The preparedness and readiness of rural and remote primary care midwives working in low- and middle-income countries: A scoping review.

BACKGROUND: A well-prepared and supported midwifery workforce is essential to providing quality maternal and neonatal health care in rural and remote communities in low- and middle-income countries. AIM: To identify the extent and type of research related to the preparedness and readiness of primary care midwives working in rural and remote settings in low- and middle-income countries. METHODS: We conducted a scoping review of primary research literature published between 2010 and 2023. FINDINGS: We identified 62 papers for inclusion, reported in two sections. Section 1 scopes the 52 papers discussing midwives' preparedness and readiness challenges, enablers and recommendations for the rural and remote context in low- and middle-income countries. We report the findings under four categories: 1). Professional preparation and competence; 2). Supportive work environments; 3). Ready, willing, and able; and 4). Governance, policy, and regulation. Section 2 scopes the 16 papers that evaluated strategies to strengthen midwives' preparedness and readiness in rural and remote contexts of low- and middle-income countries. We report these findings under three categories: 1). Education, training, and mentoring; 2). Readiness through technology: and 3). Midwifery workforce. Six papers are relevant to both sections. DISCUSSION: There is limited research evidence on primary care midwives' rural and remote preparedness and readiness in low- and middle-income countries. However, the existing literature demonstrates that midwives need contextually relevant education, training, and support in providing quality care in rural and remote health care environments in low- and middle-income countries. CONCLUSION: Further investments are required to improve primary care midwives' preparedness and readiness for rural and remote low- and middle-income country settings.