Background The code of ethics identifies the moral and ethical obligations inherent in the midwife's professional role. The practice of a code of ethics for midwives is important for the quality of care. Objective To assess the level of practice of the professional code of ethics, identify associated factors, and explore barriers to its practice among midwives in referral hospitals of the Amhara regional state, Ethiopia. Method An institutional-based cross-sectional study with concurrent triangulation of a qualitative component was conducted from December 1, 2023 to January 30, 2024. A simple random sampling technique was used to select 423 study participants. Qualitative participants were selected purposively until saturated information was obtained. The P -value <.05 was used to assert statistical significance in multivariable analysis. For the qualitative component, participants were selected purposively, and data were collected through in-depth interviews using semistructured questions. The data were analyzed using thematic analysis. Results This study revealed that 222 (53.5%) (95% confidence interval CI; 48.6%, 58.4%) midwives had good practice of the code of ethics. Training on the code of ethics (adjusted odds ratio AOR = 2.12, 95% CI: 1.10, 4.09), good knowledge about the code of ethics (AOR = 4.97, 95% CI: 2.89, 8.56), favorable attitude toward the code of ethics (AOR = 2.63, 95% CI: 1.58, 4.39) and job satisfaction (AOR = 1.83, 95% CI: 1.12, 2.98) were significantly associated with the practice of the code of ethics. Individual factors, institutional factors, patient-related factors, and current political instability emerged as themes representing barriers to the practice of the code of ethics. Conclusions According to the findings of this study, the practice of the code of ethics was lower than national expectations, as every healthcare provider had a responsibility to work in line with the professional code of ethics. Strengthening training programs, enhancing knowledge development, and fostering job satisfaction are also crucial for improving the practice of a code of ethics.
Getu et al. (Thu,) studied this question.