A Mixed-Methods Study on International Medical Corps-Supported Midwifery Education in South Sudan

South Sudan has one of the highest maternal mortality ratios in the world, with an estimated 789 maternal deaths per 100,000 live births. Investing in midwifery is critical to preventing maternal and newborn deaths. In 2022, International Medical Corps, in collaboration with the RAISE Initiative at Columbia University, conducted a cross-sectional mixed-methods evaluation of International Medical Corps’ midwifery education program. Methods used include rapid assessments of three International Medical Corps-supported midwifery schools, quantitative survey of 314 midwife graduates, key informant interviews, in-depth interviews, focus group discussions with female clients of the graduates and clinical practice data. The study found all schools maintained a teacher-to-student ratio of one teacher to 40 students; 90% of graduates found employment within one year of graduation, and 76.4% were currently working as midwives in a clinical capacity; and the most common challenge midwives faced in their work after graduation was inadequate infrastructure, including a lack of supplies followed by insecurity due to unsafe housing and poor accessibility to the health facility. The study identified the following strengths of the existing midwifery education program: well-equipped schools with trained and competent teaching staff, competency-based curriculum and practical skills application, and scholarship support. The study also identified the following areas for strengthening: dependence on donor funding, inadequate mentorship and number of tutors, insufficient practice in some services and conflict-related challenges. The program was perceived to have contributed to the decrease in maternal and newborn morbidity and mortality due to the increase in skilled birth attendant coverage especially in remote regions, as well as the increase in service utilization at health facilities. Continued investment in midwifery education and training is critical to reducing high maternal mortality and morbidity in South Sudan.