Confidence of pre-registration nurse-midwife technicians to provide intrapartum care: A case study of Southern region nursing and midwifery colleges in Malawi

Abstract

Introduction: Midwifery service provision is based on key skills which are usually acquired during training. These skills are based on guidelines set by the International Confederation of Midwives. Perceived self-efficacy to provide midwifery services has been identified as an indicator of skilled provision of midwifery care. The purpose of this study therefore was to determine the levels of confidence of pre-registration NMTs in the southern region of Malawi to provide intrapartum care and factors associated with confidence of pre-registration NMTs in the southern region of Malawi to provide intrapartum care. Methods: This was a descriptive cross-sectional study employing the quantitative approach. Data was collected from 217 students using a structured questionnaire. Confidence to provide intrapartum care was assessed using the confidence measuring tool. Confidence score was computed by summing all item scares. Bivariate and multivariate linear regression were conducted to determine factors associated with the pre-registration NMTs confidence to provide intrapartum care. Interaction and confounding were tested to develop the final model in order to determine the significant associated factors with confidence at the level of significance of 0.05. Results: Overall the confidence score ranged from 96 to 190 with a mean score of 158.9 (SD=15.6; 95% CI: 156.8 – 161.0), and an average item score of 3.3. A multivariate analysis showed that factors that have a significant association with confidence to provide intrapartum care at the level of significance of 0.05 are gender, interest in the midwifery profession, level of performance in the exam and level of familiarity with ICM intrapartum competencies. Conclusions: On average, the Malawian pre-registration NMTs rate themselves to be confident at providing intrapartum care. Familiarity with intrapartum competencies and interest in the midwifery profession are significantly associated with confidence to provide intrapartum care. Recommendations: The study recommends that Nursing and Midwifery institutions in Malawi should provide career guidance campaigns to foster interest in midwifery among potential students before the application process to join midwifery. The midwifery training institutions should emphasize the key midwifery competencies during the training of midwives.