The loss of midwives from the health workforce continues to pose a serious challenge for healthcare leadership in Ethiopia. Despite its importance, evidence remains limited regarding the intention to leave work and its contributing factors among midwifery professionals in southwest Ethiopia. In response, this study was conducted to address the existing knowledge gap regarding turnover intention and its determinants among midwives in this region. This study sought to evaluate turnover intention and its associated determinants among midwives in southwest Ethiopia in 2022. A facility-based cross-sectional study design was applied among one hundred twenty-one (121) midwives using a structured, pre-tested, self-administered questionnaire conducted from May 19/2022, to June 6/2022. The collected data were entered into EpiData 4.4.2.1 and then edited, coded, categorized, and prepared for analysis. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 24, and the findings were presented in tables, figures, and descriptive narration. Both bivariate and multivariable logistic regression models were used to identify variables associated with turnover intention at significance levels of 0.25 and 0.05, respectively. Among the 121 midwives analyzed, approximately 48.76% (95% CI: 39.86–57.74) indicated an intention to leave their current health facility, while 53.72% (95% CI: 44.68–62.52) reported dissatisfaction with their job. Male sex (AOR: 2.9 (95% CI: 1.14–7.39)), working in health centers (AOR: 0.20 (95% CI: 0.06–0.70)), and absence of mutual support (AOR: 0.17 (95% CI: 0.07–0.44)) were significantly linked with turnover intention among midwives. The magnitude of turnover intention among midwives in this study was higher compared with other local and national reports. Gender, level of mutual support, and type of health institution were identified as key influencing factors. Therefore, public health authorities should reassess maternity workforce management strategies to strengthen teamwork and enhance mutual support among staff.
