Electronic Thesis and Dissertation Repository


Master of Science




Dr. Yolanda Babenko-Mould

2nd Supervisor

Dr. Marilyn Evans

Joint Supervisor


High maternal and newborn mortality rates remain a global health issue. Every day approximately 800 women die from complications related to pregnancy. Ninety-nine percent of maternal deaths occur in low and middle income countries. In 2013, 62% of maternal deaths took place in Sub-Saharan Africa. The Advanced Life Support in Obstetrics Educational Program (ALSO) is an internationally recognized continuous professional development course aimed at increasing the knowledge, skills, competence and confidence of health professionals to manage obstetric emergencies. The purpose of this qualitative descriptive study was to explore midwives’ experiences of translating the knowledge and skills acquired from participating in the ALSO program into their professional practice in Rwanda. A purposive sample of nine midwives was recruited and participated in semi-structured interviews directed at understanding their experience of implementing new knowledge and skills into practice. All interviews were audio-recorded and transcribed verbatim. Content analysis revealed five themes: improved midwifery practice, availability of resources, inter-professional collaboration, job satisfaction and autonomy for midwifery practice. The results indicated that although midwives reported increased knowledge, skills and confidence in management of obstetric emergencies, their ability to change practice was often hampered by non-conducive work environments, a shortage of health care providers, and insufficient equipment and materials. These findings can serve to inform ALSO course module review and development, midwifery education development, and health human resources policy and planning that will address obstetrical and newborn education needs and health service delivery in Rwanda.