Evaluation of a strategy developed to revise the scope of practice to recognize midwife specialists’ competencies in South Africa

BACKGROUND: Maternal and neonatal morbidity and mortality remain major global public health challenges, even in South Africa. These challenges have necessitated the expansion of midwives' knowledge and skill through postgraduate training, preparing them as midwife specialists. Despite their advanced training and competencies, current scope of practice regulations does not fully recognize South African midwife specialists' expanded roles and capabilities. This regulatory gap limits their ability to practise to the full extent of their expertise and constrains their potential contribution to improving maternal and neonatal health outcomes. OBJECTIVE: To evaluate a strategy to revise the scope of practice to recognize midwife specialists' competencies in South Africa. METHODS: This study employed a qualitative research design using an expert review methodology to evaluate a strategy aimed at revising the scope of practice to recognize midwife specialists' knowledge and skills in South Africa. A purposive sampling strategy followed by a snowball sampling method was used to identify 19 experts to evaluate the strategies guided by Chinn, Kramer and Sitzman's theory evaluation framework via an online platform. RESULTS: The strategy to revise the scope of practice was found to be clear, simple, generalizable, accessible, and clinically significant within midwife specialists' practice. While the strategy was generally considered relevant, experts highlighted potential implementation challenges, including anticipated resistance from regulatory bodies and obstetricians. CONCLUSIONS: Although the proposed strategy to revise the scope of practice for midwife specialists was found relevant to the midwifery field, experts emphasized that its successful implementation requires collaborative effort. The strategy may grant midwife specialists formal professional autonomy, enhancing their ability to contribute optimally to clinical practice and improve maternal and neonatal health outcomes.