Introduction: Clinical supervision plays a significant role in the acquisition of psychomotor skills by student midwives during training leading to the provision of high quality midwifery care. However, the acquisition of the psychomotor skills required for successful practice and learning can only be acquired if student midwives are supported and guided by clinical supervisors in their learning environments. Main Objective: The main objective of the study was to determine factors influencing clinical supervision of Student Midwives in Lusaka Urban District. Methodology: A cross-sectional study design that employed both quantitative and qualitative methods was used. The study population comprised 124 Nurses and Midwives working in Lusaka urban District. Self-administered questionnaires were used to collect data from the Nurses and midwives and a focus group discussion guide was used to guide discussions with the student midwives at Lusaka College of Nursing and Midwifery and a total of three focus group discussions were conducted. Quantitative data were entered into by Statistical Package Social Sciences (SPSS) version 22 for windows. Chi-square test was used to test associations among variables. The confidence interval was set at 95% with a significance level of 0.05. Qualitative data were analysed using content analysis to classify words into themes and categories by looking for repeated ideas or patterns of thoughts. Results: The findings showed that a high percentage of the clinical supervisors (89.5%) had not been trained in clinical supervision and most respondents had moderate knowledge on clinical supervision of students. 373 Open Journal of Nursing dents (61%). The study revealed a significant association between clinical supervision and the respondents' knowledge on clinical supervision (p-value of 0.00). Conclusion: The current study showed that clinical supervision was untrained and had inadequate supervision skills and the learning environment was poor. There is need therefore to train clinical supervisors and improve the students' learning environment in order to enhance teaching and learning. The study offers a valuable insight into the factors influencing students' midwives learning in clinical learning environment.

Background: Approximately 303,000 women die annually while giving birth, worldwide, and more than 99% of the deaths occur in developing countries. In Zambia, a developing country situated in sub-Saharan Africa, most of the maternal mortalities occur during the intrapartum and immediate postpartum periods, arising from postpartum hemorrhage, sepsis, obstructed labor, and hypertensive disorders. Aim: The aim of this study was to assess the quality of intrapartum services provided in health facilities in the country. Methodology: Guided by a descriptive cross sectional design, data were collected from 264 women in labor using a World Health Organization validated observation checklist. Convenience sampling was used to recruit the women, while multistage sampling was used to select four health facilities. The Social Package for Social Sciences, version 23 was used to analyze the data. Results: One health facility met the World Health Organization 80% minimum standard in four out of the five categories used to measure quality in intrapartum care, while the other three met the minimum standard in one category each. Conclusion: Low numbers of midwives, inadequate supplies and equipment were major obstacles to following national and international agreed standards for providing optimal care during intrapartum period. Recommendations: There is need for local and national stakeholders in Zambia to urgently address the structural barriers that were observed, as well as invest in sufficient How to cite this paper:

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Background/Aims Quality midwifery education is important in empowering student midwives with the confidence, knowledge, skills and attitudes relevant to the provision of quality postnatal care. The study aimed to assess confidence in providing postnatal care among midwifery students upon completion of training at selected midwifery schools in Zambia. Methods A cross-sectional survey was conducted in November 2016 at 5 of the 13 midwifery schools in Zambia. The sample comprised 194 finalist midwifery students who were purposively selected. Ethical approval was sort from the University of Zambia Research and Ethics Committee and participants signed informed consent forms. A self-administered questionnaire was used for data collection. Data were analysed using SPSS version 20, and the chi-squared test was used to analyse the significance of the relationship between variables, with significance set at 0.05. Results Almost all (97%) student midwives were confident in their ability to provide postnatal care independently. Most stated that they had enough time to practice in the skills laboratory (63%) and were confident when they practiced on mothers and their babies for the first time (62%). The majority (82.5%) were satisfied with the supervision they received from their mentors. Confidence to provide postnatal care independently was significantly associated with the confidence to practice for the first time on mothers and their newborns (P=0.007) and with satisfaction with clinical supervision (P=0.004). Conclusions Student midwives were confident in their ability to provide postnatal care. Time spent practicing in the skills laboratory and the amount of clinical supervision were two factors that enhanced students' confidence. Midwifery schools must emphasise clinical practice and supervision in order to produce confident midwives.

Background: Quality education is one of the important factors in empowering midwives to provide quality health care services to mothers and newborns irrespective of their practice settings. Due to lack of standardization of the duration, content, and structure of midwifery education and different pathways to midwifery across the world, midwives may lack the confidence to deliver quality health care services in the main domain of the ICM competences. Aim: To assess the confidence of final year midwifery students in the domain of newborn care based on the ICM midwifery competencies. Methods: The first phase consisted of a quick situation analysis of midwifery education and regulation in Zambia, followed by a cross-sectional survey through a selfadministered questionnaire to assess the confidence of final year midwifery students. Results: Most (51.9%) of the respondents were aged between 18 and 28 years, and majority of them were placed in Levels 1, 2 and 3 Hospitals and also clinics for their clinical practice, with between one hundred to ten thousand annual births, followed by 16.9% who were placed in Level 3 hospitals only. Most students (38.3%) reported receiving classroom instruction by both Lecture and Demonstration. Few students (22.7%) responded that they were not satisfied with their clinical supervision, while 77.3% were satisfied. There was significant association between confidence to perform skills independently and having enough time to practice on models in the labs (p value = 0.024), confidence when practiced for the first time on mothers (p value = 0.007) and satisfaction with supervision during clinical practice (p value = 0.000). Binary logistic regression of characteristics associated with confidence to perform newborn skills independently revealed significant association between satisfaction with clinical supervision and confidence to perform How to cite this paper: Sianchapa, B.N.,