Abstract
Background: Maternal and neonatal mortalities remain a challenge in Eswatini despite the majority of pregnant women delivering in healthcare facilities. The sustained knowledge and skills of registered midwives with respect to Emergency Obstetrics and Neonatal Care (EmONC) are critical to avert preventable mortalities.
Aim: The aim of the study was to develop EmONC knowledge and skills retaining strategies to sustain the capacity of registered midwives to manage emergency obstetric and neonatal complications.
Methods: An explanatory sequential mixed-methods study design was used. The study was conducted in five phases. Phase 1 determined training needs of registered midwives. Data were collected from N=202 midwives selected using simple random sampling. A self-administered validated Hennessy Hicks training needs questionnaire was used to collect data. Data were analysed using SPSS version 29. Descriptive statistics were determined. A paired t-test was used to determine statistical significance between means, and the p-value was p=<.05. Results informed an EmONC training programme. EmONC training experiences of registered midwives were explored using focus group discussions and interviews for midwife managers. A qualitative descriptive study design was used.
Phase 2 involved synthesising the results and findings from Phase 1 with literature review to develop a conceptual framework. Phase 3 focused on development of the strategies. In Phase 4, the strategies were validated by midwifery experts. Phase 5 involved implementation and evaluation of health outcomes. Knowledge and skills retention was measured through a pre and post-test design.
Findings: The mean age of the 202 respondents was 38.06±6.9 years. The midwives predominantly fell into the age group 40–44 years (n=53, 22.2%), and they had an average of 5–9 years of work experience (n=75, 37.1%). The research/ audit category emerged as the highest (M=2.23±1.05) training need. In the qualitative part of the study, the experience of benefit, competency-based training and limited training duration emerged. The pre and post-test results showed that the average knowledge scores improved from 42.89% to 96.67%, while skills scores improved from 36.57% to 95.71% after the training.