The involvement of midwives associations in policy and planning about the midwifery workforce: A global survey

Abstract

Objectivea fit-for-purpose midwifery workforce is needed to respond to the current and future needs in sexual, reproductive, maternal and newborn health and to achieve universal health coverage. Evidence-based policy and planning that involves all stakeholders, including professional associations can assist with the development of such a workforce. The aim of the study was to explore how and when midwives׳ associations are involved in the planning processes for the midwifery workforce and which tools and approaches the associations perceived were used to support human resources for health policy. Methodsall 108 member associations of the International Confederation of Midwives were invited to participate. A questionnaire collected data including: the involvement of the association in the national planning dialogue, processes and methods for participation and engagement; mechanisms to guide and inform decision-making; and, the tools, data and evidence used to influence human resources for health policy. A descriptive analysis was conducted and comparisons were made by country group based on national income strata. Results73 (68%) midwives׳ associations participated in the study, representing 67 (71%) countries. In most (95%) countries, the planning process to determine the provision of reproductive, maternal and newborn health was centralised at the ministry of health level and included midwives׳ associations amongst others. Less than two thirds of associations reported involvement in planning and policy. The planning processes in which they took part were the reproductive, maternal and newborn plan (63%), the national health plan (58%), and the human resources for health plan (52%). Planning was more frequently undertaken at national than sub-national levels in middle- and low-income countries than in high-income countries. Midwives associations were often unaware of the human resources for health approaches used to calculate the number of midwives required, and reported low use of benchmarks, guidelines and supporting tools during their involvement in the planning process. Conclusionalthough midwives associations were involved in planning and decision-making processes for midwifery, their participation was often limited. These associations represent a key provider group in sexual, reproductive, maternal and newborn health and as such have a greater capacity to contribute to policy development and planning and have a meaningful contribution to the achievement of the goals of universal health coverage.