International Confederation Of Midwives Research Articles

Are Turkish Midwifery Students Prepared for The Profession? Their Self-Confidence Levels and Associated Factors

Objective: To determine the self-confidence levels of midwifery students in line with the International Confederation of Midwives (ICM) competencies they are expected to possess before graduation and to explore effective factors. Materials and Methods: Descriptive and cross-sectional online survey design was used among quantitative research methods. The online survey link was spread through social media. In order to increase the response rate, the online survey links were posted every day. From March to June 2020, 763 midwifery students completed a survey on demographic characteristics and rated their confidence for essential midwifery skills listed by ICM. Results: Among the subscales, the highest average belonged to postpartum care (3.32 ± 0.66) and the lowest average to intrapartum care (2.94 ± 0.59). The students reported having less self-confidence in obstetrics emergencies, risky delivery, and neonatal care. The difference between descriptive characteristics and the ICM competencies subscales was found to be statistically significant (p

What is the Status of the Scientific Association of Midwifery in Iran based on the Criteria of the International Confederation of Midwives?

Introduction: Scientific midwifery associations can play a leading role in improving maternal health policies and practices. This study aimed to evaluate the Iran Scientific Association of Midwifery (ISAM) using a translated valid version of the Member Association Capacity Assessment tool (MACAT) and also to explain the needs and propose the related strategies and actions to improve ISAM capacities. Methods: This was a mixed sequential (Quantitative-Qualitative) explanatory research in 2022. The study was performed in three phases based on the study's objectives. In the first phase, the MACAT of the International Confederation of Midwives (ICM) was translated into Persian. Then, the validity of MACAT was assessed by 10 experts. After the validity approval of the Persian version of the MACAT, in the second phase, which was a descriptive study, the capacity of ISAM was assessed by two trained evaluators using MACAT. In the third phase of the study, with a qualitative research and using a focused group discussion and six in-depth individual interviews with 14 key informants, the demonstrated challenges in the first phase of the study and the related suggestions for the problem solutions were discussed. The data from the qualitative phase of the study were analyzed using directed Qualitative content analysis. Lincoln and Guba’s criteria were used to confirm the trustworthiness of the data. Then the needs were explained, and the strategies and actions were suggested to improve ISAM capacities in the seven dimensions of MACAT, including governance, management, financial resources, functions, communication, collaboration, and visibility. Results: In the first phase of the study, the MACAT was translated into Persian, and its validity assessment showed S-CVI= 0.91 and I-CVI= 0.89. CVR scores of all items were also above 0.62 and so acceptable. In the second phase of the study, the document review and the observations showed 88 out of 96 items scored 1 (91 percent) while 8 items scored zero. In the third phase of the study, 83 codes in the 6 dimensions were categorized from directed content analysis. Then, 53 actions were proposed for seven main strategies for improving the governance, enhancing the management practices and leadership methods, increasing functions, increasing collaboration, partnership, and networks, and expanding visibility and increasing sustainability to improve ISAM capabilities. Conclusion: The Scientific Midwifery Association obtained 91 percent of the scores. The most important challenges of the ISAM were (1) low advocacy, (2) a shortage of human and financial resources and sponsors, and (3) low contribution in policy and decision-making in midwifery affairs. The most necessary actions for the ISAM capacity improvement were suggested to be (1) considering more independence in a culturally and politically-based context governance, (2) paying attention to infrastructure improvement, and (3) defining the mechanisms in communication with the other midwifery-related sectors, other NGOs, and potential sponsors; (4) the ISAM involvement in making macro policies and midwifery affairs, and (5) using the ISAM capacity for participating in mega health projects for fundraising.

