Four Key Steps to Make Midwife Continuity Work Worldwide

Researchers wanted to see how midwife continuity could be put into practice across many health systems. They used a worldwide qualitative research approach and a recognized framework for complex interventions. The goal was to map the kinds of work needed in different settings.

Twenty‑two experts took part, including midwives and implementation scientists from all six WHO regions. Some people had both kinds of experience. Interviews were held between June and November 2025. The team recorded detailed conversations about how continuity was being tried in various places.

Data were first sorted using the framework’s big, middle and small system levels, plus legal, political, cultural, economic, geographic, health and ethical aspects. Then the researchers looked for patterns that showed up again and again. This two‑step coding helped them spot the recurring tasks that made continuity possible.

Four overlapping types of work emerged. First, midwives were given real decision‑making power. Second, continuity was built into steady service setups. Third, the model was adjusted to fit local needs. Fourth, contested professional and organizational roles were made accepted. These steps together help continuity become a practical reality in many health systems.