Knowledge and use of the ICM global standards for midwifery education

To explore how the International Confederation of Midwives Global Standards for Midwifery Education are currently used and their influence, if any, on the development of education programs globally. Secondarily, to identify current challenges to midwifery education. Cross-sectional exploratory descriptive qualitative study using focus groups and one-on-one interviews to collect data about knowledge of and use of the Education Standards and participants perceived current challenges to midwifery education. Interviews conducted in English, Spanish, and French. Midwife educators, education directors, or regulators attending one of four national/international conferences or one-on-one interviews in person or via internet. Thematic analysis was employed using the Framework approach for data analysis. There were 11 focus groups and 19 individual interviews involving 145 midwives from 61 countries. There was a general awareness of the Education Standards amongst the participants although knowledge about the specifics of the document was lacking. The Standards were mainly used as a reference and greater use was made when developing new educational programs. The Standards identified as most difficult to meet included: organization and administration of the program, ensuring that teachers were formally prepared as teachers, meeting targets for teacher to student ratios and that 50% of educational time took place in the clinical setting. Universally endorsed challenges to midwifery education were: 1) inability to accommodate the increase in curricular content without compromising prior content or lengthening programs; 2) insufficient resources including lack of classroom and clinical teachers; 3) medicalization of childbirth and health system changes limiting student exposure to the midwifery care model; 4) role conflict and competition for clinical experience with other health professionals. The Education Standards need to be more widely disseminated and implemented. Stronger collaborations with clinical settings and government systems are required to solve the current challenges to midwifery education. Well-educated midwives can provide the majority of maternal and neonatal care, however it will require an investment in strengthening midwifery programs globally for this goal to be achieved.