Evaluating a midwifery leadership programme: a process evaluation study.

Background: Despite global support for midwifery leadership investment, there is a notable lack of scientific evaluations of leadership programmes worldwide for midwives. The Government of India's Midwifery Initiative launched the Midwifery Leadership Programme to enhance the leadership capacity of state-level midwifery leaders.

Aim: To evaluate the Midwifery Leadership Programme in India using implementation science as a framework.

Methods: A qualitative research design using the UK Medical Research Council guidance for process evaluation of a 12-week midwifery leadership programme in India. Data were collected through focus group discussions (n=6) with midwives and medical doctors, who have responsibility in maternal and child health services, midwifery education, practice and regulation, and individual interviews (n=3) with programme directors and a government representative, resulting in an individual participant total of 22. Transcribed discussions were analysed guided by an evaluation framework, using content analysis.

Results: The midwifery leadership programme was successfully implemented in terms of fidelity, dose, and reach, with continuous adaptations. Having the programme's design, structure, and content tailor-made for the Indian context was valued highly. Easy-to-follow assignments led to state-level action plans, while participants' motivation and improved communication skills enhanced leadership capacity.

Conclusions: This study demonstrates the utility of a process evaluation framework in evaluating midwifery education programmes, using the Midwifery Leadership Programme in India as an example. It is recommended that future research on evaluating midwifery education initiatives adopt implementation science frameworks to evaluate both the implementation process and the mechanisms driving programmes' impact for change, thereby informing the design and delivery of effective midwifery education programmes.