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.

Challenges of Management and Care in Normal Birth Centers: Qualitative Study With Obstetric Nurses

“…To achieve full performance and decision-making power in the actions developed in the NBC, it is necessary to acquire skills through training and updates such as specializations, residency in Obstetric Nursing, or other training as mechanisms for professional qualification 15 . Regarding the training of the professional responsible for childbirth in the NBC, there are guidelines for childbirth and postpartum care.…”

“…This study emphasizes that the duality in training versus professional experience must be overcome to build training bases aimed at parturient women, rich in humanized knowledge, and with the deconstruction of unnecessary practices that contribute to an increase in compromising results in the childbirth experience 15,17 .…”

Desafios Da Gestão E Cuidado Em Centros De Parto Normal: Estudo Qualitativo Com Enfermeiros Obstetras

“…Para que se obtenha a plenitude de atuação e poder de decisão nas ações desenvolvidas no CPN é necessário adquirir competências por meio de capacitações e atualizações como especializações, residência em Enfermagem Obstétrica ou outros treinamentos como mecanismos de qualificação profissional 15 . No concernente à formação do profissional responsável pelo parto no CPN, há direcionamentos à assistência ao parto e pós-parto, mas é necessário perceber quais competências e responsabilidades são importantes e necessárias para alcançar a autonomia e o respeito na equipe de saúde 1, 16 .…”

“…Neste estudo ressalta-se que a dualidade que existe na formação versus experiência profissional deve ser superada, para construir as bases formativas direcionadas às mulheres parturientes, ricas em saberes humanizados e com a desconstrução de práticas desnecessárias que contribuem para o aumento de resultados comprometedores na experiência do parto 15,17 .…”

Midwifery care providers’ childbirth and immediate newborn care competencies: a cross-sectional study in Benin, Malawi, Tanzania and Uganda

“…A recent mapping review of pre-service curricula in the ALERT project countries against the International Confederation of Midwives (ICM) Essential Competencies framework [30] suggests that main competence gaps relate to women-centred care, inclusion of women in decision making, fundamental human rights of individuals and evidence-based learning. The review also revealed that in many cases the course literature reading lists were based on outdated textbooks and lacked references to literature on evidence-based guidelines and scientific papers [47].…”