The role and scope of practice of midwives in humanitarian settings: a systematic review and content analysis

Kristen Beek, Alison McFadden (Lead / Corresponding author), Angela Dawson

    Research output: Contribution to journalReview articlepeer-review

    25 Citations (Scopus)
    504 Downloads (Pure)


    Background: Midwives have an essential role to play in preparing for and providing sexual and reproductive health (SRH) services in humanitarian settings due to their unique knowledge and skills, position as frontline providers and geographic and social proximity to the communities they serve. There are considerable gaps in the international guidance that defines the scope of practice of midwives in crises, particularly for the mitigation and preparedness, and recovery phases. We undertook a systematic review to provide further clarification of this scope of practice and insights to optimise midwifery performance. The review aimed to determine what SRH services midwives are involved in delivering across the emergency management cycle in humanitarian contexts, and how they are working with other professionals to deliver health care.

    Methods: Four electronic databases and the websites of 33 organisations were searched between January and March 2017. Papers were eligible for inclusion if they were published in English between 2007 and 2017 and reported primary research pertaining to the role of midwives in delivering and performing any component of sexual and/or reproductive health in humanitarian settings. Content analysis was used to map the study findings to the Minimum Initial Service Package (MISP) for SRH across the three phases of the disaster management cycle and identify how midwives work with other members of the health care team.

    Results: Fourteen studies from ten countries were included. Twelve studies were undertaken in conflict settings, and two were conducted in the context of the aftermath of natural disasters. We found a paucity of evidence from the research literature that examines the activities and roles undertaken by midwives across the disaster management cycle. This lack of evidence was more apparent during the mitigation and preparedness, and recovery phases than the response phase of the disaster management cycle.

    Conclusion: Research-informed guidelines and strategies are required to better align the scope of practice of midwives with the objectives of multi-agency guidelines and agreements, as well as the activities of the MISP, to ensure that the potential of midwives can be acknowledged and optimised across the disaster management cycle.

    Original languageEnglish
    Article number5
    Pages (from-to)1-16
    Number of pages16
    JournalHuman Resources for Health
    Issue number1
    Publication statusPublished - 14 Jan 2019


    • Disaster management cycle
    • Humanitarian settings
    • Midwives
    • Sexual and reproductive health
    • Systematic review
    • Task-sharing
    • Task-shifting
    • Health Services
    • Relief Work
    • Reproductive Health
    • Humans
    • Sexual Health
    • Midwifery
    • Patient Care Team
    • Professional Role
    • Altruism
    • Nurse Midwives
    • Reproductive Health Services
    • Pregnancy
    • Disasters
    • Delivery of Health Care
    • Health Personnel
    • Female

    ASJC Scopus subject areas

    • Public Health, Environmental and Occupational Health
    • Public Administration


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