Mixed methods analysis of childbirth care provider education in Nepal shows priorities to strengthen maternal and newborn health

Abstract Despite increased global access to skilled health personnel, persistent disparities in maternal and neonatal outcomes highlight the importance of care quality. Nepal’s substantial reductions in mortality offer a critical setting to examine the preparedness of childbirth care providers. Here, as part of a multi‑country initiative, we assessed the quality of pre‑service education in Nepal using a mixed‑methods design. Twenty‑four key informant interviews were conducted with stakeholders from educational institutions, government agencies, development partners and regulatory and professional bodies. Curricula were reviewed against the International Confederation of Midwives global standards. Overall, programmes demonstrated strong curricula, qualified educators and adequate infrastructure, particularly within Bachelor of Midwifery training. However, gaps in intrapartum competencies, delays in implementing updated modules, and misalignment between training outputs and available job opportunities were identified. These findings underscore priority actions to strengthen pre‑service education and accelerate progress towards improved maternal and newborn health outcomes.