Women’s experiences of disrespect and abuse in Swiss facilities during the COVID-19 pandemic: a qualitative analysis of an open-ended question in the IMAgiNE EURO study

BackgroundThe COVID-19 pandemic has challenged the provision of maternal care. The IMAgiNE EURO study investigates the Quality of Maternal and Newborn Care during the pandemic in over 20 countries, including Switzerland.AimThis study aims to understand women’s experiences of disrespect and abuse in Swiss health facilities during the COVID-19 pandemic.MethodsData were collected via an anonymous online survey on REDCap®. Women who gave birth between March 2020 and March 2022 and answered an open-ended question in the IMAgiNE EURO questionnaire were included in the study. A qualitative thematic analysis of the women’s comments was conducted using the International Confederation of Midwives’ RESPECT toolkit as a framework for analysis.FindingsThe data source for this study consisted of 199 comments provided by women in response to the open-ended question in the IMAgiNE EURO questionnaire. Analysis of these comments revealed clear patterns of disrespect and abuse in health facilities during the COVID-19 pandemic. These patterns include non-consensual care, with disregard for women’s choices and birth preferences; undignified care, characterised by disrespectful attitudes and a lack of empathy from healthcare professionals; and feelings of abandonment and neglect, including denial of companionship during childbirth and separation from newborns. Insufficient organisational and human resources in health facilities were identified as contributing factors to disrespectful care. Empathic relationships with healthcare professionals were reported to be the cornerstone of positive experiences.DiscussionSwiss healthcare facilities showed shortcomings related to disrespect and abuse in maternal care. The pandemic context may have brought new challenges that compromised certain aspects of respectful care. The COVID-19 crisis also acted as a magnifying glass, potentially revealing and exacerbating pre-existing gaps and structural weaknesses within the healthcare system, including understaffing.ConclusionsThese findings should guide advocacy efforts, urging policy makers and health facilities to allocate adequate resources to ensure respectful and high-quality maternal care during pandemics and beyond.

ICM 2023 Theme: Newborn Health

Midwives play a crucial role in pregnancy, childbirth, postnatal care, and the preservation of newborn health. The International Confederation of Midwives (ICM) has chosen evidence-based practices as the theme for the year 2023, aiming to support and empower midwives in their profession. According to this theme, it is stated that the provision of safe and accurate midwifery care can prevent maternal deaths, stillbirths, and neonatal deaths. In this context, evidence-based midwifery practices are found to play a key role in newborn health.

Investing in midwifery for sustainable development goals in low- and middle-income countries: a cost-benefit analysis

BackgroundMaternal and neonatal mortality in low- and middle-income countries is frequently caused by inadequate management of obstetric and neonatal complications and a shortage of skilled health workers. The availability of these workers is essential for effective and high-quality healthcare. To meet the needs of sexual, reproductive, maternal, new-born, child, and adolescent health by 2030, more than one million health workers, including 900 000 midwives, are required globally. Despite this, uncertainty persists regarding the return on investment in the health workforce.MethodsThe objective of this research was to determine the cost-benefit ratio of increasing investment in midwifery in Morocco from 2021 to 2030. A comparative analysis was conducted between scenarios “with” and “without” the additional investment. The costs and benefits were estimated using relevant data from national and international sources.ResultsFollowing the International Confederation of Midwives’ recommendations, it is advised that Morocco recruit 760 midwives annually to achieve 95% of universal health coverage. This increase in midwifery could result in saving 120 593 lives by 2030, including reducing maternal deaths by 3 201, stillbirths by 48 399, and neonatal deaths by 68 993. The estimated economic benefit of investing in midwives was US$ 10 152 287 749, while the total cost was US$ 638 288 820. Consequently, the cost-benefit ratio was calculated as 15.91, indicating that investing in midwifery would provide 16 times more benefits than costs.ConclusionIncreasing investment in midwifery appears to be an efficient strategy for achieving comprehensive maternal and child health coverage in low- and middle-income countries.

