Do the pre-service education programmes for midwives in India prepare confident ‘registered midwives’? A survey from India

Sharma, Bharati; Hildingsson, Ingegerd; Johansson, Eva; Prakasamma, M.; Ramani, K. V.; Christensson, Kyllike

doi:10.3402/gha.v8.29553

Cited by 37 publications

(52 citation statements)

References 26 publications

(27 reference statements)

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“…The results showed that one third to one fourth of the students in the present study scored high on confidence in the three domains. This is quite similar to the findings from India, where Sharma and co-authors [13] found that 23-28% scored above the 75 th percentile.…”

Section: High Levels Of Confidencesupporting

confidence: 89%

“…Nevertheless, the multi-country approach and the large number of respondents make the data reliable. The questionnaire has been used in other studies [13,22,27], and further developed and refined by a group of senior researchers for the current study. This strengthen the validity of the tool.…”

Section: Age and Sexmentioning

confidence: 99%

“…work, family, social events, or relationships [12]. Some aspects of confidence are related to competence but are not synonymous [13]. Fullerton and co-workers describe confidence as an achievement, e.g.…”

Section: Introductionmentioning

confidence: 99%

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African midwifery students’ self-assessed confidence in antenatal care: a multi-country study

Hildingsson

Lindgren

Karlström

et al. 2019

Global Health Action

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Background: Evidence-based antenatal care is one cornerstone in Safe Motherhood and educated and confident midwives remain to be optimal caregivers in Africa. Confidence in antenatal midwifery skills is important and could differ depending on the provision of education among the training institutions across Africa.Objective: The aim of the study was to describe and compare midwifery students’ confidence in basic antenatal skills, in relation to age, sex, program type and level of program.Methods: A survey in seven sub-Saharan African countries was conducted. Enrolled midwifery students from selected midwifery institutions in each country presented selfreported data on confidence to provide antenatal care. Data were collected using a selfadministered questionnaire. The questionnaire consisted of 22 antenatal skills based on the competency framework from the International Confederation of Midwives. The skills were grouped into three domains; Identify fetal and maternal risk factors and educate parents; Manage and document emergent complications and Physical assessment and nutrition.Results: In total, 1407 midwifery students from seven Sub-Saharan countries responded. Almost one third (25-32%) of the students reported high levels of confidence in all three domains. Direct entry programs were associated with higher levels of confidence in all three domains, compared to post-nursing and double degree programs. Students enrolled at education with diploma level presented with high levels of confidence in two out of three domains.Conclusions: A significant proportion of student midwives rated themselves low on confidence to provide ANC. Midwifery students enrolled in direct entry programs reported higher levels of confidence in all domains. It is important that local governments develop education standards, based on recommendations from the International Confederation of midwives. Further research is needed for the evaluation of actual competence.

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Section: High Levels Of Confidencesupporting

confidence: 89%

Section: Age and Sexmentioning

confidence: 99%

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African midwifery students’ self-assessed confidence in antenatal care: a multi-country study

Hildingsson

Lindgren

Karlström

et al. 2019

Global Health Action

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“…These interviews and evidence reported elsewhere reinforce the urgent need to improve midwifery and nursing education [26,29,[37][38] .…”

Section: Discussionmentioning

confidence: 62%

Challenges and Reforms in Midwifery and Nursing Regulatory Systems in India: Implications for Education and Practice

Mayra

Padmadas

Matthews

2020

Preprint

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Background: Nursing regulation is poor and midwifery coexists with nursing in India, where 88% of midwifery and nursing education is provided by the private sector. The Indian health system faces major challenges for maternal health provision, with a 12% share of total maternal deaths globally, poor quality, indeterminate regulatory functions and lack of reforms. Methods: We undertake a qualitative investigation to understand the experiences and perceptions of of participants on midwifery and nursing regulatory systems, education and development in India. Thirty-four in-depth interviews were conducted with senior midwifery and nursing leaders representing administration, advocacy, education, regulation, research and service provision. Results: There’s a lack of importance accorded to midwifery roles within the nursing system. The councils and statutes do not adequately reflect midwifery practice, and are a barrier to good quality care provision. The lack of amendment of Acts, lack of representation of midwives and nurses in key governance positions in councils and committees have restrained and undermined leadership positions, which has also impaired the growth of the profession. The standards for education in private institutions appeared imprudent with lack of opportunities for practice and unfair assessment practices. Discrimination against midwifery and nursing students was rampant in the education system in public and private institutions, with limited opportunities for practice when compared to medical students. Conclusions: The study concludes with a reform measure including a recommendation for implementing direct-entry midwifery education, empowering midwives and nurses with decision-making powers within health care and workforce governance.

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“… 18 An Indian study indicated that final year midwifery students had low level of confidence in basic midwifery competencies for antepartum, intrapartum, postpartum, and newborn care. 19 The State of the World’s Midwifery Report 2014 covering 73 low- and middle-income countries also found pervasive gaps in midwifery education. 8…”

Section: Discussionmentioning

confidence: 99%

Using task analysis to generate evidence for strengthening midwifery education, practice, and regulation in Ethiopia

Yigzaw¹,

Carr²,

Stekelenburg³

et al. 2016

IJWH

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PurposeRealizing aspirations for meeting the global reproductive, maternal, newborn, and child health goals depends not only on increasing the numbers but also on improving the capability of midwifery workforce. We conducted a task analysis study to identify the needs for strengthening the midwifery workforce in Ethiopia.MethodsWe conducted a cross-sectional study of recently qualified midwives in Ethiopia. Purposively selected participants from representative geographic and practice settings completed a self-administered questionnaire, making judgments about the frequency of performance, criticality, competence, and location of training for a list of validated midwifery tasks. Using Statistical Package for the Social Sciences, Version 20, we computed the percentages and averages to describe participant and practice characteristics. We identified priority preservice education gaps by considering the tasks least frequently learned in preservice, most frequently mentioned for not being trained, and had the highest not capable response. Identification of top priorities for in-service training considered tasks with highest “not capable” and “never” done responses. We determined the licensing exam blueprint by weighing the composite mean scores for frequency and criticality variables and expert rating across practice categories.ResultsOne hundred and thirty-eight midwives participated in the study. The majority of respondents recognized the importance of midwifery tasks (89%), felt they were capable (91.8%), reported doing them frequently (63.9%), and learned them during preservice education (56.3%). We identified competence gaps in tasks related to obstetric complications, gynecology, public health, professional duties, and prevention of mother to child transmission of HIV. Moreover, our study helped to determine composition of the licensing exam for university graduates.ConclusionThe task analysis indicates that midwives provide critical reproductive, maternal, newborn, and child health care services and supports continuing investment in this cadre. However, there were substantial competence gaps that limit their ability to accelerate progress toward health development goals. Moreover, basing the licensure exam on task analysis helped to ground it in national practice priorities.

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Do the pre-service education programmes for midwives in India prepare confident ‘registered midwives’? A survey from India

Cited by 37 publications

References 26 publications

African midwifery students’ self-assessed confidence in antenatal care: a multi-country study

African midwifery students’ self-assessed confidence in antenatal care: a multi-country study

Challenges and Reforms in Midwifery and Nursing Regulatory Systems in India: Implications for Education and Practice

Using task analysis to generate evidence for strengthening midwifery education, practice, and regulation in Ethiopia

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