Midwifery education in Sub- Saharan Africa – A systematic integrative literature review

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Abstract: Background: Maternal mortality remains a major global health concern, with the highest rate found in Sub-Saharan Africa. There is documented lack of well-trained midwives, hence, a need for increased quality midwifery education to improve maternity care and secure women's reproductive health. Objective: This review aims to describe facilitators of and barriers to providing quality midwifery education in Sub- Saharan Africa. The specific question asked was how midwifery education stands against the ICM’s Global Midwifery Education Standards. Method: An integrative review, as described by Whittemore and Knafl, was conducted following the five stages: Problem identification, Literature search, Data evaluation, Data analysis, and Presentation of the result. The literature search was conducted in three databases: PubMed, CINAHL and Scopus in January 2023. A deductive approach, using ICM´s six Standards for Midwifery Education guided the analysis. Result: The searches identified 1664 publications, 82 were read in full, leaving 29 publications included, describing studies conducted in 18 countries within Sub-Saharan Africa. Programme governance: there was little support for the midwifery program such as its registration and knowledge of scope of practice. Faculty: The faculty was not competent enough for the tasks they were assigned. Students: The students showed a clear demand for more support. Midwifery programme & curriculum: The content and execution of the midwifery programme & curriculum was limited and did impact on the students' achievement. Resources: A conspicuous lack of resources. Quality improvement: Shortage of funding and knowledge about quality improvement processes limited the quality assurance within the program as well as external accreditation. Conclusion: The included studies in this review reports challenges within each and one of the educational standards that could have serious implication for the quality of the midwifery education provided. Further research is therefore required.

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