Reflections on The International Confederation of Midwives Congress 2023

There is something inspiring about a group of thousands of the world’s most passionate and experienced midwives coming together, as was the case at the International Confederation of Midwives (ICM) congress, held in Bali earlier this year. This triennial conference fosters empowerment, knowledge exchange and collaboration. The purpose and significance of the conference is multifaceted, bringing together professionals dedicated to improving maternal and newborn health outcomes globally. Attendees were spoiled for choice with a programme filled with inspirational midwifery leaders from all corners of the world. If only we could hear from them all!

A global survey on national standard care for newborn bathing.

To describe national standard care for newborn bathing and its influential factors. A global survey was conducted using a web-based questionnaire. The targeted countries were 166 member countries of either the International Confederation of Midwives (ICM) or the International Council of Nurses (ICN). An eligible person included someone well informed of midwifery education/training or neonatal care, including newborn bathing, in their country. To examine the factors associated with the standard care for newborn bathing, information on mean annual temperature, precipitation, gross domestic product per capita, and basic water coverage was collected as external factors. Student's t tests and Chi-square tests were used for analysis. Care standards were identified in 46 countries: seven from Africa, eight from the Americas, 15 from Asia, 14 from Europe, and two from Oceania. In most countries, newborns were bathed with warm water in a tub within 10 min. Bathing frequency, moisturization, and use of soap or cleanser varied by country. There were significant associations between bathing frequency and temperature and between moisturization and precipitation. The national standard care for newborn bathing in each country was unique. Standard bathing care was associated with the climate. More consideration should be given to the differences in standard care for newborn bathing between countries when interpreting existing studies and conducting future studies on neonatal skin care.

Validating midwifery professionals' scope of practice and competency: A multi-country study comparing national data to international standards.

There is a global shortage of midwives, whose services are essential to meet the healthcare needs of pregnant women and newborns. Evidence suggests that if enough midwives, trained and regulated to global standards, were deployed worldwide, maternal, and perinatal mortality would decline significantly. Health workforce planning estimates the number of midwives needed to achieve population coverage of midwifery interventions. However, to provide a valid measure of midwifery care coverage, an indicator must consider not only the raw number of midwives, but also their scope and competency. The tasks midwives are authorized to deliver and their competency to perform essential skills and behaviors provide crucial information for understanding the availability of safe, high-quality midwifery services. Without reliable estimates for an adequate midwifery workforce, progress toward ending preventable maternal and perinatal mortality will continue to be uneven. The International Labor Organization (ILO) and the International Confederation of Midwives (ICM) suggest standards for midwifery scope of practice and competencies. This paper compares national midwifery regulations, scope, and competencies in three countries to the ILO and ICM standards to validate measures of midwife density. We also assess midwives' self-reported skills/behaviors from the ICM competencies and their acquisition. We compared midwives' scope of practice in Argentina, Ghana, and India to the ILO Tasks and ICM Essential Competencies for Midwifery Practice. We compared midwives self-reported skills/behaviors with the ICM Competencies. Univariate and bivariate analysis was conducted to describe the association between midwives' skills and selected characteristics. National scopes of practice matched two ILO tasks in Argentina, four in India, and all in Ghana. National standards partially reflected ICM skills in Categories 2, 3, and 4 (pre-pregnancy and antenatal care; care during labor and birth; and ongoing care of women and newborns, respectively) in Argentina (range 11% to 67%), mostly in India (range 74% to 100%) and completely in Ghana (100% match). 1,266 midwives surveyed reported considerable variation in competency for skills and behaviors across ICM Category 2, 3, and 4. Most midwives reported matching skills and behaviors around labor and childbirth (Category 2). Higher proportions of midwives reported gaining basic skills through in-service training and on-job-experience than in pre-service training. Estimating the density of midwives needed for an adequate midwifery workforce capable of providing effective population coverage is predicated on a valid numerator. A reliable and valid count of midwives to meet population needs assumes that each midwife counted has the authority to exercise the same behaviors and reflects the ability to perform them with comparable competency. Our results demonstrate variation in midwifery scopes of practice and self-reported competencies in comparison to global standards that pose a threat to the reliability and validity of the numerator in measures of midwife density, and suggest the potential for expanded authorization and improved education and training to meet global reference standards for midwifery practice has not been fully realized. Although the universally recognized standard, this study demonstrates that the complex, composite descriptions of skills and behaviors in the ICM competencies make them difficult to use as benchmark measures with any precision, as they are not defined or structured to serve as valid measures for assessing workforce competency. A simplified, content-validated measurement system is needed to facilitate evaluation of the competency of the midwifery workforce.

