Midwives' experiences of care provision in refugee camps under the guidelines of the ORAMMA project: a qualitative...

This study aimed to explore the experiences of midwives providing care in primary care walk-in clinics (PCWCs) within refugee camps, examining the challenges they encounter, and the relevance the ORAMMA framework.

Refugee camps present a complex environment for maternal care provision, due to limited resources, high population mobility, cultural and linguistic diversity, and increased psychosocial vulnerability among women. Midwives often being the primary providers of maternal care, must address both social and clinical needs. The ORAMMA framework was developed to support culturally sensitive and equitable maternity care for migrant and refugee populations. However, limited evidence exists regarding field experiences of ORAMMA-guided midwifery practice.

A qualitative study design was employed to capture midwives' in-depth experiences. Data were collected from 22 ORAMMA-trained registered midwives working in refugee camp PCWCs. Data were collected using semi-structured individual interviews (n = 15) and two focus groups (n = 7). Data were thematically analysed to identify recurring patterns and key themes.

Midwives reported persistent challenges, including inadequate infrastructure, shortages of essential medical supplies and disrupted care continuity. Language and cultural barriers limited effective communication, trust-building, and clinical decision-making. Despite these constraints, midwives demonstrated adaptability and professional resilience, through collaborative teamwork, creative problem-solving, and culturally sensitive care. ORAMMA training strengthened their confidence and awareness in providing care, although participants emphasised the need for enhanced material resources, interpreter services, and psychosocial support. Overall, findings highlight the value of ORAMMA-guided capacity-building to support midwives' resilience and commitment to quality care delivery.