Abstract:
Collaboration between midwives and traditional birth attendants for maternal and child
healthcare is a challenge in rural South African communities due to the absence of a guiding framework. To address this, this study sought to develop and validate an inclusive framework informed
by the Donabedian structure–process–outcome (SPO) framework for collaboration between these
healthcare professionals. Method: Key stakeholders were invited to participate in a co-creation
workshop to develop the framework. Twenty (20) participants were purposively sampled based
on their maternal and child healthcare expertise. A consensus design using the nominal group
technique was followed. Results: Participants identified the components needed in the framework,
encompassing (i) objectives, (ii) structures, (iii) processes, and (iv) outcomes. Conclusion: This paper
will contribute to the development of an inclusive healthcare framework, providing insights for
stakeholders, policymakers, and practitioners seeking to improve maternal and child healthcare
outcomes in resource-constrained, rural settings. Ultimately, the proposed framework will create a
sustainable and culturally sensitive model that optimises the strengths of midwives and TBAs and
fosters improved healthcare delivery to rural South African communities
