-structured interviews with 30 midwives, information was collected about the compatibility of services with the capacity and scope of the activities of midwives. A panel of 12 experts was assembled to develop a proposed service package. The content analysis method was applied to data analysis and interpretation. Results: The service package developed covered 82 services that midwives can offer at the 8 healthcare facility groups. Although midwives were trained to manage a range of primary and gynaecological care services, certain essential aspects of reproductive health services were not being delivered on the frontline. These include sexually transmitted diseases and human papilloma virus management, diagnosis and treatment of common gynaecological problems, sexual education and counselling, and childbirth services. Midwives were not adequately engaged to provide reproductive health care at the secondary level. Conclusion: There are drawbacks to the current reproductive health service delivery in the Islamic Republic of Iran. The service package designed and proposed in this study aims to strengthen reproductive health care services and planning and better integration of midwife-led programmes.