Improving the quality of midwifery education to international standards is critical to prepare competent midwives. Despite the recognised impact of competent midwives, little is known concerning the implementation of Competency-Based Education (CBE), especially in Africa, where poor investment in quality midwifery education has been reported. The aim of this study is to scope and synthesize the existing literature on the implementation of CBE for midwifery programmes and its sustainability in Africa. The scoping review methodology outlined by Arksey and O’Malley framework was adopted to explore the extent of the literature on the implementation of CBE for midwifery programmes and its sustainability in Africa. This framework directed the scoping review methodology, with reference to PRISMA-ScR guidelines. A total sample of 72 studies were finally included in this scoping review. Reporting of the scoping review findings follows the PRISMA- ScR format. The study showed that of the 54 African countries as per the World Bank classification, after review of the full articles following the eligibility criteria for inclusion, literature on midwifery education programmes only spanned 17 African countries as at the time of this report. Of which, 11 are implementing CBE, 5 are still using Traditionally Based Approaches (TBA) while Problem-Based Learning (PBL) is the main teaching pedagogy used in Botswana. This review revealed that for the successful implementation of CBE, a CBE curriculum implementation process must be strictly observed. Evidence from the literature confirmed that CBE has not been sustained in Africa. There is still a struggle to fully integrate the major components of the competency-based midwifery programme due to inadequate support and an inadequate monitoring system. It is expedient that CBE implementation should be planned concurrently with its sustainability for it to be effective. Adequate training and support should be continuously provided to faculties, institutions, policy makers, professional bodies, students and other stakeholders for successful implementation and sustainability. PRR1- https://doi.org/10.2196/47603 .

Background: Competency-based education (CBE) for midwifery programs is a system of academic instruction and evaluation that aims to achieve proficiency in midwifery student learning outcomes, which is based on students’ ability to demonstrate the knowledge, attitudes, self-perceptions, and skills of a predetermined set of educational activities in theory and practice. CBE focuses on ensuring that midwifery students can develop critical thinking abilities, values, and the clinical decision-making abilities needed for the delivery of safe care in future practice. Objective: The objective of this scoping review is to map and synthesize existing literature on the implementation of CBE for midwifery programs and its sustainability in Africa. Methods: We will use the Arksey and O’Malley approach for scoping reviews for the research methodology. The 3-stage search process, proposed by the Joanna Briggs Institute, will be used to determine the eligibility of published and unpublished studies. PubMed, Science Direct, Web of Science, CINAHL, PsycINFO, and Scopus will be searched to screen published articles. ProQuest Dissertations and Theses and Google Scholar will be used to search for unpublished studies. Findings will only apply to studies conducted in Africa from 2010 to the present year in English. The 2 reviewers will work independently to carefully screen and compare the full text of the selected citations to the inclusion criteria. In the event of any disagreements between the 2 reviewers at any stage of the selection process regarding the inclusion of an article, this will be settled by discussion or consultation with a third reviewer. The extracted data will be presented using a PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review) flow diagram with an attached narrative summary. The review will summarize and disseminate findings on the implementation of the CBE for midwifery programs and its sustainability in Africa. Results: It is intended that this scoping review will be completed within 6 months following the publication of this protocol. Conclusions: The conclusions from this scoping review will inform midwifery educators, institutions, policy makers, and other stakeholders on the strategies to implement and sustain CBE for midwifery programs in Africa.

A well-educated midwifery workforce is critical to providing quality health services. However, the quality of midwifery education in Nigeria is identified as a factor contributing to the country’s poor maternal and neonatal health outcomes and inability to meet global development goals. This study aimed to analyse the process used to strengthen the quality of midwifery education with the aim of generating a middle-range model to prepare competent and confident midwifery graduates. The Strauss and Corbin version of the Grounded Theory approach that is underpinned by the Social Constructivism Paradigm was adopted for this qualitative study. Strengthening the quality of midwifery education (SQME) emerged as the model’s core phenomenon. Major concepts, including the midwifery education context, nature of the curriculum, SQME process, pillars, and outcomes, supported the core phenomenon. Strengthening the quality of midwifery education can be achieved over a long time provided the pillars of SQME are deep-rooted to sustain the process of strengthening the quality of midwifery education. The model can be used to strengthen the quality of midwifery education and may be adapted to nursing/allied health programmes in Nigeria and other developing countries.

BACKGROUND Competency-based education (CBE) for midwifery programs is a system of academic instruction and evaluation that aims to achieve proficiency in midwifery student learning outcomes, which is based on students’ ability to demonstrate the knowledge, attitudes, self-perceptions, and skills of a predetermined set of educational activities in theory and practice. CBE focuses on ensuring that midwifery students can develop critical thinking abilities, values, and the clinical decision-making abilities needed for the delivery of safe care in future practice. OBJECTIVE The objective of this scoping review is to map and synthesize existing literature on the implementation of CBE for midwifery programs and its sustainability in Africa. METHODS We will use the Arksey and O’Malley approach for scoping reviews for the research methodology. The 3-stage search process, proposed by the Joanna Briggs Institute, will be used to determine the eligibility of published and unpublished studies. PubMed, Science Direct, Web of Science, CINAHL, PsycINFO, and Scopus will be searched to screen published articles. ProQuest Dissertations and Theses and Google Scholar will be used to search for unpublished studies. Findings will only apply to studies conducted in Africa from 2010 to the present year in English. The 2 reviewers will work independently to carefully screen and compare the full text of the selected citations to the inclusion criteria. In the event of any disagreements between the 2 reviewers at any stage of the selection process regarding the inclusion of an article, this will be settled by discussion or consultation with a third reviewer. The extracted data will be presented using a PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review) flow diagram with an attached narrative summary. The review will summarize and disseminate findings on the implementation of the CBE for midwifery programs and its sustainability in Africa. RESULTS It is intended that this scoping review will be completed within 6 months following the publication of this protocol. CONCLUSIONS The conclusions from this scoping review will inform midwifery educators, institutions, policy makers, and other stakeholders on the strategies to implement and sustain CBE for midwifery programs in Africa. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/47603