Advancing Midwifery Education in Liberia: A Strategic Approach to Global Competitiveness ()
1. Introduction
Midwifery has a crucial role in enhancing the well-being of both mothers and infants, especially in regions like Liberia, where the rate of maternal mortality is significantly elevated (Sherman, 2024). The inadequate quality of midwifery education in Liberia has adversely affected healthcare outcomes and the global competitiveness of its midwifery graduates. Strengthening midwifery education is crucial for delivering healthcare that adheres to global benchmarks and simultaneously addressing the maternal health requirements of the country as part of the worldwide effort to improve healthcare systems.
Midwifery education in Liberia is plagued by insufficient resources, an outdated curriculum, and incompetent instructors, among other challenges affecting the country’s healthcare sector (Buseh, 2008). To ensure the relevance of midwifery education in Liberia, it is imperative to integrate evidence-based approaches, state-of-the-art technology, and global healthcare trends into its instructional programs. This study investigates the causes and consequences of Liberia’s midwifery graduates’ competitiveness in the international arena, aiming to bolster midwifery education in the country.
This study aims to enhance the midwifery education system by analyzing faculty training, clinical training availability, government assistance, and curriculum modernization to conclude. Implementing measures to overcome these obstacles in Liberia will enhance the readiness of its midwives to compete effectively on a global scale, leading to improved healthcare results and increased employment prospects for graduates.
2. Problem and Discussion
2.1. Outdated Midwifery Curriculum
Insufficient preparation of Liberian midwifery students is primarily attributed to obsolete curricula that fail to conform to global healthcare norms (Beyan, 2021). Contemporary, empirically supported methods are essential for enhancing the care of newborns and mothers, yet they are deliberately excluded from this obsolete curriculum. Although novel approaches to prenatal care, labour and delivery, and postnatal care have arisen, they have not been integrated into the existing midwifery and maternal health curriculum. Consequently, the graduates of midwifery schools in Liberia lack the necessary skills and knowledge to fulfil the demanding requirements of contemporary healthcare systems worldwide.
Liberian midwives are deprived of crucial new knowledge and innovative practices that are increasingly becoming the norm in healthcare systems of other industrialized nations due to the lack of updates in their curricula to represent these realities accurately. Consequently, they fail to learn about state-of-the-art healthcare technology and innovative methods to ensure patient safety and provide quality care. Given the persistently high rates of infant and maternal mortality in our country, it is deeply worrisome that midwives are unable to deliver the best possible care due to a profound lack of knowledge.
The antiquated training methods of the curriculum also restrict the capacity of Liberian midwives to advance in their professions and compete internationally. Graduates from institutions with obsolete curricula may encounter difficulties, if not failure, in obtaining the necessary international accreditation and certificates to engage in or progress in their selected professions. This constrains their capacity to effectively execute healthcare reforms rooted in global standards in Liberia, guaranteeing the persistence of chronic underfunding in the country.
The obsolete midwifery curriculum in Liberia is impeding efforts to enhance maternal and newborn health outcomes and the ability of midwives to meet global healthcare standards. This curriculum must be promptly updated.
2.2. Insufficient Clinical Training Opportunities
The lack of suitable clinical training facilities poses substantial obstacles for Liberian midwifery students (Maweu et al., 2021). Clinical training is essential in becoming a midwife since it equips students with the valuable hands-on experience necessary to become proficient midwives. Nevertheless, many midwifery trainees in Liberia lack practical experience since adequately equipped training facilities are scarce. Consequently, many graduates lack the necessary skills to handle intricate matters related to the health of maternal and newborn infants.
Insufficient practical experience in clinical settings hinders midwifery students from effectively using the knowledge acquired in the classroom. This lack of understanding renders them ill-equipped to manage high-risk pregnancies, challenging labour, and emergency procedures, all of which jeopardize the health and safety of both the mother and child. In addition, their understanding of modern medical equipment and technology is lacking due to insufficient clinical experience, which hampers their capacity to deliver care of superior quality.
The lack of adequate clinical training in Liberia hampers the professional growth of midwifery students and has a detrimental effect on healthcare outcomes (Mehn, 2018). The persistently elevated rates of maternal and neonatal mortality in the country are exacerbated by the lack of preparedness among graduates entering the field to manage the intricacies of maternity healthcare effectively. Enhancing and optimizing the availability of clinical training opportunities for midwifery students is essential for elevating the quality of healthcare in Liberia and enhancing the efficacy of midwifery education.
