What is the Status of the Scientific Association of Midwifery in Iran based on the Criteria of the International Confederation of Midwives?
Authors: Kiani Zahra , Simbar Masoumeh 
Published: August 2024

Introduction:
Scientific midwifery associations can play a leading role in improving maternal health policies and practices. This study aimed to evaluate the Iran Scientific Association of Midwifery (ISAM) using a translated valid version of the Member Association Capacity Assessment tool (MACAT) and also to explain the needs and propose the related strategies and actions to improve ISAM capacities.

Methods:
This was a mixed sequential (Quantitative-Qualitative) explanatory research in 2022. The study was performed in three phases based on the study's objectives. In the first phase, the MACAT of the International Confederation of Midwives (ICM) was translated into Persian. Then, the validity of MACAT was assessed by 10 experts. After the validity approval of the Persian version of the MACAT, in the second phase, which was a descriptive study, the capacity of ISAM was assessed by two trained evaluators using MACAT. In the third phase of the study, with a qualitative research and using a focused group discussion and six in-depth individual interviews with 14 key informants, the demonstrated challenges in the first phase of the study and the related suggestions for the problem solutions were discussed. The data from the qualitative phase of the study were analyzed using directed Qualitative content analysis. Lincoln and Guba’s criteria were used to confirm the trustworthiness of the data. Then the needs were explained, and the strategies and actions were suggested to improve ISAM capacities in the seven dimensions of MACAT, including governance, management, financial resources, functions, communication, collaboration, and visibility.

Results:
In the first phase of the study, the MACAT was translated into Persian, and its validity assessment showed S-CVI= 0.91 and I-CVI= 0.89. CVR scores of all items were also above 0.62 and so acceptable. In the second phase of the study, the document review and the observations showed 88 out of 96 items scored 1 (91 percent) while 8 items scored zero. In the third phase of the study, 83 codes in the 6 dimensions were categorized from directed content analysis. Then, 53 actions were proposed for seven main strategies for improving the governance, enhancing the management practices and leadership methods, increasing functions, increasing collaboration, partnership, and networks, and expanding visibility and increasing sustainability to improve ISAM capabilities.

Conclusion:
The Scientific Midwifery Association obtained 91 percent of the scores. The most important challenges of the ISAM were (1) low advocacy, (2) a shortage of human and financial resources and sponsors, and (3) low contribution in policy and decision-making in midwifery affairs. The most necessary actions for the ISAM capacity improvement were suggested to be (1) considering more independence in a culturally and politically-based context governance, (2) paying attention to infrastructure improvement, and (3) defining the mechanisms in communication with the other midwifery-related sectors, other NGOs, and potential sponsors; (4) the ISAM involvement in making macro policies and midwifery affairs, and (5) using the ISAM capacity for participating in mega health projects for fundraising.