Facilitating the Implementation of Midwifery Services: The Case of Montérégie, Quebec
Bibliographic record
Abstract
Objectives: This study analyzed midwifery services implementation in one region (Montérégie) of Quebec. The objectives were to determine whether services were implemented as planned and to identify factors that facilitated or impeded implementation. The aspects studied included organizational components; types of midwifery services provided; levels of interprofessional collaboration among midwives, physicians, nurses, and community organizations; and training activities offered to perinatal care providers and students. Methods: This is a qualitative case study of one implementation experience and is based on three data sources: individual interviews and focus groups; policy and administrative documents related to the implementation; and a database compiled by the midwives on services provided. Data were collected and analyzed between July 2012 and March 2013. Results: The implementation of midwifery services in Montérégie was successful and largely accomplished as planned. Its success was due to the alignment of two categories of favourable conditions. The first category consisted of appropriate policies and regulations, demand from service users, and support from front-line professionals. The second category concerned the implementation process and governance and included effective governance structures and mechanisms, dedicated resources, and leadership from champions. Conclusion: The lessons from this study can be usefully applied to the introduction of midwifery services in jurisdictions where they are not currently present. They may also inform the implementation of other publicly funded health services or professionals in other jurisdictions. This article has been peer reviewed.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.028 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".