Motivational Factors Underpinning Midwives' Commitment to Efficacious Implementation of Prophylactic Programmes in ICO: Insights from a Focus Study in Poland

Background: Employing a focused study methodology, our investigation centers on the motivational drivers from the perspectives of midwives, elucidating key incentives that shape their dedication to the successful and very efficient implementation of preventive healthcare initiatives within the operational framework of an Integrated Care Organization (ICO) in Poland. Inclusion criteria and Methods: A qualitative research design was employed, featuring focused interviews conducted with midwives operating within the integrated care structure in Poland. All 6 midwifes working in 4 medical centres in a rural and small town community, which turned out to have much better results than large city (70%, 63%, 69% and 65% in cervical cytology prophylactic programme in small town and rural area of lukowski county (eastern part of Poland, close to the border with Belarus and Ukraine) vs 31% in the capital city of Warsaw) were selected to participate in a focus group discussion, ensuring a diverse representation of experiences and viewpoints pertaining to midwife-led prophylactic programs. Thematic analysis was employed to discern recurring patterns and emergent themes from the collected data. Results: The study identifies several pivotal incentives that contribute to the commitment of midwives in facilitating efficient prophylactic programs. Foremost among these is the intrinsic motivation rooted in a sense of professional fulfilment derived from actively contributing to preventive healthcare measures. Midwives expressed a genuine commitment to enhancing patient outcomes through the promotion of health and the prevention of ailments. Moreover, current integrated care organisation politics, extensive financial incentives and the provision of ongoing professional development opportunities emerged as significant extrinsic incentives. Midwives acknowledged the importance of continuous learning, skill enhancement, and staying abreast of innovative healthcare practices as instrumental in fostering efficiency. Institutional support in the form of educational resources, workshops, and training sessions was deemed crucial in bolstering midwives' competence and efficacy in prophylactic initiatives. Additionally, the study underscored the value of recognition and acknowledgment within the organizational context as motivational stimuli. Midwives expressed that acknowledgment of their contributions, both at individual and collective levels, served as a reinforcement mechanism, fostering a positive work environment and a sense of professional pride. Conclusion: This focused study provides comprehensive insights into the intrinsic and extrinsic incentives shaping midwives' commitment to the efficient execution of prophylactic programs within the context of an Integrated Care Organization in Poland. The identified motivational factors, encompassing intrinsic professional fulfilment, current integrated care organisation politics, extensive financial incentives, opportunities for continuous learning, and institutional support, inform strategies to optimize midwives' engagement in preventive care delivery, thereby contributing to the overall effectiveness of integrated healthcare systems.