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Abstract

Background: Malnutrition is a major public health problem in Ethiopia contributing to half of infant and child mortality. The 2014 mini Ethiopian Demographic and Health Survey revealed that four out of ten children under five are stunted, nearly one out of ten are wasted, and a quarter are underweight. One of the factors that contributed to the high stunting rate is the shortage of capable providers who are competent to provide nutrition services. The purpose of this study was to assess graduating midwifery and nursing students’ nutrition competence and explore the factors that influence their competence.

Methods: A cross-sectional survey was employed in June 2015. Students’ knowledge was assessed using objective written assessment questions; and their skills were assessed using a five-station objectively structured clinical examination. Students’ perception of the nutrition learning environment and their learning experience was obtained by administering a structured questionnaire using interviews. Bivariate and multivariable analysis, including Chi-square test and independent sample t-test, were used to detect statistically significant associations or differences.

Results: A total of 113 students from four public universities in Ethiopia participated in the study. Only 38.1% of students demonstrated adequate competency in nutrition. The mean percentage score for nutrition knowledge and skills were 63.8% and 46.6% respectively. There was no statistically significant difference between midwifery and nursing students’ nutrition competence (P>0.05). Both cadres scored a mean value above 50% in the knowledge assessment, except in the competency areas of nutrition and HIV. However, both showed lesser competence in performing basic nutrition skills such as anthropometry. Midwives scored higher than nurses on counseling mothers on optimal breast feeding (p=0.001). The majority (98.2%) of students reported that they had no access to nutrition skills laboratory when they took the nutrition course. In multivariable analysis, students who perceived the practice sites as conducive for nutrition skills learning achieved higher levels of competence.

Conclusions: The target students were deficient in nutrition competencies. The study suggests revision of midwifery and nursing curricula for adequacy and relevance of nutrition contents, learning and assessment techniques. Nutrition skills learning both in skills lab and at clinical and practical settings need to be strengthened.