Midwives’views and experiences of providing midwifery care in the task shifting context:a meta-ethnography approach

摘要

Objective:This study aimed to explore the existing knowledge about midwives’views and experiences of providing care for women in the context of task shifting.Methods:We conducted a qualitative systematic review using meta-ethnography to describe the views and experiences of midwives on providing care in the context of task shifting.Comparative textual analysis of published qualitative studies involved translation of first-order key concepts and meanings from included studies to generate second-and third-order concepts.A grid was made to identify core findings and compare them reciprocally.Results:Thirty-six qualitative studies met the inclusion criteria.The literature comprised of 32 first key concepts.Eight second-order constructs emerged,and three third-order interpretations were generated.The three overarching themes were:(1)midwives perceived themselves as providing culturally competent and high quality women-centered care;(2)they valued their profession but saw it as complex and challenging;(3)as health professionals,they reported a variety of organizational,cultural,and professional barriers to providing women-centered care.Conclusions:While performing a specific task in the task shifting context,midwives perceived their crucial roles and responsibilities,along with achieved value and reward.However,due to a range of existing barriers,the caring task posed great challenges in completely implementing women-centered care.It is essential for systems to identify and eliminate these barriers early,to consider midwives’emotional well-being,and to develop overall strategies to better support the midwifery workforce.Policy makers and administrators should establish a supportive environment to facilitate midwives to perform women-centered caring tasks in more effective and efficient ways.