Opening the door to the full scope of midwifery practice: Midwives' experiences of implementing continuity of care in Ethiopia.

内容摘要

Few midwives are given the opportunity to provide continuity of midwife care despite the suggested benefits. Translating evidence into practice remains challenging, particularly in low-income settings where workforce limitations, structural constraints, and leadership capacity influence implementation. Although continuity of care models have gained increasing attention globally, little is known about how midwives in low-income countries perceive their readiness and capacity to initiate and sustain such models. To explore how midwives experience and perceive their capacity to implement and lead continuity of midwife care in Ethiopia. A qualitative exploratory design was used. Twenty-one midwives providing continuity of midwife care participated in semi-structured individual online in-depth interviews. The data were analysed using reflexive thematic analysis. The overarching theme, "Opening the door to the full scope of midwifery practice," captured how continuity of midwife care enabled midwives to utilise their full professional capacity. Four interrelated themes described this capacity: 1) clinical competence and autonomy, 2) individualised care and trustful relationships, 3) motivation, commitment and professional pride, and 4) teamwork and structural support. The findings suggest that midwives' capacity was shaped not only by individual competence and motivation, but depended on organisational conditions that enabled autonomy, responsibility, and continued professional development. Continuity of midwife care can function as a liberating structure that releases midwives' existing capacity, when recognised and supported by the system. Enabling midwives to fully exercise their professional role is foundational to delivering respectful, equitable, and effective maternity care in Ethiopia and similar settings worldwide.