An analysis of the global diversity of midwifery pre-service education pathways

BackgroundThe development of competent professional midwives is a pre-requisite for improving access to skilled attendance at birth and reducing maternal and neonatal mortality. Despite an understanding of the skills and competencies needed to provide high- quality care to women during pregnancy, birth and the post-natal period, there is a marked lack of conformity and standardisation in the approach between countries to the pre-service education of midwives.This paper describes the diversity of pre-service education pathways, qualifications, duration of education programmes and public and private sector provision globally, both within and between country income groups. MethodsWe present data from 107 countries based on survey responses from an International Confederation of Midwives (ICM) member association survey conducted in 2020, which included questions on direct entry and post-nursing midwifery education programmes. FindingsOur findings confirm that there is complexity in midwifery education in many countries, which is concentrated in low -and middle-income countries (LMICS). On average, LMICs have a greater number of education pathways and shorter duration of education programmes. They are less likely to attain the ICM-recommended minimum duration of 36 months for direct entry. Low- and lower-middle income countries also rely more heavily on the private sector for provision of midwifery education. ConclusionMore evidence is needed on the most effective midwifery education programmes in order to enable countries to focus resources where they can be best utilised. A greater understanding is needed of the impact of diversity of education programmes on health systems and the midwifery workforce.

A review and comparison of post registration midwifery curriculum in Sri Lanka with global standards.

This paper presents the findings of a study comparing the post-registration midwifery curriculum (PRMC) taught in Sri Lanka with the International Confederation of Midwives (ICM) curriculum and five otherselected curricula from other parts of the world to train midwifery trained registered nurses (MTRNs). In so doing, we consider the historical origins of post-registration midwifery training and its implications formodern teachings in Sri Lanka and other low-middle income countries (LMICs). Data collected through document review are read, summarized, and compared using checklists across different curricula components, content, and length. The wide variation in terms of length of the programs, content covered, the ratio of theoretical to practical content, and the range of skills and competencies developed has implications for the individual and professional growth of MTRNs. While there is a need to align the PRMC with the ICM standards toensure safer maternity care in Sri Lanka, implications for developing and promoting the growth of midwifery as a strong independent body in LMIC is discussed.

Women's Perspectives on Cultural Sensitivity of Midwives During Intrapartum Care at a Maternity Ward in a National Referral Hospital in Zimbabwe.

Midwives attend intrapartum women of diverse ethnic backgrounds who each bring their cultural beliefs into the labor and delivery rooms. The International Confederation of Midwives has recommended providing culturally appropriate maternity care in its quest to increase skilled birth attendance and subsequently improve maternal and newborn health. This study aimed to examine midwives' cultural sensitivity during intrapartum care from women's perspectives, and how this relates to women's satisfaction with maternity care services. A qualitative phenomenological design was employed. Two focus group discussions were conducted with 16 women who had delivered in the labor ward of the selected national referral maternity unit. An interpretive phenomenological approach was used to analyze the data. This study revealed ineffective midwife-woman collaboration that excludes the incorporation of women's cultural beliefs in the design of maternity care plans. Emotional, physical, and informational support in the care provided to women during labor and childbirth was found to be incompetent. This suggests that midwives are not sensitive to cultural norms and do not provide woman-centered intrapartum care. Various factors implying midwives' lack of cultural sensitivity in their provision of intrapartum care were identified. Resultantly, women's expectations of labor are not met and this could negatively affect future maternity care-seeking behaviors. This study's findings provide policy makers, midwifery program managers and implementers with better insights for developing targeted interventions to improve cultural sensitivity for the delivery of respectful maternity care. Identifying factors that affect the implementation of culture-sensitive care by midwives could guide the adjustments required in midwifery education and practice.

