Developing a career and competency framework for midwives in China

In mainland China, midwifery lacks an independent regulatory system. The subordination of midwifery practice to the nursing framework impedes professional advancement.

To establish a framework that defines midwifery competencies, scopes of practice, and career advancement pathways in China.

A mixed-methods approach was adopted. A literature review and reference group discussions were used to draft the framework. Two rounds of national e-Delphi consultations followed, revising and refining the competency items. A satisfaction survey preliminarily assessed the framework's overall suitability.

The framework was confirmed through two rounds of e-Delphi consultations. The authority coefficient of the Delphi experts reached 0.93, indicating a high level of authority within the expert panel. In the final round, all coefficient of variation (CV) values were below 0.25 (importance: 0-0.200; feasibility: 0-0.210). Kendall's W indicated a significant level of consensus (importance: 0.170-0.315; feasibility: 0.159-0.212; P < 0.001), demonstrating good consistency among expert opinions. The finalized framework clearly defined 12 core concepts, including the term midwife, systematically delineated the scope of practice and competency requirements for midwives, and established a tiered admission standard comprising 262 items. The satisfaction survey showed that specialized midwives rated the overall framework at (17.99 ± 4.11) points. High scores were observed across multiple dimensions, including professionalism (4.54 ± 1.04), comprehensiveness (4.50 ± 1.08), feasibility (4.44 ± 1.07), and the necessity of the application (4.51 ± 1.02).

This study developed a comprehensive midwifery career and competency framework that demonstrates strong professionalism, feasibility, and practical necessity.