Evaluating the effectiveness of preservice midwifery curricula in Ethiopia: A comparison of neonatal resuscitation and infection prevention practice of midwifery graduates trained in competency-based versus conventional curricula

Abstract

Background Infection control and neonatal resuscitation are essential midwifery practices that can reduce maternal and neonatal mortality. However, in Ethiopia, theory-heavy midwifery education leads to limited clinical competence. To address this, Debre Tabor University implemented a competency-based curriculum in 2013. This study examines whether competency-based midwifery education produces graduates with significantly better performance in neonatal resuscitation and infection prevention compared to conventional education, thereby framing a testable argument about the curriculum’s effectiveness. Methods A comparative cross-sectional study assessed the infection prevention and neonatal resuscitation performance of 68 BSc midwifery graduates (32 competency-based vs. 36 conventional) from third-generation Ethiopian universities. Performance was measured using a validated observation tool in clinical settings for infection prevention and simulations for neonatal resuscitation. Mean percentage scores were compared using t-tests, with effect size illustrated via Gardner–Altman plots. Results Overall, midwives demonstrated 63.6% of essential neonatal resuscitation tasks, with competency-based curriculum graduates (CBCGs) having higher performance than conventional curriculum graduates (CCGs) (71.6% vs. 56.5%; t (66.0) = 3.82, p