Barriers and facilitators to the implementation of a midwifery-led care model: a qualitative systematic review.
Despite the overwhelming benefits of midwifery-led care models, in many countries, for several reasons, there is a resistance to their implementation. These care models provide both short-term and long-term advantages for mothers and newborn, demonstrate sustainability, and offer economic benefits....
| Publicado en: | Midwifery Vol. 148 |
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| Autores principales: | , , , |
| Formato: | research systematic review Journal Article |
| Publicado: |
Elsevier B.V.
Sep2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187232475&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 187232475 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02666138 8IR jtl: Midwifery issn: 02666138 maglogo: N pubinfo: dt: Sep2025 vid: 148 pid: 82545 pub: Elsevier B.V. place: Philadelphia, Pennsylvania artinfo: ui: 187232475 187232475 187232475 10.1016/j.midw.2025.104514 187232475 ppct: 1 formats: tig: atl: Barriers and facilitators to the implementation of a midwifery-led care model: a qualitative systematic review. aug: au: Goncalves, Andreia Soares Pestana-Santos, Márcia McCourt, Christine Prata, Ana Paula affil: Department of Nursing and Midwifery, Escola Superior de Saúde, Instituto Politécnico de Viana do Castelo, Rua Dom Moisés Alves Pinho, 4900-314 Viana do Castelo, Portugal sug: subj: Midwifery Methods Obstetric Care Methods Continuity of Patient Care Patient Centered Care Health Services Accessibility Implementation Science Stakeholder Participation Human Expectant Mothers Midwives Obstetricians Health Educators Systematic Review Prenatal Care Models, Theoretical Collaboration Maternal Health Services Shared Services, Health Care Faculty Health Knowledge Health Education ab: Despite the overwhelming benefits of midwifery-led care models, in many countries, for several reasons, there is a resistance to their implementation. These care models provide both short-term and long-term advantages for mothers and newborn, demonstrate sustainability, and offer economic benefits. This qualitative systematic review explores and synthesises evidence on stakeholders' perceptions of the barriers and facilitators to implementing a shift from doctor-led or shared-care models to midwifery-led models of care. The review followed Joanna Briggs Institute guidance for qualitative systematic reviews, including a comprehensive database search, study selection, quality appraisal by two independent reviewers, data extraction using a tool for qualitative findings, and thematic synthesis. The Consolidated Framework for Implementation Research guided the organisation and presentation of results, and the credibility and dependability of findings were assessed using ConQual. Seven studies met the inclusion criteria. Fourteen findings, five facilitators and nine barriers, were identified by stakeholders including women, midwives, doctors and educators. These relate to four implementation domains: innovation, outer setting, inner setting, and individuals. Key themes included cost, local attitudes, local attitudes and conditions, laws and policies, tension for change, relationships, infrastructure, compatibility, access to knowledge, client-centeredness and capability. The review underscores the need for evidence-based strategies to overcome barriers and enhance facilitators. Context-specific strategies informed by implementation science must be developed to support the sustainable integration of midwifery-led care models, with a particular emphasis on policy development and stakeholder engagement. pubtype: Academic Journal doctype: research systematic review Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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