Midwives' self-perceived confidence in their knowledge and skills in Kenya: An observational cross-sectional study

Abstract

Background: Midwives’ confidence in the requisite knowledge, skills and behavior acquired during training is essential for high-quality pregnancy and childbirth care and positive experiences by women and newborns. Purpose: Assess the midwives’ self-perceived confidence in their knowledge and skills based on ICM competencies in Kenya. Methods: An observational cross-sectional study among 576 midwives from 31 public hospitals using a self-administered questionnaire. Confidence categorized as low, moderate or high and relationships between confidence and midwives’ characteristics tested by Kruskal-Wallis tests. Findings: A total of 495 (85.9%) midwives participated in the study with a median age of 37.0 (32.0–43.0). Most of the midwives were diploma nurse/midwives (295, 59.6%) followed by degree nurse/midwives (156, 31.5%) and diploma midwives (44, 8.9%). Majority of the midwives had high confidence in knowledge (57.2%) and skills (62.0%) in the labor and birth domain while the general competency domain had the least confidence in knowledge (30.5%) and skills (36.6%). Male midwives reported high confidence in skills compared to females (57.7% vs 45.0%, P = 0.036) with no differences in knowledge (P = 0.148). Midwives in tertiary hospitals reported higher confidence in knowledge and skills compared to those at county/sub-county hospitals (P < 0.001). There were significant differences between midwives’ qualifications and confidence in knowledge on the general competency domain (P = 0.02) and skills in the labor and birth domain (P = 0.017). Conclusions: Labour and childbirth domain and working in tertiary facilities were associated with high confidence in knowledge and skills. In-service capacity building opportunities for midwives to build their confidence in obstetric care is needed.

Keywords

• Confidence
• Midwives
• Midwifery education
• Knowledge
• Skills and behaviour