Self-perceived competency of midwives in Kenya: A descriptive cross-sectional study.

Midwifery competence is demonstrated in the context of midwifery education, regulation and practice to support the quality delivery of care to women. Midwives with appropriate competencies can deliver up to 80% of maternal health services. The pre-service education programmes in Kenya offers different midwifery competencies for the various programmes, influencing expected outcomes in practice. This study aimed to assess midwives' perceived level of competence based on the International Confederation of Midwives (ICM) standards in Kenya. The study was conducted in selected public health facilities in Kenya. An observational cross-sectional design was used. A multi-stage sampling technique was used to select the counties and health facilities and random sampling to determine 576 midwives. Data were collected using a self-administered assessment tool adopted from the ICM competency domains. A total of 495 (85.9%) midwife respondents participated in this study, of which 389 (78.6%) respondents in all training categories were highly competent in the four ICM domains. The midwives' qualifications and facility level were associated with their self-perceived competence during practice. Those trained in the direct-entry midwifery programme were more competent, p = 0.016 (Kruskal wallis H = 8.432). Midwives' competence was influenced by the level of education and facility where they practice. All pre-service midwifery programme graduates must meet the essential ICM competencies and need to enhance continuous professional development (CPD) programmes and facility-based mentorship for the midwives.Contribution: To optimise midwifery-led practice in primary health care, midwifery competence should be enhanced in pre-service and in-service education for improved health outcomes.

Midwives speaking out on COVID-19: The international confederation of midwives global survey.

Maternity services around the world have been disrupted since the outbreak of the COVID-19 pandemic. The International Confederation of Midwives (ICM) representing one hundred and forty-three professional midwifery associations across the world sought to understand the impact of the pandemic on women and midwives. The aim of this study was to understand the global impact of COVID-19 from the point of view of midwives' associations. A descriptive cross-sectional survey using an on-line questionnaire was sent via email to every midwives' association member of ICM. The survey was developed and tested by a small global team of midwife researchers and clinicians. It consisted of 106 questions divided into seven discreet sections. Each member association was invited to make one response in either English, French or Spanish. Data were collected between July 2020 and April 2021. All respondents fulfilling the inclusion criteria irrespective of whether they completed all questions in the survey were eligible for analysis. All data collected was anonymous. There were 101 surveys returned from the 143 member associations across the world. Many countries reported being caught unaware of the severity of the infection and in some places, midwives were forced to make their own PPE, or reuse single use PPE. Disruption to maternity services meant women had to change their plans for place of birth; and in many countries maternity facilities were closed to become COVID-19 centres. Half of all respondents stated that women were afraid to give birth in hospitals during the pandemic resulting in increased demand for home birth and community midwifery. Midwifery students were denied access to practical or clinical placements and their registration as midwives has been delayed in many countries. More than 50% of the associations reported that governments did not consult them, and they have little or no say in policy at government levels. These poor outcomes were not exclusive to high-, middle- or low-income countries. Strong recommendations that stem from this research include the need to include midwifery representation on key government committees and a need to increase the support for planned out of hospital birth. Both these recommendations stand to enhance the effectiveness of midwives in a world that continues to face and may face future catastrophic pandemics.

