Impact of Implementing the Midwifery Model of Care on Maternal and Neonatal Health Outcomes in Ethiopia

The intervention group will receive a continuity of midwifery care model organized by a team of qualified midwives. In this model, antenatal, intrapartum, and postnatal care will be provided by a named (or primary) midwife, who works within a small team (4-8) of CoMC midwives to their cohort of women and will refer or consult an obstetrician in case of complications that requires specialized care. Each named midwife will be backed up by a partner midwife and other team colleagues. The CoMC team comprises 8 whole-time equivalent midwives, including an experienced senior midwife, who leads the team. Following a training needs assessment by the team leader, midwives will receive specialist training, provided by a team of clinical experts and educators, on how to work in midwife continuity models. Pregnant women receive their entire antenatal, intrapartum, and postnatal care from one of the participating CoMC midwives.

Pregnant women who receive antenatal, intrapartum, and postnatal care following standard practice in Ethiopia will be assigned to the control group. An established practice followed the shared model of care in which responsibility is shared among different staff members, including midwives, nurses, health officers, and medical doctors. Midwives and other health care providers worked conventional eight-hour shifts and handed over care to the next health care provider coming on duty during the next shift. In this model of care, each unit of care had its staff working independently. Besides, the health care provider assigned to the postnatal ward will be responsible for immediate postnatal care. After discharge, each woman in this group become the responsibility of a different group of healthcare providers (usually midwives or nurses) in the family planning and immunization room.