Midwifery scope of practice among staff nurses: A grounded theory study in Gujarat,India |
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| Authors: | Bharati Sharma Eva Johansson M. Prakasamma Dileep Mavalankar Kyllike Christensson |
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| Affiliation: | 1. Centre for Management of Health Services, Indian Institute of Management, Ahmedabad, India;2. Department of Womens'' and Childrens'' Health, Division of Reproductive and Child Health, Karolinska Institute, Sweden;3. Global Health, Karolinska Institute, Sweden;4. Academy of Nursing Studies and Womens'' Empowerment Research, Hyderabad, India;5. Public Systems Group, Indian Institute of Management, Ahmedabad, India;1. School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria 3086, Australia;2. Mother and Child Health Research, La Trobe University, Melbourne, Victoria 3000, Australia;3. The Royal Women''s Hospital, Parkville, Victoria 3052, Australia;1. University of Western Australia, Faculty of Education, Graduate School of Education, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia;2. Curtin University, Faculty of Health Sciences, School of Nursing and Midwifery, Building 405, Kent Street, Bentley, Perth, Western Australia 6102, Australia;1. Johns Hopkins Bloomberg School of Public Health, 455 Massachusetts Ave., NW Washington, DC 20001, USA;2. PATH, A-9, Qutab Institutional Area, New Delhi 110067, India;3. Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA;4. Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA;1. Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th Street, University Park, AHC5-477, Miami FL 33199, USA;2. Public Health Research Institute of India, 89/B, 2nd Cross, 2nd Main, Yadavgiri, Mysore 570020, India;3. Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA |
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| Abstract: | ![]()
Backgroundmidwifery is a part of the nursing profession in India. This current study explores and describes the midwifery scope of practice among staff nurses.Methodsa grounded theory approach was used to develop a model. Twenty-eight service providers from the maternity sections of public health facilities, selected through purposive and theoretical sampling were interviewed in-depth. Unstructured observations in the labour wards were also used for developing the model.Findingsthe midwifery practice of staff nurses was limited in scope compared to international standards of midwifery. Their practice was circumstance driven, ranging from extended to marginal depending on the context. Their right to practice was not legally defined, but they were not specifically prohibited from practice. As a consequence, the staff nurses faced loss of skills, and deskilling when their practice was restricted. Their practice was perceived as risky, when the scope of practice was extended because it was not rightfully endorsed, the nurses having no officially recognized right to practice midwifery at that level. The clinical midwifery education of nursing and midwifery students was marginalized because the education of medical students was given priority, and the students only got exposed to the restricted practice of staff nurses.Conclusionsunclear definitions of the right to practice and the scope of practice have led to the un-utilized potential of staff nurses practising midwifery. This is detrimental because India faces an acute shortage of qualified personnel to meet the need in providing human resources for maternal health. |
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