Assessment of clinical competency of nurse-midwives : implications for maternal and neonatal health care at the national level/
Date of Award
Master of Science in Nursing (MScN)
School of Nursing and Midwifery, Pakistan
The study purpose: To establish the extent to which the TNMC standard guidelines for midwifery practice are utilized in the facilities, explore and describe the level of clinical competence of nurse-midwives as well as identify the existing knowledge and skills gaps. Methods: An explorative descriptive study design was conducted at two public health care facilities in the Ilala district, on the practicing nurse-midwives. Systematic sampling technique was utilized in recruitment of participants. A sample of 55 nurse-midwives was involved in the study. The eligibility was: practicing midwife, work experience; length of stay at the facility, and willingness to participate. Data were collected in June, 2010, through test of knowledge of nurse-midwives, through a structured objective examination, and direct observation of participants in the actual performance of their duties using a structured skill check list. The data were analysed, and expressed in frequencies and percentages. Results: The findings, revealed that of the respondents' 52.9% had sufficient level of competency to provide care. Out of the 52.9% respondents, 43.5% had score between 65% - 95% in the knowledge test, and 80 - 94% in skills, and 9.4% had scored above 86% in the knowledge lest and 95% in skills and fell in highly sufficient category. The remaining, 47.1% of the respondents had low score in both the knowledge, and skills. Low levels were revealed on; monitoring of the mother and the babies condition; use of partograph, and infection prevention and control. Discussion: These findings call for the urgent attention of hospital management to improve the level of clinical competency of nurse-midwives. The nurse-midwives should be provided comprehensive training and refresher courses for effective and up to date knowledge and skills; the working should take place in also an enabling environment to in order to enhance competence. Implications: The findings of this study have created a platform that could be used to inform nurse/midwives leaders, other decision makers, and nurse-midwives working in maternity care units about what are the issues in midwifery practice; hence, plan for strategies that may contribute to improve the midwifery practices. Thus, findings of this study may have significance for nurse-midwife clinicians, nursing and midwifery teachers in the clinical and class room settings, and hospital administrators, working in facilities with characteristic similar to the two study sites.
Mwasha, L. K. (2010). Assessment of clinical competency of nurse-midwives : implications for maternal and neonatal health care at the national level/ (Unpublished doctoral thesis). Aga Khan University, Karachi, Pakistan.