WHO Consultation: Theory of Change (ToC) for transitioning to a midwifery model of care |
Introduction
If you already took part in the December 2021 virtual consultations on the ToC, please ignore this survey. Your contribution has been included in the survey below.
The World Health Organization (WHO) is developing a Theory of Change (ToC) to support countries transitioning to a midwifery model of care. Your experience and inputs to developing the ToC is hugely appreciated, the WHO thanks you in advance for your valuable time in this survey. All respondents will be acknowledged for their contribution.
This survey has been developed from the initial findings of the two WHO virtual consultations in December 2021, and has been designed to enable further on-line participation. This survey will take between 30-45 minutes to complete.
The survey includes the following concepts:
· A Theory of Change is is a comprehensive description and illustration of how and why a desired change is expected to happen in a particular context. It is based on a problem analysis and helps us to understand the theoretical process of desired change.
· Transitioning to a midwifery model of care refers to the process through which countries move over time from no midwives to well-functioning systems in which midwives are educated, regulated and work within an enabling policy and health system environment.
· The Midwifery Continuity of Care (MCoC) model, which has been shown to result in highly positive outcomes for women, newborns and their families (Sandall et al 2016), builds upon the concept of continuity of care in primary care. This model of care involves the care of individuals (i.e. individual pregnant women), rather than populations (all pregnant women) and includes three types of continuity: relational; informational, and management (Baker R, Freeman GK, Haggerty JL, Bankart MJ, Nockels KH. Primary medical care continuity and patient mortality: a systematic review. Br J Gen Pract. 2020;70(698):e600-e11.).
· Midwife-led continuity of care (MLCoC), in well-developed health systems with well-functioning midwifery systems, is recommended by WHO, as follows:
“Midwife-led continuity-of-care models, in which a known midwife or small group of known midwives supports a woman throughout the antenatal, intrapartum and postnatal continuum, are recommended for pregnant woman in settings with well-functioning midwifery programmes”.
(Context-specific recommendation, 2016 ANC, 2018 IPC)
• Networks of Care (NoC), in which midwifery continuity of care is implemented. A network of care for maternal and perinatal health is a collection of public and/or private health facilities and health workers deliberately interconnected to promote multi-disciplinary teamwork and collaborative learning to provide comprehensive, equitable, respectful, person-centred care from home/community to primary and tertiary levels. A functional network of care results in collaborative and coordinated continuity of quality and respectful care for maternal and perinatal health, and ultimately optimizes linkages for efficient and resilient health systems.
For the purposes of this draft theory of change we are referring to healthcare providers as follows:
· Midwives (MW), in countries where there is a distinct occupational group of midwives (separate to nurses, and who are not deployed as nurses)
· Midwifery Care Providers (MCP) in countries where there is no distinct occupational group, but elements of midwifery care are provided multiple