Exploring midwifery competence and confidence based on midwives’ experiences and stakeholders’ insights in Kenya: a descriptive phenomenological approach

Abstract Background Midwives who are educated and regulated to international standards can provide 90% of the needed essential care for women and newborns and reduce preventable maternal and child mortalities. However, inadequacies in midwifery care, especially in low- and middle-income countries, l...

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Main Authors: Edna Tallam, Doreen Kaura, Robert Mash
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Nursing
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Online Access:https://doi.org/10.1186/s12912-025-03589-6
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author Edna Tallam
Doreen Kaura
Robert Mash
author_facet Edna Tallam
Doreen Kaura
Robert Mash
author_sort Edna Tallam
collection DOAJ
description Abstract Background Midwives who are educated and regulated to international standards can provide 90% of the needed essential care for women and newborns and reduce preventable maternal and child mortalities. However, inadequacies in midwifery care, especially in low- and middle-income countries, leads to lack of competence and confidence among midwives to achieve their potential. The study objective was to explore midwives’ experiences and stakeholder insights into midwives’ competence and confidence in the four International Confederation of Midwives (ICM) domains; general competence, pre-pregnancy and antenatal care, labour and childbirth, and ongoing care of the woman and the baby. Methods A descriptive phenomenological study was utilised to explore these experiences. Ten midwives were purposively selected from subcounty, county and tertiary referral hospitals. Further, stakeholders (nine County Chief Nursing Officers and one Chief Executive Officer from the tertiary hospital in Kenya) were included. Interview guide questions were developed following the findings of the midwives’ self-perceived competence and confidence. All interviews were recorded, translated, and transcribed verbatim. Thematic analysis was done using the Colaizzi framework. Atlas. ti 9 software was utilised to assist with the coding categorisation and creating the themes. Findings Four themes emerged from the analysis. They included qualification categories, clinical practice experience, clinical practice environment and the need to optimise midwifery. In addition, multidisciplinary support and standardisation of midwifery practice were identified as key to promote the confidence and competence of midwives. Conclusions Midwives had disparities in competence and confidence during clinical practice, based on their different qualifications. A supportive environment emerged as necessary in enabling appropriate clinical experience, confidence, and competence. Standardisation of midwifery qualification promotes competence, which promotes the confidence of midwives in the clinical environment.
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spelling doaj-art-203263ba3be04dd9ae07fde6336db3662025-08-20T03:45:48ZengBMCBMC Nursing1472-69552025-08-0124111710.1186/s12912-025-03589-6Exploring midwifery competence and confidence based on midwives’ experiences and stakeholders’ insights in Kenya: a descriptive phenomenological approachEdna Tallam0Doreen Kaura1Robert Mash2Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch UniversityDepartment of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch UniversityDepartment of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch UniversityAbstract Background Midwives who are educated and regulated to international standards can provide 90% of the needed essential care for women and newborns and reduce preventable maternal and child mortalities. However, inadequacies in midwifery care, especially in low- and middle-income countries, leads to lack of competence and confidence among midwives to achieve their potential. The study objective was to explore midwives’ experiences and stakeholder insights into midwives’ competence and confidence in the four International Confederation of Midwives (ICM) domains; general competence, pre-pregnancy and antenatal care, labour and childbirth, and ongoing care of the woman and the baby. Methods A descriptive phenomenological study was utilised to explore these experiences. Ten midwives were purposively selected from subcounty, county and tertiary referral hospitals. Further, stakeholders (nine County Chief Nursing Officers and one Chief Executive Officer from the tertiary hospital in Kenya) were included. Interview guide questions were developed following the findings of the midwives’ self-perceived competence and confidence. All interviews were recorded, translated, and transcribed verbatim. Thematic analysis was done using the Colaizzi framework. Atlas. ti 9 software was utilised to assist with the coding categorisation and creating the themes. Findings Four themes emerged from the analysis. They included qualification categories, clinical practice experience, clinical practice environment and the need to optimise midwifery. In addition, multidisciplinary support and standardisation of midwifery practice were identified as key to promote the confidence and competence of midwives. Conclusions Midwives had disparities in competence and confidence during clinical practice, based on their different qualifications. A supportive environment emerged as necessary in enabling appropriate clinical experience, confidence, and competence. Standardisation of midwifery qualification promotes competence, which promotes the confidence of midwives in the clinical environment.https://doi.org/10.1186/s12912-025-03589-6CompetenceCompetencyConfidenceExperiencesMidwiferyQualitative
spellingShingle Edna Tallam
Doreen Kaura
Robert Mash
Exploring midwifery competence and confidence based on midwives’ experiences and stakeholders’ insights in Kenya: a descriptive phenomenological approach
BMC Nursing
Competence
Competency
Confidence
Experiences
Midwifery
Qualitative
title Exploring midwifery competence and confidence based on midwives’ experiences and stakeholders’ insights in Kenya: a descriptive phenomenological approach
title_full Exploring midwifery competence and confidence based on midwives’ experiences and stakeholders’ insights in Kenya: a descriptive phenomenological approach
title_fullStr Exploring midwifery competence and confidence based on midwives’ experiences and stakeholders’ insights in Kenya: a descriptive phenomenological approach
title_full_unstemmed Exploring midwifery competence and confidence based on midwives’ experiences and stakeholders’ insights in Kenya: a descriptive phenomenological approach
title_short Exploring midwifery competence and confidence based on midwives’ experiences and stakeholders’ insights in Kenya: a descriptive phenomenological approach
title_sort exploring midwifery competence and confidence based on midwives experiences and stakeholders insights in kenya a descriptive phenomenological approach
topic Competence
Competency
Confidence
Experiences
Midwifery
Qualitative
url https://doi.org/10.1186/s12912-025-03589-6
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