From Practice to Legacy: Empowering Midwives through Succession Planning in Philippine Birthing Homes (A Gioia Methodological Study)

Succession in small healthcare enterprises, particularly midwife-led birthing clinics in the Philippines, presents unique challenges influenced by family aspirations, regulatory requirements, and mission-driven values. The purpose of this novel type of study is to discover the succession plans of two birthing home owners in the province of La Union using purposive sampling. The study employed a qualitative design guided by the Gioia methodology to capture participants’ lived experiences and surface data-driven concepts. Data were gathered through unstructured interviews. Following Gioia’s three-step analytic process, transcripts were open-coded into first-order concepts, aggregated into second-order themes, and distilled into aggregate dimensions that represent the emergent theory. Analysis produced 17 first-order concepts clustered into 17 second-order themes in the first participant, while the second participant had 23 first-order concepts clustered into 23 second-order themes. These themes converged into 12 aggregate dimensions: Succession Aspirations, Successor Selection Challenges, Preparation for Continuity, Values & Principles for Succession, Fears and Risks in Succession, Transitioning Ownership Role, Foundational Beliefs for Survival, Succession Context, Successor Readiness, Core Qualities for Succession, Sustaining the Legacy and Ownership and Structural Considerations which depict the structural importance of a strong succession plan. The findings reveal that while founders initially aspire for family succession to preserve legacy and socioemotional wealth, the lack of qualified heirs or the departure of family members often necessitates identifying non-family staff as potential successors. Succession success is contingent on a combination of technical competence, regulatory compliance, and values stewardship, including compassion, patient-centered care, and trustworthiness. Founders employ strategies such as staged role transitions, mentoring, comprehensive knowledge transfer, and operational guidance to ensure continuity of operations. Despite fears of business closure, sabotage, and client resistance to new leadership, founders demonstrate resilience by fostering loyalty, emphasizing ethical practices, and creating pseudo-familial relationships with trusted staff. The study proposes a mission-driven succession model, highlighting a shift from family-centered continuity to professionalized, ethically grounded leadership in small healthcare enterprises. Practical implications include guidance for founders on early succession planning, training, and mentoring of successors, as well as recommendations for policymakers to support certification, capacity-building, and regulatory frameworks that facilitate continuity of care. This research contributes to succession literature by integrating socioemotional, institutional, and stewardship perspectives in a context-specific model for healthcare micro-enterprises.