Design and evaluation of midwifery educator Continuous Professional Development Programme in Kenya

Midwifery education is the bedrock for equipping midwives with the essential competencies to provide high standards of safe, evidence-based care and to practise to international standards. There is clear evidence on the positive impact of midwifery education and care on reducing maternal and newborn mortality and morbidity. However, it has been found that there is a “startling lack of investment” in midwifery education with the recent State of the World Midwifery report (2021) calling for improved investment in high quality pre-service education and training of midwives to achieve their potential. Strengthening midwifery education and training to international standards is a key step to improving quality of care and reducing maternal and newborn mortality and morbidity.

Pre-service midwifery education and training in low- and middle- income countries

Pre-service midwifery education, training curriculum and professional development in low- and middle-income countries (LMICs) have been shown to be deficient. Key challenges include the lack of investment in educators as well as their limited skills and knowledge in contemporary teaching and learning, inadequate “hands-on” experience for students and gaps in infrastructure such as a lack of training equipment and skills laboratories; and human resource deficiencies particularly in LMICs^-6. It has also been evidenced that many midwifery educators are more confident with theoretical classroom teaching than clinical practice teaching and that they also struggle to maintain their own midwifery clinical skills.

How to strengthen midwifery education and training

This can be accomplished by strengthening the capacity of educators through upskilling existing midwifery educators to ensure that they are competent using contemporary teaching pedagogies to combine theory, simulation and clinical practice to provide evidence-based midwifery education and to support students during their in midwifery placements.

The ICM underscores the importance of maintaining midwifery education standards to promote an education process to prepare midwives who have all the essential ICM competencies for basic midwifery practise as well as additional competencies based on individual country needs and promote safe midwifery practise and quality midwifery care for women and their families. Investments in strengthened midwifery education as a strategy has successfully contributed to a reduction in maternal mortality in Burkina Faso, Cambodia, Indonesia and Morocco – LMICs that previously reported high maternal mortalities.

Continuous professional development (CPD)

Continuous professional development (CPD) enables practitioners to sustain knowledge and skills and assure competence for midwifery practice. This will enable midwifery educators to demonstrate their professional competence, update existing qualifications, increase self-esteem and keeping up to date and continuously seeking to improve. This is an essential ingredient for midwives and midwifery educators to ensure high-quality patient care. Therefore, this CPD will provide a pillar to ensure patient safety, midwifery competency and effective practice as well as advancing knowledge and skills.

Midwifery educator CPD programme in Kenya

In Kenya, nursing and midwifery training is regulated and standardized by the Nursing Council of Kenya (NCK). Nursing Council of Kenya reports 121 nursing/midwifery training institutions – 84 medical training colleges and 37 universities – approved to train nurse/midwife practitioners and educators at basic and post basic diploma, bachelors and masters level for various branches of nursing and midwifery practice.  After initial registration and licensing, nurse/midwives are expected to renew their licenses for retention with Nursing Council of Kenya (NCK) every year. All practitioners are required to attain a minimum of 20 CPD points per CPD calendar year before expiry of the license to qualify for retention in the annual register. The CPD system aims to ensure nurse/midwives keep abreast of new developments in health care through organized CPD programmes and is currently, accessed through an online CPD submission system.

Currently, the NCK hosts the online CPD courses on the WCEA portal. In addition, it provides opportunities for self-reporting for various CPD events including accredited online CPD activities/programs, skill development workshops, attending conferences and seminars, in-service short courses, practice-based research projects (as learner, principal investigator, principal author, or co-author) among others (available at https://osp.nckenya.com/cpd?self_reporting=show). However, the accredited programs specific for midwifery educators are limited. Key stakeholders in Kenya’s Ministry of Health under the pre-service taskforce have recognised the urgent need for a specific midwifery educator programme that will upskill and improve the competencies of the midwifery educators.

The proposed framework and content

This is a 20 credit (20 hour) module focusing on upskilling midwifery educators’ teaching skills to provide a quality, evidence-based learning environment for midwifery students. It is proposed to use the ICM essential competencies for midwifery practice framework to structure the module into four sections each carrying 5 credits (5 hours of effort).

Mode of delivery of the CPD program

1. Mandatory self-directed online learning on the WCEA portal which hosts NCK approved nursing/midwifery CPD courses. This will be the predominant mode of delivery and will be mandatory.
2. Webinars on selected topics of interest – this component will be optional.
3. Face-to-face sessions focusing on skills demonstration in CPD centres – this component will be optional.

Learning outcomes

At the end of the CPD modules, midwifery educators will be able to:

• Apply contemporary teaching pedagogies to create innovative learning events
• Design and utilise effective assessment techniques to assess knowledge, attitude and practical skills
• Provide individualised student-centred feedback and mentoring to enable students to maximise their potential
• Develop competency in using reflective practice and writing to enhance teaching and midwifery practice