Factors Affecting The Learning Implementation Of Midwife In-Service Training In South Sudan

Background: In South Sudan where both maternal mortality rate and infant mortality rate are among the worst in the world, we conducted a qualitative study in the area of midwife in-service training outcomes with an aim to contribute to the in-service training development that fits the local context and serves the needs of midwives in dire environment. Methods: We conducted semi-structured interviews with five graduates of a midwife in-service training program. The interview guide was developed to determine the progress, the facilitators and the bottleneck in the transfer of knowledge from the training program to practicum. The interviews were conducted in Juba, South Sudan, and transcribed verbatim followed by content analysis of data using the Modified- Grounded Theory Approach. Results: The content analysis of data produced 24 concepts, 5 subcategories and 3 categories. Those categories were “Development of motivation for application,” “Building up midwife skills,” and “Midwife care improvement in the facility.” We found that the midwife leaders’ skills building processes were influenced by environmental factors such as community members' perception which impedes safe delivery, lack of pregnancy and birth related knowledge among women in the community, and low level of language skills of colleagues. There were also intrinsic factors including having successful experiences, recognition from others, and confidence in new skills. Conclusion: Overall, the study indicated the incorporation of participant-centered learning methodology and strategies to effectively work through environmental issues and midwives’ level of self-efficacy will increase successful application of learning