An evaluation of a national intervention to improve the postabortion care content of midwifery education in Nigeria

Abstract

Objective: To examine the impact of a national intervention to improve the postabortion care (PAC) content of midwifery education in Nigeria. Methods: A 3-part quantitative assessment was carried out during and post-intervention. The first baseline component developed and examined the intervention to improve teaching capacity and improve the PAC curriculum among 6 midwifery schools that were to become regional training centers. The second survey was a pre-and post-assessment conducted among midwifery instructors from all schools of midwifery in the country. In the third component, 149 midwives graduating from the 6 regional midwifery schools were interviewed once 3-9 months after graduation to evaluate whether the intervention had improved their knowledge of PAC and clinical practice, and the likelihood that they would provide PAC after graduation. Results: Data from 6 schools of midwifery in 2003 showed that none offered PAC or had educators trained in PAC prior to the intervention. Incorporation of PAC content and teaching capacity increased in all 6 study schools during the 3 years after a national intervention. Midwifery instructors demonstrated statistically significant improvements in knowledge of and exposure to PAC and manual vacuum aspiration (MVA) after the intervention. A follow-up interview with 149 student midwives post graduation showed increased knowledge, exposure to, and use of MVA in the workplace. Conclusion: Significant changes in graduate midwives' exposure, practice, and provision of PAC services resulted from a national intervention to improve the training environment and skills of midwifery instructors and students in the 6 schools of midwifery selected for evaluation.

Building midwifery educator capacity in teaching in low and lower-middle income countries. A review of the literature

“…Improvements noted from this approach included the implementation of contemporary adult education methods, which involved the use of simulation materials and sessions delivered by clinicians from teaching hospitals. The pre and post-test evaluation of this programme demonstrated successful outcomes including an increased level of midwifery educator's knowledge and skills relating to both content (postabortion care) and teaching (Akiode et al, 2010). After the intervention, the results of surveyed midwifery graduates indicated that there was an increase in exposure to theoretical teaching and clinical practice in the area of post-abortion care, greater availability of equipment in the clinical area and more learning support from clinicians (Akiode et al, 2010).…”

“…Four of the papers were discursive (Pons et al, 2002;Fullerton et al, 2011;The RESPOND Project, 2012;Usher et al, 2012) and three based on primary research (Akiode et al, 2010;Voetagbe et al, 2010;Turkmani et al, 2013).…”

“…Master-trainer or train-the-trainer approaches involving key national educators featured in papers describing large projects where a national curriculum update required the involvement of multiple institutions (Pons et al, 2002;Akiode et al, 2010;Usher et al, 2012). An example was provided from Nigeria by Akiode et al (2010) where a master-trainer model using a combination of theory and clinical practice was used to develop the knowledge, skills and attitudes of 169 midwifery educators from all 70 training institutions in Nigeria.…”

“…An example was provided from Nigeria by Akiode et al (2010) where a master-trainer model using a combination of theory and clinical practice was used to develop the knowledge, skills and attitudes of 169 midwifery educators from all 70 training institutions in Nigeria. Improvements noted from this approach included the implementation of contemporary adult education methods, which involved the use of simulation materials and sessions delivered by clinicians from teaching hospitals.…”

Editor's Comment

“…The third paper in this issue describes a program to improve preservice training in the area of postabortion care [5]. Clinicians have a tendency to practice as they were taught in medical/nursing school, and thus improving the quality of pre-service training is an important beginning.…”