The State of Midwifery Education, Regulation, and Practice in East and Southern Africa Region 2022

A Lancet article published in 2020 shows that achieving universal coverage of midwives could avert 67% of maternal deaths by 2035. Data and evidence-based programming is instrumental to guide and track investment in midwifery programmes. This assessment is the second regional assessment (the first being in 2017) of the state of midwives in the East and Southern Africa (ESA) region commissioned by the United Nations Population Fund (UNFPA) ESA regional office. It provides a comprehensive assessment of the current state of the region's sexual, reproductive, maternal, newborn, and adolescent health workforce in 23 countries. It gives clear evidence of the region's progress and identifies bottlenecks and challenges that must be addressed.

Setting Students Up for Success: An Innovative Orientation to Clinical Placement in Sierra Leone 

Sierra Leone has one of the world's highest maternal mortality ratios. There is currently a critical shortage of midwives to address this situation. The Government of Sierra Leone is investing in strengthening and expanding midwifery education. Major challenges hampering progress include inadequate student oversight and a lack of hands-on clinical experience. Numerous factors affect students' clinical learning; however, the absence of supportive learning environments is a significant barrier. To strengthen clinical midwifery education and create a more supportive learning environment at Makeni Regional Hospital, a comprehensive, three-day student orientation to clinical practice was developed. Content consisted of teamwork and communication concepts, clinical assessment and documentation, rotation objectives and expectations, self-care strategies, medical ethics, respectful maternity care, and informed consent. Orientation culminated with postpartum hemorrhage and neonatal resuscitation simulation and debrief to promote practical application of all learning content.

Systematic Review of National Continuous Professional Development Processes and Systems for Midwifery Educators in Low- and Middle-Income Countries (LMICs) 

Midwifery educators play a critical role in strengthening the midwifery workforce in low- and middle-income countries (LMICs) for achieving the maternal-newborn health Sustainable Development Goal (SDG) targets. However, midwifery educator development is grossly under-invested, with variation in quality, insufficient/poorly trained educators, scope of practice, weak regulation, and lack of opportunities for educators to update their knowledge or skill competencies in LMICs. Participating in relevant continuous professional development (CPD) is a key strategy to ensure that midwifery educators maintain their competence for quality midwifery graduates and workforce. This systematic review describes the current approaches, content, and effectiveness of midwifery educator CPD programs in LMICs.

Tools to Guide School-Specific Investments in Pre-service Midwifery Education: Results from a Field Test in Three African Countries 

The COVID-19 pandemic exacerbated global challenges to quality pre-service midwifery education. In resource-constrained settings, educational institutions' needs are complex and investments may not address the specific needs of a school, creating or even worsening inefficiencies. To address this challenge, African midwifery leaders co-created five educational capacity frameworks (ECFs), one for each of five pre-service education domains: clinical sites, curriculum, faculty, students, and infrastructure/management. The ECFs quantify a school's capacity, or ability to meet international and/or regional standards, in each domain. They are intended for internal school self-assessment that guides identification of school-specific investment and improvement priorities. The ECFs have recently been field-tested. Our objectives were to (1) report the findings from a field test of ECFs for five domains of pre-service midwifery education and (2) describe participants' feedback using the ECFs.