Challenges of midwifery services in the health reform plan in Iran: A qualitative study

Background & Aims: Improving the health reform plan implementation in terms of quality of health services and fulfilling the goals requires a review of the status quo of midwifery services and identification of their strengths, weaknesses, and challenges, especially in the health sector. The present study was conducted to investigate and comprehensively understand the challenges of midwifery services in the primary health care(PHC) system and provide recommendations for improving midwifery services. Materials & Methods: This Qualitative descriptive design study selected 44key informants using purposive sampling and collected their views on midwifery positions and midwifery tasks performed in the PHC system through semi-structured interviews conducted in 2015-16. These informants included 12 midwives, 10 public health experts, 10 faculty members, and 12 managers and officials, who worked in educational and healthcare centers affiliated with Kashan University of Medical Sciences, Kashan, Iran. The transcribed interviews were analyzed in MaxQDA-10 using conventional content analysis. Results: After analysis, the data of this study were classified into 14 categories and 6 themes. From the participants' point of view, the midwifery services challenges of the health system transformation plan in the field of health were: policymaking and management, rights, referral system, satisfaction, costs, and development and promotion. Most of the extracted codes are related to policymaking and management. Conclusion: The present findings showed the midwifery sector needs in the Iranian health system for reforms. It is recommended that the role of faculties in training human resources for the health sector be emphasized and new training requirements be integrated into the curriculum by educational departments promptly.