Ann-Beth Moller1, Joanne Welsh2, Mechthild M Gross2, Max Petzold3, Elizabeth Ayebare4, Effie Chipeta5, Hashim Hounkpatin6, Bianca Kandeya5, Beatrice Mwilike7, Antoinette Sognonvi6, Claudia Hanson8,9. 1. School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden. ann-beth.moller.2@gu.se. 2. Midwifery Research and Education Unit, Hannover Medical School, Hannover, Germany. 3. School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden. 4. Department of Nursing, Makerere University, Kampala, Uganda. 5. College of Medicine, The Centre for Reproductive Health, University of Malawi, Blantyre, Malawi. 6. Centre de Recherche en Reproduction Humaine et en Démographie (CERRHUD), Cotonou, Benin. 7. Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania. 8. Global Public Health, Karolinska Institute, Stockholm, Sweden. 9. Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
Abstract
BACKGROUND: We aim to assess competencies (knowledge, skills and attitudes) of midwifery care providers as well as their experiences and perceptions of in-service training in the four study countries; Benin, Malawi, Tanzania and Uganda as part of the Action Leveraging Evidence to Reduce perinatal mortality and morbidity in sub-Saharan Africa project (ALERT). While today more women in low- and middle-income countries give birth in health care facilities, reductions in maternal and neonatal mortality have been less than expected. This paradox may be explained by the standard and quality of intrapartum care provision which depends on several factors such as health workforce capacity and the readiness of the health system as well as access to care. METHODS: Using an explanatory sequential mixed method design we will employ three methods (i) a survey will be conducted using self-administered questionnaires assessing knowledge, (ii) skills drills assessing basic intrapartum skills and attitudes, using an observation checklist and (iii) Focus Group Discussions (FGDs) to explore midwifery care providers' experiences and perceptions of in-service training. All midwifery care providers in the study facilities are eligible to participate in the study. For the skills drills a stratified sample of midwifery care providers will be selected in each hospital according to the number of providers and, professional titles and purposive sampling will be used for the FGDs. Descriptive summary statistics from the survey and skills drills will be presented by country. Conventional content analysis will be employed for data analysis of the FGDs. DISCUSSION: We envision comparative insight across hospitals and countries. The findings will be used to inform a targeted quality in-service training and quality improvement intervention related to provision of basic intrapartum care as part of the ALERT project. TRIAL REGISTRATION: PACTR202006793783148-June 17th, 2020.
BACKGROUND: We aim to assess competencies (knowledge, skills and attitudes) of midwifery care providers as well as their experiences and perceptions of in-service training in the four study countries; Benin, Malawi, Tanzania and Uganda as part of the Action Leveraging Evidence to Reduce perinatal mortality and morbidity in sub-Saharan Africa project (ALERT). While today more women in low- and middle-income countries give birth in health care facilities, reductions in maternal and neonatal mortality have been less than expected. This paradox may be explained by the standard and quality of intrapartum care provision which depends on several factors such as health workforce capacity and the readiness of the health system as well as access to care. METHODS: Using an explanatory sequential mixed method design we will employ three methods (i) a survey will be conducted using self-administered questionnaires assessing knowledge, (ii) skills drills assessing basic intrapartum skills and attitudes, using an observation checklist and (iii) Focus Group Discussions (FGDs) to explore midwifery care providers' experiences and perceptions of in-service training. All midwifery care providers in the study facilities are eligible to participate in the study. For the skills drills a stratified sample of midwifery care providers will be selected in each hospital according to the number of providers and, professional titles and purposive sampling will be used for the FGDs. Descriptive summary statistics from the survey and skills drills will be presented by country. Conventional content analysis will be employed for data analysis of the FGDs. DISCUSSION: We envision comparative insight across hospitals and countries. The findings will be used to inform a targeted quality in-service training and quality improvement intervention related to provision of basic intrapartum care as part of the ALERT project. TRIAL REGISTRATION: PACTR202006793783148-June 17th, 2020.
Entities:
Keywords:
In-service training; Intrapartum care; Midwifery care providers; Multi country study; Sub-Saharan Africa
Authors: Nynke van den Broek; Charles Ameh; Barbara Madaj; Jennifer Makin; Sarah White; Karla Hemming; J Moodley; Robert Pattinson Journal: BMJ Glob Health Date: 2019-11-10