PURPOSE:
To provide an overview of a national approach to implementing a national midwifery leadership structure across a nation. To give an overview of the processes and work required to gain nation wide approval for implementation and the key enablers and barriers in the process for other countries learning.

DISCUSSION:
NZ has moved all its 18 local districts to having district Chief Midwives, sitting at an equal position to Chief Medical Officers, Chief Nurses and Chief Allied Health. We no longer have any district chiefs reporting through nursing. We have 4 regional chief midwives and 1 national chief midwife. All work within multidisciplinary teams with medicine, nursing and allied health to make up the MDT team that advises our senior operational leaders.

EVIDENCE WHERE RELEVANT:
The implementation currently as of 25th June 2025 of all 18 districts in NZ now having midwifery leaders who sit at the same level in organisational structures to Nursing, Medicine and Allied Health. The disestablishment of all joint Nursing and Midwifery leadership roles in NZ over the last 6 months so there are no longer any structures where midwifery reports through nursing and midwifery is now an equal position in the organisational structure.

KEY MESSAGE:
The identification of the key enablers and the key barriers when implementing a national midwifery leadership structure throughout a country. What key relationships were required and levers to enable the change to midwifery being at the same level as Medicine and Nursing and Allied Health in all levels within our national organisation. Abuse - survivors sexual violence