Development of accreditation standards for midwifery clinical education in Iran

BackgroundAccreditation is one of the most important methods of quality assurance and improvement in medical education. In Iran, there are no specific midwifery education accreditation standards. This study was designed to develop accreditation standards for midwifery clinical education in Iran.MethodsThis study was performed in Iran in 2021. It consisted of two phases. In the first phase, accreditation standards for midwifery education in the United Kingdom, the United States, Australia and the International Confederation of Midwives were thoroughly examined through a narrative review. The domains obtained from this phase were used as a framework for coding in the second phase. In the second phase, a qualitative study was conducted with a directed content analysis approach to determine standards and criteria for clinical midwifery education accreditation in Iran. Participants were policymakers and senior managers of midwifery education, faculty members of midwifery departments with clinical teaching experience, and final year undergraduate midwifery students. The participants were selected by purposive sampling method, and data collection continued until data saturation.ResultsThe standards and accreditation criteria of midwifery education from the review study were formed 6 domains: Mission and goals; Curricula; Clinical instructors; Students, Clinical setting; and Assessment. In the second phase, data analysis led to the extraction of 131 codes, which were divided into 35 sub-subcategories, 15 sub-categories, and 6 main categories.ConclusionImplementing the specific and localized standards of clinical midwifery education in Iran can lead to improved quality of clinical education programs.

Improving midwifery educators’ capacity to teach emergency obstetrics and newborn care in Kenya universities: a pre-post study

Background:International Confederation of Midwives and World Health Organization recommend core competencies for midwifery educators for effective theory and practical teaching and practice. Deficient curricula and lack of skilled midwifery educators are important factors affecting the quality of graduates from midwifery programmes. The objective of the study was to assess the capacity of university midwifery educators to deliver the updated competency-based curriculum after the capacity strengthening workshop in Kenya.Methods:The study used a quasi-experimental (pre-post) design. A four-day training to strengthen the capacity of educators to deliver emergency obstetrics and newborn care (EmONC) within the updated curriculum was conducted for 30 midwifery educators from 27 universities in Kenya. Before-after training assessments in knowledge, two EmONC skills and self-perceived confidence in using different teaching methodologies to deliver the competency-based curricula were conducted. Wilcoxon signed-rank test was used to compare the before-after knowledge and skills mean scores. McNemar test was used to compare differences in the proportion of educators’ self-reported confidence in applying the different teaching pedagogies. P-values < 0.05 were considered statistically significant.Findings:Thirty educators (7 males and 23 females) participated, of whom only 11 (37%) had participated in a previous hands-on basic EmONC training – with 10 (91%) having had the training over two years beforehand. Performance mean scores increased significantly for knowledge (60.3% − 88. %), shoulder dystocia management (51.4 – 88.3%), newborn resuscitation (37.9 − 89.1%), and overall skill score (44.7 − 88.7%), p < 0.0001. The proportion of educators with confidence in using different stimulatory participatory teaching methods increased significantly for simulation (36.7 – 70%, p = 0.006), scenarios (53.3 – 80%, p = 0.039) and peer teaching and support (33.3 – 63.3%, p = 0.022). There was improvement in use of lecture method (80 – 90%, p = 0.289), small group discussions (73.3 – 86.7%, p = 0.344) and giving effective feedback (60 – 80%, p = 0.146), although this was not statistically significant.Conclusion:Training improved midwifery educators’ knowledge, skills and confidence to deliver the updated EmONC-enhanced curriculum. To ensure that midwifery educators maintain their competence, there is need for structured regular mentoring and continuous professional development. Besides, there is need to cascade the capacity strengthening to reach more midwifery educators for a competent midwifery workforce.

Do in-service training materials for midwifery care providers in sub-Saharan Africa meet international competency standards? A scoping review 2000–2020

