Table 8 Summary of all key results, qualitative and quantitative

1)Number of facilities ready for obstetric emergencies 

3 of 7

1 of 6

4 of 6

2) Percent of staff who valued, felt capable of using, and used evidence-based care practices 

68%

81%

92%

3) Number of evidence-based care practices used > 50% of the time 

4 of 8

6 of 8

8 of 8

4) Number of evidence-based practices with significantly greater use than in facilities without midwives

(fixed effect logistic regression) 

N/A

(reference group)

3 of 8

5 of 8

5) Midwives’ competence 

Staff imagined that having midwives would improve service provision.

Among nurses and managers, some affirmed midwives’ contribution, while some felt they were too inexperienced to be autonomous. Midwives expressed having the capacity to do more but not being allowed (e.g., some were not allowed to deliver babies).

Managers affirmed midwives’ capacities and contribution and midwives stated they were proud to be midwives.

6) Separate ANC corners 

Non-existent

Transitioning to staffing ANC corners with midwives

ANC corners consistently staffed by midwives

7) Management of obstetric emergencies 

Nurses reported that they do not manage obstetric emergencies (commonly, patients were referred).

Midwives expressed confidence in managing obstetric emergencies but have limited autonomy so were not able to if another staff person decided to refer.

Midwives said they managed obstetric emergencies.

8) Caring for the poor 

Not discussed

Managers discussed under-the-table fees that motivated nurses to perform deliveries.

Midwives expressed a commitment to caring for the poor and providing services free of charge.

9) Midwives’ pride 

Not discussed

Not discussed

Midwives stated that they “are proud to be providing quality care to women”.