# Can we implement midwifery-led continuity of care in Ethiopia? Maternal health leaders and midwives perspective: a qualitative study

## TL;DR

This study explores the feasibility of implementing midwifery-led continuity of care in Ethiopia by examining the perspectives of maternal health leaders and midwives.

## Contribution

The study provides insights into the perspectives of health professionals on implementing MLCC in Ethiopia, where such information is limited.

## Key findings

- Health professionals recognize potential benefits of MLCC, such as improved patient satisfaction and personalized care.
- Challenges include resistance to change and the need for interdisciplinary collaboration.
- The study recommends targeted training and policy measures for successful MLCC implementation.

## Abstract

Recognition of the importance of midwifery-led continuity of care (MLCC) in promoting positive maternal and neonatal outcomes is remarkably increasing. Despite its potential benefits, the implementation of this model may face challenges, and understanding health professionals’ perspectives is crucial for successful integration into existing healthcare systems. Furthermore little is known about feasibility of implementation of MLCC model in Ethiopia. Therefor this qualitative study aims to explore the perspectives of maternal health leaders and midwives regarding the implementation of midwifery-led continuity of care.

A qualitative study was conducted in Guraghe zone health facilities, Central Ethiopia, from May 1st to 15th, 2022. Three focused group discussions among midwives and twenty in-depth interviews were conducted among either maternity ward head and/or chief executive directors/medical directors who were selected using a purposive sampling method. Data were first transcribed and then translated from local language to English. Thematic analysis was applied using open code software to identify recurring themes and patterns in the data, ensuring a comprehensive understanding of the professionals’ perspectives.

The findings reveal a spectrum of perspectives among maternal health leaders and midwives regarding MLCC. Positive themes include improved patient satisfaction, enhanced personalized care, and potential quality care. Conversely, challenges such as resistance to change, concerns about coordination, and the need for interdisciplinary collaboration were identified. The result favors implementing this model and underscores the importance of addressing issues for successful integration.

Maternal health leaders and midwives acknowledge the potential benefits of MLCC model implementation besides recognizing the need for careful consideration of challenges in its implementation. During implementation by health facilities targeted training programs, inter-professional education, and strategic policy measures to facilitate a smooth transition are recommended.