BackgroundLevels of maternal and neonatal mortality remain high in sub-Saharan Africa, with an estimated 66% of global maternal deaths occurring in this region. Many deaths are linked to poor quality of care, which in turn has been linked to gaps in pre-service training programmes for midwifery care providers. In-service training packages have been developed and implemented across sub-Saharan Africa in an attempt to overcome the shortfalls in pre-service training. This scoping review has aimed to summarize in-service training materials used in sub-Saharan Africa for midwifery care providers between 2000 and 2020 and mapped their content to the International Confederation of Midwives (ICM) Essential Competencies for Midwifery Practice.MethodsSearches were conducted for the years 2000–2020 in Cumulative Index of Nursing and Allied Health Literature, PubMed/MEDLINE, Social Science Citation Index, African Index Medicus and Google Scholar. A manual search of reference lists from identified studies and a search of grey literature from international organizations was also performed. Identified in-service training materials that were accessible freely on-line were mapped to the ICM Essential Competencies for midwifery practice.ResultsThe database searches identified 1884 articles after removing duplicates. After applying exclusion criteria, 87 articles were identified for data extraction. During data extraction, a further 66 articles were excluded, leaving 21 articles to be included in the review. From these 21 articles, six different training materials were identified. The grey literature yielded 35 training materials, bringing the total number of in-service training materials that were reviewed to 41. Identified in-service training materials mainly focused on emergency obstetric care in a limited number of sub-Saharan Africa countries. Results also indicate that a significant number of in-service training materials are not readily and/or freely accessible. However, the content of in-service training materials largely met the ICM Essential Competencies, with gaps noted in the aspect of woman-centred care and shared decision making.ConclusionTo reduce maternal and newborn morbidity and mortality midwifery care providers should have access to evidence-based in-service training materials that include antenatal care and routine intrapartum care, and places women at the centre of their care as shared decision makers.

Are midwives ready to provide quality evidence-based care after pre-service training? Curricula assessment in four countries-Benin, Malawi, Tanzania, and Uganda.

This research sought to map midwifery pre-service training curricula as part of the Action Leveraging Evidence to Reduce perinatal morTality and morbidity in sub-Saharan Africa (ALERT) project conducted in Benin, Malawi, Tanzania, and Uganda. We conducted the review in two phases. In the first phase, online interviews were performed with the lead project midwives in all four study countries to get an overview of midwifery care providers' pre-service training courses, registration, and licensing requirements. We performed a mapping review of midwifery care providers' pre-service training curricula from different training institutions in the four study countries during the second phase. Curricula were reviewed and mapped against the International Confederation of Midwives (ICM) Essential Competencies framework to assess whether these curricula included the minimum essential training components described in the ICM framework. We identified 10 different professional titles for midwifery care providers. The number of years spent in pre-service training varied from one and a half to four years. Ten pre-service curricula were obtained and the assessment revealed that none of the curricula included all ICM competencies. Main gaps identified in all curricula related to women-centred care, inclusion of women in decision making, provision of care to women with unintended or mistimed pregnancy, fundamental human rights of individuals and evidence-based learning. This review suggests that there are skills, knowledge and behaviour gaps in pre-service training curricula for midwifery care providers when mapped to the ICM Essential Competencies framework. These gaps are similar among the different training courses in participating countries. The review also draws attention to the plethora of professional titles and different pre-service training curricula within countries. Trial registration: PACTR202006793783148-June 17th, 2020.

O96 - How is cultural safety translated into midwifery practice? A review of the literature

Providing culturally safe maternity care for Aboriginal and/or Torres Strait Islander Australians is a key element of midwifery practice and in recent years this has been recognised in the professional codes and standards. The Australian Nursing and Midwifery Accreditation Council (ANMAC) Midwifery Education Standards (ANMAC, 2021), the International Confederation of Midwives (ICM) Code of Ethics (ICM, 2014) and the Nursing and Midwifery Board of Australia (NMBA) Code of Conduct for Midwives (NMBA 2018a) and the Midwife Standards for Practice (NMBA, 2018b) each identify that the provision of culturally safe care is integral to the midwifes role. Whilst research to date has explored midwifery academics awareness of cultural safety (Fleming et al., 2017), and how cultural safety is taught within midwifery education programs (Biles et al., 2021), it is important to understand how this knowledge, once registered, is understood, and translated into midwifery practice. To identify and map the literature that has explored midwives understanding of cultural safety and how this translates into practice. A scoping review of the literature was undertaken. Pre-determined electronic databases were searched, and the data extracted from the included articles was thematically analysed. The findings have identified that there is limited research about how midwives translate cultural safety into the care of Aboriginal and/or Torres Strait Islander women and their families.

