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 capac‑
ity 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 stratifed 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 fndings 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.
