Designing and Validating an Educational Model based on Accountable Midwifery

Midwifery is a discipline mixed with science and skills that has a professional background of socio- cultural and human relations. The current education of medical groups with the philosophy of objectivism has led to the morbid adaptation of midwifery and less use of available and inexpensive services of this profession. Not only lack of timely health services receiving by the weak level of society has irreoverable consequences in health or life, but also it imposes huge costs on the health system. Therefore, the current research was conducted with the aim of extracting the concepts and dimensions of accountability of midwifery services and designing and validating the educational model based on it.

This exploratory sequential mixed study was done 2021 to 2022 at Allameh Tabatabai University, Guilan University of Medical Sciences, Tehran University of Medical Sciences and Islamic Azad University, Rasht branch. In first qualitative stage with grounded theory method, personal exploratory interviewes were conducted by a semi- structured questionnaire and the Key informants that were selected from the faculty members in form of mostly purposeful sampling. Theoretical sampling was continued until the data saturation with 11 infotmants. The analysis process was completed with  triple open, axial and selective coding . In the last part, the validation of the extractive model was done by a descriptive cross- sectional quantitative method, with a researcher- made questionnaire, which was designed based on the findings of the qualitative stage. Sampling of professors was done by non- randomly purposeful and snowball methods and finally the analysis was performed with descriptive statistics.

In the qualitative part, the concept of accountable midwifery were extracted in six components including the basics of accountability, accountability in midwifery ethics framework, accountability within the legal framework, accountability within the framework of professional rules and standards, accountability in the social framework and accountability within the midwifery models .Then, with the main dimensions of the Grounded theory, educational model was desighned with nine basic elements of objectives, teacher role, learner role, providing learning opportunities, content creation and access to resources, learning environment, teaching methods, assessment and evaluation and the learning outcomes for six components of accountable midwifery. In the quantitative part, components of accountable midwifery and extracted educational model were confirmed.

Accontable midwifery is a multifaceted phenomenon, and to achieve it, we need necessarily move the policy approaches of maternal health services and midwifery education towards more comprehensiveness and the implementation of a suitable educational model.