Midwifery Students’ Confidence in New-Born Care at Completion of Training in Selected Midwifery Schools in Zambia. A Multicentric Study: A Case of Zambia

Background: Quality education is one of the important factors in empowering midwives to provide quality health care services to mothers and newborns irrespective of their practice settings. Due to lack of standardization of the duration, content, and structure of midwifery education and different pathways to midwifery across the world, midwives may lack the confidence to deliver quality health care services in the main domain of the ICM competences. Aim: To assess the confidence of final year midwifery students in the domain of new-born care based on the ICM midwifery competencies. Methods: The first phase consisted of a quick situation analysis of midwifery education and regulation in Zambia, followed by a cross-sectional survey through a self-administered questionnaire to assess the confidence of final year midwifery students. Results: Most (51.9%) of the respondents were aged between 18 and 28 years, and majority of them were placed in Levels 1, 2 and 3 Hospitals and also clinics for their clinical practice, with between one hundred to ten thousand annual births, followed by 16.9% who were placed in Level 3 hospitals only. Most students (38.3%) reported receiving classroom instruction by both Lecture and Demonstration. Few students (22.7%) responded that they were not satisfied with their clinical supervision, while 77.3% were satisfied. There was significant association between confidence to perform skills independently and having enough time to practice on models in the labs (p value = 0.024), confidence when practiced for the first time on mothers (p value = 0.007) and satisfaction with supervision during clinical practice (p value = 0.000). Binary logistic regression of characteristics associated with confidence to perform new-born skills independently revealed significant association between satisfaction with clinical supervision and confidence to perform skills independently, 95% CI [1.83, 15.37]. Conclusion: Midwifery students need quality training both theoretically and practically in order for them to gain confidence in newborn care upon completion of their training. They need adequate time to practice on models in the skills laboratory, and need adequate clinical supervision for them to gain confidence in performing new born skills independently.

Migration of Healthcare Professionals: Exploring Self-Perception about Midwifery Professional Life and Continued Education

Introduction: International migration has always existed, primarily as a means to find economic opportunity. Recently, the number of health care professionals seeking to work outside Albania is growing rapidly. In 2021 alone, 1073 nurses left Albania. The departure of health care professionals is reflected in education where it can be observed that a good part of the students who finished the bachelor’s level program did not enroll to continue the second level of study in the master’s. The student’s decision not to continue further levels of education has brought consequences from programs shutting down due to lack of students and forcing the university to spread out the few remaining students to other programs. Objective: The purpose of the study was to explore the opinions of Midwifery Students studying at the Bachelor level, regarding their professional future and continuing education. Methodology: This is a cross-sectional study. In this study are included the students of the bachelor level of education. Student participating are studying Midwifery in the 2022-2023 academic year, at the Faculty of Technical Medical Sciences at the University of Medicine, Albania. Results: The students on average believe they can find a job as a midwife. The career is relatively safe and the profession of midwifery will ensure economic well-being for them. Most of the students hope to emigrate and develop their professional career outside of Albania. This was a surprise given that most frequent answers given by the students for not continuing their Master’s level education was the fact that the program was not accredited, their Bachelor’s diploma was also not accredited and so not recognized by other countries, the cost of continuing their studies was too high and their desire for a better economic and social status which they cannot get in Albania. The majority of students participating in the study identified emigration as the main way they plan to further their studies. Conclusions and Recommendations: Although the students had willingly chosen to continue the midwifery diploma, as they thought it would provide them with a proper future, this dignified professional future was seen as unattainable in Albania so they are seeking it out in more developed countries. A significant number of health professionals prefer to continue their second cycle studies in another country. The professional security within their home country does not satisfy the students. As the market demand for nurses around the globe escalates, the changes and consequences associated with nurse migration are increasingly in need of policy solutions that will address the needs of all parties involved. .