A Phenomenological Study of Midwives' and Nurses' Perceptions in the Implementation of Clinical Pathways on Maternal and Infant Mortality Risks

Abstract

Maternal and infant mortality remain key indicators for assessing of healthcare systems, especially in developing countries. One way to reduce these risks is by implementing clinical pathways as evidence-based standard care guidelines. However, their implementation in practice is often not effective. This study aims to explore the perceptions and experiences of midwives and nurses regarding the implementation of clinical pathways in reducing the risk of maternal and newborn deaths. The research uses a qualitative approach with a phenomenological study method. Participants were selected purposively, including midwives, nurses, specialist doctors, ward heads, and quality managers at healthcare facilities that have implemented clinical pathways. Data was collected through semi-structured in-depth interviews and analyzed using Colaizzi's method. The study identified three main themes: variable adherence to procedures, weak inter-professional coordination dan lack of monitoring systems from management affecting patient outcomes. It was found that there are gaps between the ideal practices expected in clinical pathways and the realities on the ground, which could increase the risk of failing to manage maternal and newborn cases. The study emphasizes the importance of training, strong monitoring systems, and strengthening a collaborative work culture as strategies to improve the effectiveness of clinical pathways. These findings contribute to the development of policies and improvements in maternal-neonatal healthcare services in Indonesia.