Challenges of Iranian Maternal Health Program from Midwives’ Perspectives: A Qualitative Study

Abstract

Background:Maternal health program is one of the most important programs in Iran primary health care (PHC). Considering the necessity of its continuous quality improvement, the present study was designed to identify the challenges of Iran maternal health program from the midwives' perspectives. Methods: This is a qualitative study with 27 midwives working in East Azerbaijan province PHC system. The sampling method was purposeful and the inclusion criterion for participants included at least 5 years of experience in the maternal health program. The researchers conducted eight individual and group unstructured interviews and the content analysis method was used for data analysis. Results: This study identified 9 themes, 16 subthemes, and 39 items related to the challenges of the maternal health program from the midwives' perspectives. The main identified themes were human resources, information management, service continuity, cultural barriers, legal and administrative barriers, care facilities, medical equipment, monitoring and evaluation, and geographic access. Conclusions:The study results indicated that there are significant challenges to the maternal health program, which implies the urgent attention of the managers and policymakers to designing and implementing effective interventions.

Strategies to improve the quality of midwifery care and developing midwife-centered care in Iran: analyzing the attitudes of midwifery experts

“…It is worth mentioning that of the 8000 employed midwives, 2700 are temporarily employed (after graduation, each midwife can work in hospitals or health centers for 2 years and then can continue working if she is accepted in the employment exam). Therefore, after two years, most midwives become unemployed [ 27 ]. This is despite the fact that the need for midwives and midwifery care and services is on the rise, and more midwives should be employed.…”

Women's and care providers' perspectives of quality preconception care: A qualitative descriptive study

“…In a similar vein, in another study, The poor physical conditions of government centers in compare with private sector was one of problem in Care delivery physical spaces. [ 26 ]…”

“…This researcher noted that a series of essential information could not be extracted from the system for the assessment of a person's medical history. [ 26 ] Furthermore, the expression of satisfaction via text messages is not indicative of the quality of services provided by health personnel. The experts of the Maternal Health Program stated that since the clients is not aware of the content of the preconception care, their satisfaction does not reflect the quality of provided care.…”

Strategies to improve the quality of midwifery care and developing midwife-centered care in Iran: Analyzing the attitudes of midwifery experts

“…In this respect, the head of the midwifery association pointed out that according to the law approved by the Ministry of Health, there must be twelve midwives for every 1000 live births in hospitals, but at the present time, only 8-9 midwives are available for every 1000 live births in Iranian hospitals. It is worth mentioning that of the 8000 employed midwives, 2700 are provisionally employed, and after two years, most of them become unemployed (30). As far as the employment of midwives is concerned, the need for midwifery care and services is on the rise and more midwives should be employed, considering the implementation of the urban family doctor plan in Iran and the fact that vaginal delivery is free of charge in governmental hospitals.…”