Midwives’ Experiences in Adjusting to their New Role as Healthcare Provider in Health Transformation Plan in Iran: A Qualitative Study

Document Type : Original Research Article

Authors

1 Assistant Professor, Department of Midwifery, Ur.C., Islamic Azad University, Urmia, Iran

2 Professor, Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 a) Professor, Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran b) Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran

5 a) Associate Professor, Social Determinant of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran b) Department of Biostatistics & Epidemiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

10.22038/jmrh.2024.82059.2460

Abstract

Background & aim: Midwives as healthcare providers, in their new role in Iran’s health care system, to provide services for several aspects of primary health care, face numerous intricacies after the implementation of the health transformation plan. This role shift compels them to fulfill their responsibilities in their new positions despite its incompatibility with their academic training and nature of profession. The present study was conducted to explain the midwives’ experiences in adjusting to their new role as healthcare provider in the health transformation plan in Iran.
Methods: In this qualitative content analysis, data were collected through in-depth semi-structured interviews with 18 midwives selected via purposive sampling with maximum variation working in the healthcare centers of Urmia in West Azerbaijan, Iran from April to October 2023. Data were analyzed using Zhang and Wildemuth’s eight-step conventional content analysis approach run in the MAXQDA software.
Results: Data analysis led to the emergence of two themes and seven main categories. The first theme, namely ‘efficient adjustment’, encompassed two main categories: ‘providing high-quality services’ and ‘inner satisfaction’, and the second theme, i.e., ‘inefficient adjustment’, was explained by five main categories, including ‘low-quality services’, ‘reduced utilization’, ‘emotional fatigue’, ‘systemic bullying’, and ‘changes in social expectations’.
Conclusion: It seems that midwives’ satisfaction with providing services to all clients as well as accountability are the paramount factors associated with their  adjustment. Midwives’ job satisfaction depends on the specialty of delegated responsibilities, correction of the rules in health transformation plan, and preservation of midwives’ dignity and career grace.

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