2.3. Shortage of Qualified Instructors
An extensive shortage of qualified and seasoned instructors is a significant problem at Liberia’s midwifery school (Dreisbach, 2019). Insufficient access to contemporary medical practices, current training, and global exposure among teachers adversely affect the quality of instruction students provide. Due to this inadequacy, midwifery educators often neglect to convey the latest advancements in maternity and newborn care to their students, leading to a dearth of fundamental knowledge and practical abilities necessary for success in the ever-changing healthcare industry.
Insufficient knowledge of contemporary midwifery practices among teachers results in students being deprived of crucial chances to learn about the latest developments in maternal health, evidence-based therapies, and patient care protocols (Pincombe et al., 2010). Due to this knowledge deficit, recent graduates lack the skills to manage the intricate requirements of contemporary healthcare systems effectively. Despite their efforts to comply with international standards and laws, Liberian midwifery graduates have challenges maintaining competitiveness in the global market.
Moreover, current educators are already experiencing significant pressure due to the scarcity of instructors, leading to increased class sizes and reduced individualized support for students. This exacerbates the constraints on students’ capacity to acquire comprehensive and applicable knowledge, diminishing their educational experience. The quality of midwifery education in Liberia is deficient owing to a dearth of competent instructors, therefore impeding the country’s efforts to enhance the health of mothers and newborns. Addressing this challenge is crucial for developing a midwifery education system that meets worldwide healthcare needs.
2.4. Limited Access to Modern Medical Technologies and Updated
Textbooks
Insufficient funding and a dearth of contemporary medical equipment pose substantial obstacles to Liberia’s midwifery education system (Beyan, 2021). In contemporary healthcare, technological advancements are essential for accurate diagnosis, efficient therapy, and outstanding patient results. The absence of contemporary medical equipment and technical resources in the training facilities of midwifery students in Liberia poses significant challenges in acquiring and applying new methodologies.
Insufficient availability of appropriate technology prevents students from acquiring practical experience with the latest healthcare systems and technologies. Their inability to effectively utilize essential diagnostic and treatment tools due to limited exposure to contemporary technology affects their overall preparedness to deliver appropriate care postgraduate. The increasing disparity in training opportunities and rapid integration of new healthcare technologies provide challenges for graduates transitioning to and excelling in technically advanced healthcare settings.
A dearth of technology resources poses further challenges for midwifery program graduates in maintaining their competitiveness in the global employment market (Salisu et al., 2020). Despite the high expectations of employers in industrialized healthcare systems for graduates to possess expertise in new medical technologies, Liberian graduates may face difficulties in meeting these expectations without such competencies. To adequately address this problem, it is crucial to improve the accessibility of modern medical technology in educational institutions. This would enable Liberian midwifery students to contribute to healthcare systems locally and globally.
Use of Old Midwifery Textbook in Liberia:
In an interview with some students and faculty members of midwifery training programs or colleges, it was established that only two out of the nine institutions are using the 17th edition of the Myles Textbook for midwives, which was released on July 3, 2020. According to these groups of people, the rest of the training programs, colleges or universities are using the 16th edition of Myles Textbook, which was released in May of 2014, 10 years ago, while others are using the 15th edition, which was released or published in 2009.
Myles Textbook is the most widely used textbook for midwifery training or education. When I was in midwifery school, I got to know that it was written by midwives for midwives, and it is the leading midwifery textbook.
Number of Institutions Offering Midwifery at Different Levels:
I made an inquiry with the registrar of the Liberia Board of Nursing and Midwife, and I was told that there are “nine (9) institutions, offering midwifery in Liberia at different levels; according to the registrar, two of the institutions are offering direct entry BSC in midwifery as well as bridging, two others are offering post-basic midwifery BCS, one offers direct entry BSc in midwifery, two direct entry associate degree in midwifery and two offer diploma and bridging.” Through this inquiry, I was able to establish that there are 6700 midwives in Liberia. They are either (Registered Midwife/RM, Certified Midwife/CM, Registered Nurse-Midwife/RNM).
2.5. Inadequate Government and Institutional Support
Neither the government nor educational institutions in Liberia especially support improving midwifery education (Goodman et al., 2018). Lack of sufficient financial resources is evident in several forms, such as a failure to allocate resources towards training programs, clinical facilities, and faculty growth. Given the substantial financial constraints, midwifery programs cannot augment curricula, enhance clinical training conditions, or broaden instructor capabilities.
Insufficient funding and institutional support have resulted in the obsolescence or complete absence of specific essential resources for midwifery education. Consequently, educational institutions cannot offer students hands-on training to become proficient healthcare professionals and incorporate the latest maternity and newborn care developments into their educational programs. An additional consequence of inadequate funding is the incapacity to attract and retain competent educators, further diminishing the quality of instruction.