O73 - Us, together- Co-creating a Mentoring in Midwifery Program in NSW

This presentation outlines the approach taken by NSW Health, Nursing and Midwifery Office to lead the co-creation and design of a new mentoring program for midwives. The NSW Health Mentoring in Midwifery Program (MiM) aims to develop a reciprocal learning relationship that expands opportunities for connection, learning, growth and support for midwifery students and midwives working in NSW Health. This presentation will outline how a co-creative process was used to collaborate with a range of midwifery leaders, midwives, and academics to envisage the MiM Program. The International Confederation of Midwives (ICM) Mentoring Guidelines and Principles of Appreciative Inquiry informed our approach. This presentation will describe the Senses Framework as the underpinning ingredient to promote learning in the workplace, and how this was enhanced using Appreciative Inquirer, Belinda Dewar’s Caring Conversations. The tools used to promote generative conversations about midwifery practice between the mentor and the mentee will be described. The NSW Health Midwifery Strategy aims to support midwifery leaders to respond to the needs of the profession now and into the future. MiM builds on previous work sponsored by the Nursing and Midwifery Office that revealed successful relationships between students and midwives was key to a sense of belonging and positive learning environments. Midwives valued the opportunity to provide a learning environment to students and recognised the importance of supporting our future workforce. A structured mentoring program was identified by midwives as an opportunity to strengthen the midwifery profession together. The intention of this work is to develop and implement an innovative and sustainable mentoring program that is transferable across all midwifery training and clinical facilities to become a normal part of midwifery culture in NSW. This program will support the midwifery profession, develop leadership at all levels and help in the retention of a strong, confident, and skilled midwifery workforce.

Midwifery-led researches for evidence-based practice: Clinical midwives engagement in research in Ethiopia, 2021.

IntroductionHealth workers involvement in research had an impact on studies and whole system. They influence the clinical practice and help to implement evidences. Although International Confederation of Midwives (ICM) put research as one of the midwifery competencies and professional development activity, clinical midwives are poorly involved in research. Therefore, this study is aimed to assess clinical midwives engagement in research and bridge the gap through applicable strategies.MethodInstitution-based cross-sectional study was conducted among clinical midwives working at public health facilities of Central and North Gondar Zone, Ethiopia from September to October, 2020 G.C. A structured and pre-tested self-administered questionnaire was used to collect data and entered into Epi-info version 7. Descriptive statistics was used to describe study population. Bi-variable and multi-variable logistic regression analysis was performed using STATA Version 14 and significance level declared at 95% confidence interval, p-value ≤ 0.05 and respective odds ratios.ResultOut of 335 clinical midwives, 314 were participated making the response rate 93.7%. Among the midwives, one hundred seventy two (54.8%) (95% CI: 49.08%, 60.37) have good skill on conducting a research. Clinical midwives with mothers with formal education [AOR: 1.90, 95% CI: (1.03, 3.51), currently work on referral hospitals [AOR: 2.33, 95% CI: (1.19, 4.53)] and having good level of knowledge on research [AOR: 2.19, 95% CI: (1.25, 3.82)] have significant association with having good research skill. Forty eight (15.2%) (95% CI: 11.5%, 19.7%) ever participated in research during their clinical practice. Clinical midwives who have good knowledge on research [AOR: 0.31, 95% CI: (0.14, 0.70)] are about 0.3 times less likely to participate on research than who have poor knowledge [AOR: 0.31, 95% CI: (0.14, 0.70)].Conclusion and recommendationAlthough more than half have good research skill, only a small proportion of midwives were involved in research. Capacity building activities are crucial to strengthen midwives skill on research and ensure their involvement.