Pre-service midwifery education in sub-Saharan Africa: A scoping review

Nicole Warren, Ashley Gresh, Nkosazana Ruth Mkhonta, Abigail Kazembe, Susheela Engelbrecht, Jenna Feraud, Kalin Patel, Heloise Adandogou-d'Almeida, Phelelo Marole, Nancy Reynolds, Peter Johnson

Research output: Contribution to journalReview articlepeer-review


Background: In response to a global call for more midwives, maternal health stakeholders have called for increased investment in midwifery pre-service education. Given the already long list of challenges and the increasing burden on health care systems due to the COVID-19 pandemic, the need to prioritize investment is acute, particularly in sub-Saharan Africa. An important first step is to examine the current evidence. Methods: We conducted a scoping review of the peer-reviewed literature about pre-service midwifery education in sub-Saharan Africa. A search of studies published between 2015 and 2021 in French or English was conducted using six databases (PubMed, CINAHL, Embase, Scopus, Web of Science and African Index Medicus). Results: The search yielded 3061 citations, of which 72 were included. Most were a mix of qualitative and quantitative cross-sectional, country-specific studies. Organized by pre-service educational domain, the literature reflected a misalignment between international standards for midwifery education and what schools and clinical sites and the larger administrative systems where they operate, reliably provide. Inadequate infrastructure, teaching capacity in school and clinical settings and clinical site environment were factors that commonly impede learning. Literature related to faculty development and deployment were limited. Conclusion: Schools, faculty and clinical sites are overwhelmed yet recommendations by key stakeholders for change are substantive and complex. Efforts are needed to help schools map their current status by pre-service education domain and prioritize where scarce resources should be directed. These results can inform research and investments in pre-service midwifery education in sub-Saharan Africa.

Original languageEnglish (US)
Article number103678
JournalNurse Education in Practice
StatePublished - Aug 2023


  • Global health
  • Health workforce
  • Midwifery
  • Midwives
  • Pre-service education
  • Scoping review
  • Sub-Saharan Africa

ASJC Scopus subject areas

  • Education
  • General Nursing


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