Midwifery graduates lack the necessary and comprehensive preparation to meet global healthcare demands effectively (Barger et al., 2019). They may face challenges in fulfilling Liberia’s intricate healthcare needs while competing in major international employment marketplaces. Deficiencies in training and substandard healthcare results are further intensified by a dearth of institutional and governmental backing, worsening the issues. To enhance circumstances, the government and educational institutions must allocate more funds and give enhanced support for midwifery education. Implementing this will guarantee that training programs, facilities, and personnel are sufficiently equipped to address the requirements of contemporary healthcare.
2.6. Poor Global Competitiveness of Midwifery Graduates
The challenges provide significant obstacles for Liberian midwifery school graduates in pursuing global competitiveness (World Health Organization, 2016). Due to obsolete curricula, inadequate clinical training, and a lack of funding for advanced medical equipment, students graduate from medical schools with inadequate knowledge and skills to compete globally. The disparity in knowledge and resources hinders individuals from pursuing global career prospects or making significant contributions to comprehensive healthcare reform.
Liberia’s limited capacity to effectively compete internationally has consequences for the professional development of individual midwifery graduates and the country’s healthcare system. Due to a lack of exposure to global best practices and breakthroughs, Liberia’s healthcare system is isolated from crucial international insights and discoveries. Insularity hinders the nation’s ability to embrace innovative concepts, technologies, and methods that could enhance the quality of care for newborns and mothers.
Fundamentally, the obstacles encountered by new graduates of midwifery schools restrict their employment opportunities and impede the progress and growth of healthcare in Liberia (Beyan, 2021). Resolving these concerns is crucial for Liberian midwifery graduates to effectively compete globally and significantly contribute to healthcare progress within their own country and internationally.
3. Recommendations
Enhancing midwifery education in Liberia, which is now facing several challenges, and elevating the standards for student and practitioner results necessitate implementing several comprehensive proposals. The primary objective should be revising the midwifery curriculum to represent contemporary practices and regional and global standards accurately. In order to achieve this objective, the curriculum should incorporate the latest breakthroughs in healthcare technology, practices supported by substantial research, and worldwide trends. In order to enhance the preparedness of midwifery students to address the healthcare demands of both countries and regions, it is proposed that the curriculum be revised to incorporate current practices and knowledge.
Furthermore, it is crucial that midwifery program or education be taught or offered at graduate level and as well allocate resources towards state-of-the-art medical infrastructure. Schools must prioritize procuring advanced medical equipment to offer students substantial practical experience. This investment will enhance students’ understanding of the technology employed in contemporary healthcare systems and contribute to developing their practical skills. Clinical training facilities must be adequately equipped to enhance the general standard of midwifery education. This would facilitate the integration of theoretical knowledge with practical applications.
Prioritizing faculty development is imperative to tackling the scarcity of competent and prioritized educators. Effective collaboration between educational institutions and the government is paramount to guarantee continuous education and training opportunities for midwifery educators. The curriculum encompasses exposure to internationally recognized recognitions, state-of-the-art teaching methodologies, and the most recent advancements in midwifery care. A clear relationship exists between enhancing teacher competence and enhancing the educational quality received by students.
Moreover, augmenting government and institutional funding for midwifery education is imperative. Financial resources must be allocated to training programs, infrastructure, and faculty growth. By allocating resources to these domains, we may tackle current educational system challenges while guaranteeing the robustness and sustainability of midwifery programs. Advocating for increased funding and resources at both the global and national levels can facilitate securing the necessary support for these reforms.
Of equal importance is the expansion of clinical training possibilities. Establishing partnerships between healthcare facilities and schools can yield significant advantages by offering students increased practical experience and exposure opportunities. These partnerships enable students to gain practical experience in various healthcare environments through internships and other courses of instruction. To enhance students’ readiness for their professional careers, they must acquire practical experience in treating challenging patients and utilizing medical equipment.
Another approach to enhancing midwifery education is promoting cooperation between educational institutions and international organizations. These collaborations can be advantageous for students and instructors as they facilitate the exchange of knowledge, resources, and strategies. International collaborations can provide students with several benefits, such as enhanced availability of training materials, more proficient instructors, and exposure to diverse healthcare environments. Furthermore, partnerships can facilitate the interchange of novel concepts and advancements in newborn and maternal care.
Finally, it is necessary to deliberately prioritize local training programs to meet international standards and tackle the problem of global competitiveness. Periodic evaluation and updating of the curriculum are necessary to guarantee that students are adequately prepared to meet worldwide demands and capitalise on prospects overseas. Enhanced worldwide relevance of midwifery schools would give Liberian graduates a greater chance to contribute to global healthcare advancements and gain significant professional experience.