Reframing Midwifery Education and Leadership: A Comparative Meta-Synthesis of Filipino, ASEAN, and Middle Eastern Curricula and Policy Roles

This study, conceptualized and led by Dr. Fernan Torreno in collaboration with Francia Ganituen, Frincess Flores, and Famiela Torreno, presents a comparative meta-synthesis of midwifery education and leadership in the Philippines, ASEAN, and Middle Eastern regions. Midwives are vital to maternal and newborn health, yet their education and leadership pathways remain uneven and fragmented despite international frameworks from WHO, UNFPA, and ICM advocating competency-based, policy-engaged training.

Drawing on 500 studies published between 2000 and 2025, including CHED and DOH reports, ASEAN and Gulf regulatory frameworks, university theses, institutional audits, and peer-reviewed literature, the team applied PRISMA screening, thematic coding, and GRADE-CERQual confidence assessment. Six recurring domains were identified:
1. Curriculum misalignment – Philippine curricula remain clinically focused with minimal leadership content, ASEAN shows partial harmonization through MRAs, while Gulf systems emphasize hospital-based training.
2. Leadership role ambiguity – Midwives report low confidence in leadership roles, especially in hierarchical Gulf systems.
3. Educator competency gaps – Educators juggle clinical and teaching duties with limited pedagogical preparation, though ASEAN has begun adopting WHO and ICM frameworks.
4. Mobility and benchmarking barriers – Filipino midwives face restricted mobility due to incomplete CHED alignment, while Gulf countries lack cross-border recognition.
5. Policy engagement deficits – Midwives rarely participate in policy formulation, with emerging advocacy roles seen mainly in select ASEAN countries.
6. Quality assurance fragmentation – QA systems are fragmented in the Philippines, uneven in ASEAN, and centralized but physician-dominated in the Gulf.

The findings highlight a persistent gap between global advocacy and national implementation. However, the study also provides a policy roadmap: the Philippines should embed leadership and policy modules, expand educator training, and align CHED curricula with ASEAN benchmarks; ASEAN must strengthen enforcement of MRAs and QA systems; and Gulf countries should transition toward academic-led midwifery models with inclusive policy engagement.

By situating midwives not only as clinical providers but also as educators, advocates, and leaders, the authors argue for reforms that prepare the workforce to shape equitable, resilient health systems. Comparative tables, coding matrices, CERQual ratings, and a PRISMA flow diagram ensure methodological transparency and compliance with PRISMA 2020, ENTREQ, and GRADE-CERQual standards.

The collaboration of Dr. Fernan Torreno, Francia Ganituen, Frincess Flores, and Famiela Torreno ensures both scholarly rigor and practical policy relevance. This research advances global discourse on midwifery education by offering region-specific strategies for curriculum reform, leadership integration, and quality assurance harmonization.