A global review of the inferred meaning of woman centred care within midwifery professional standards

BackgroundAs an integral and guiding approach, woman centred care is well-grounded as the cornerstone of midwifery training and practice. A previous global review established that the concept, even though acknowledged as pivotal, has limited attention within the professional standards documents that underpin the discipline [1]. Whilst not detracting from the overall importance of woman centred care, it is further suggested that a broader meaning is generally being implied.ObjectiveWhether other related inferences and meanings of the actual term ‘woman centred care’ are also being utilised, has not yet been established. Therefore, this review of professional documents sought to investigate the occurrence of further depictions of the concept.MethodsWith an implied and inferred meaning of ‘woman centred care’ as the focus, a review and synthesis of narrative from a global sample of midwifery professional standards was conducted. The principles of meta-ethnography were utilised to develop a qualitative approach. Rather than the actual words ‘woman centred care’ further phrases implying or inferring the concept were sought. ‘A priori’ phrases were developed and narrative and examples were synthesised for each.FindingsStandards and governance documents were located from within Australia, the United Kingdom and New Zealand and a further 139 nations. Overall, the seven phrases, each considered as an inference to woman centred care, were all substantiated. As a proportion of all documents, these were collated with the outcomes being a woman’s right to choice (89%), being culturally sensitive (80.5%), a woman’s voice and right to be heard (78%), the woman as an individual (68%), universal human rights (40%), being holistic (39%) and being self-determined (17.5%).ConclusionThe outcomes of this review demonstrate that woman centred care may be a multidimensional concept. There were occurrences of all seven phrases across a broad scope of global professional midwifery documents, and each can be shown through its meaning to contribute something to an understanding of woman centred care. The creation of a universal meaning is recommended.     

“Do as I Do and Not as I Say”: Exploring Price‐Oriented Maverick Buying During Supplier Selection

This article empirically examines the occurrence of price‐oriented maverick buying (MB) during supplier selection, in a direct purchasing process context. Drawing on agency theory, maverick buying, and total cost of ownership (TCO) literature, the statistically significant existence of price‐oriented MB is investigated and the purchasing manager (PM)‐related factors that influence such noncompliant behavior are determined. A discrete choice experiment is designed to simulate a TCO‐based supplier selection process in which an established purchasing framework agreement stipulates PMs not necessarily be price‐oriented (i.e., select suppliers primarily based on lowest price), and then models PM choice behavior in the supplier selection process (SSP), utilizing a conditional logit model (CLM) to determine PM compliance to the established purchasing framework agreement and identify if price‐oriented MB exists. Statistical tests utilizing comprehensive primary and secondary data are then conducted to determine if correlational relationships exist between PM‐related factors and PM price‐orientation. Results indicate that three PM‐related factors bear a significant correlational relationship to PM price‐orientation.