It Takes a Village to Bring up a Child: Addressing Quality Control Mechanisms in a Capacity Building Programme Strengthening Midwifery Education and Research in Malawi, Zambia and Zimbabwe

Abstract

Background: A global reduction in maternal mortality is a major target among the Sustainable Development Goals. Midwives make significant contribution towards achieving these goals by improving maternal and neonatal mortality. However, the shortage of midwives is eminent in the world today, creating critical gaps in delivery of essential health services in some of the most vulnerable parts of the world. There are several methods in place to relieve this shortage, one of which is capacity building programmes strengthening midwifery education and research at universities in low- and middle-income countries. The aim of this research is to discover current gaps and understand future opportunities for improvement of such capacity building programmes to improve future aid in this area. Methods: A five-year period capacity building programme (NORHED) strengthening midwifery education and research in three sub-Saharan African countries were identified through, and overseen by the Norwegian Agency for International Development, Norad. In order to evaluate the programme, this study analysed the experience and perception of the intended beneficiaries of the programme. The programme’s consortium members (n=7) participated in in-depth interviews. Interviews were completed over Skype, in person, by phone call or via e-mail. Interviews were audiotaped and transcribed verbatim. Data analysis was performed by Systematic Text Condensation followed by a content and thematic analysis. Results: Activities to strengthen midwifery education and research includes; development and improvement of curriculum, enriching student’s knowledge base by utilizing expert consultants, and offering a postgraduate diploma in midwifery enabling those without a midwifery component from previous studies to pursue a Master’s degree. The midwifery curriculum was successfully developed and improved by involving several stakeholders. This involvement is seen as a sustainable component. A high number of published articles from the Master’s and doctoral students are identified as a success factor in this programme. However, lack of resources and incentives might hinder the efforts and the NORHED programme’s aim to gain the wanted critical mass. Conclusion: A five-year period is insufficient in achieving capacity building, it is rather a stepping stone. Enduring partnerships with funders, academics and health practitioners in donor countries and building local capacity to continue training is essential. Quality control and sustainability seem to go hand in hand, but more research is needed to determine the robustness of quality control mechanisms in the studied programme.