PROFESSIONAL COMPETENCE AND ASSOCIATED FACTORS AMONG MIDWIVES WORKING IN GOVERNMENTAL HEALTH FACILITES OF HARARI REGIONAL STATE, ESTERN ETHIOPIA

Abstract

Although maternal mortality reduced substantially worldwide, Ethiopia has remained as the large contributor to maternal and neonatal deaths. Mothers and new born continue to suffer from preventable death. Qualities of maternity care services, particularly the competence of maternal health care providers directly affect maternal and neonatal health outcomes. Little is known about the level of professional competence on maternal and new born health care providers in Ethiopia, particularly in the study area. Objective: To assess professional competence and its associated factor among midwives working at Governmental Health Facilities in Harari region, Eastern Ethiopia from March 1 to April 30, 2022. Methods: Facility-based cross-sectional study was conducted, using quantitative survey and direct observation of midwives’ care provision, using a standardized competence checklist, adopted from previous research. Due to small number of midwives during the study in the region all of them were included in the study (107). Collected data were entered to EpiData version 3.01 and exported to SPSS version 23 for cleaning and further statistical analysis. Descriptive analysis was performed to calculate frequencies. A percentage mean competence score was calculated for each skill area. Multivariable linear regression was used to identify predicators associated with overall clinical competence of midwives. Results: The mean competence score of midwives was found to be 61.5% (95% CI (58.98, 63.95). In multivariable linear regression, being recognized for improved performance (β = 14.76; 95% CI: 11.70, 17.82, P = 0.000), Training (β = 10.81; 95% CI: 4.83, 16.80,P=0.001), male midwifery professionals (β = 5.96;95% CI: 2.42, 9.49,p = 0.001), Unit coordinator (β = 7.12;95% CI: 0.97,13.27,P=0.024) and Age in year (β = 0.79;95% CI: 0.14, 1.45 ,P=0.017) were significantly associated with competence of midwives in the provision of care during labor, childbirth and immediate postpartum period. Conclusion: The overall mean Professional competence of midwives was relatively high compared to other studies done in Ethiopia. Midwives who received recognition/awards for better performance, Job training in the last two year, being male was found the most dominant predictors for high competence.