Are midwives ready to provide quality evidence-based care after pre-service training? Curricula assessment in four countries - Benin, Malawi, Tanzania, and Uganda

Abstract

This research sought to map midwifery pre-service training curricula as part of the Action Leveraging Evidence to Reduce perinatal morTality and morbidity in sub-Saharan Africa (ALERT) project conducted in Benin, Malawi, Tanzania, and Uganda. We conducted the review in two phases. In the first phase, online interviews were performed with the lead project midwives in all four study countries to get an overview of midwifery care providers' pre-service training courses, registration, and licensing requirements. We performed a mapping review of midwifery care providers’ pre-service training curricula from different training institutions in the four study countries during the second phase. Curricula were reviewed and mapped against the International Confederation of Midwives (ICM) Essential Competencies framework to assess whether these curricula included the minimum essential training components described in the ICM framework. We identified 10 different professional titles for midwifery care providers. The number of years spent in pre-service training varied from one and a half to four years. Ten pre-service curricula were obtained and the assessment revealed that none of the curricula included all ICM competencies. Main gaps identified in all curricula related to women-centred care, inclusion of women in decision making, provision of care to women with unintended or mistimed pregnancy, fundamental human rights of individuals and evidence-based learning. This review suggests that there are skills, knowledge and behaviour gaps in pre-service training curricula for midwifery care providers when mapped to the ICM Essential Competencies framework. These gaps are similar among the different training courses in participating countries. The review also draws attention to the plethora of professional titles and different pre-service training curricula within countries.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study is part of the ALERT project which is funded by the European Commission’s Horizon 2020 (No. 847824) under a call for implementation research for maternal and child health. Publication fees paid by University of Gothenburg, Sweden.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Not Applicable

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This study is part the Action Leveraging Evidence to Reduce perinatal morTality and morbidity in sub-Saharan Africa (ALERT) project. The project received ethical approval from the local and national institutional review boards as follows: Karolinska Institutet, Sweden (Etikprövningsmyndigheten). Uganda National Council for Science and Technology (UNCST). Muhimbili University of Health and Allied Sciences (MUHAS). Research and Ethics Committee, Tanzania and The Aga Khan University Ethical Review Committee, Tanzania. College of Medicine. Research and Ethics Committee, Malawi. Comité National d’Ethique pour la Recherche en Santé, Cotonou, Bénin. The Institutional Review Board at the Institute of Tropical Medicine Antwerp and the Ethics Committee at the University Hospital Antwerp, Belgium.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

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Data Availability

The midwifery pre-service training curricula are not publicly available due to potential confidentiality concerns and only shared with the authors for this paper.

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