Clinical Competence and Perceived Stress Among Newly Graduated Midwives in Rural Public Hospitals

African Journal of Nursing and Midwifery | Vol. 14, No. 4, April 2026 | pp. 12–21

DOI: 10.46882/2026/AJNM/000134

Original Research Article

Title: Clinical Competence and Perceived Stress Among Newly Graduated Midwives in Rural Public Hospitals

Names of Authors: Amina O. Bello¹, Chinedu K. Okafor²

Authors’ Affiliations: ¹Department of Maternal and Child Health, University of Ibadan, Nigeria; ²School of Nursing and Midwifery, University of South Africa, Pretoria, South Africa

Abstract:
The transition from a student midwife to a practicing professional is often accompanied by significant stress, which can impact clinical performance. This study evaluated the relationship between clinical competence and perceived stress levels among newly graduated midwives deployed to rural public hospitals. A cross-sectional, descriptive survey design was utilized across 12 rural healthcare facilities. A total of 145 midwives within their first 12 months of practice completed the Perceived Stress Scale (PSS-14) and the Clinical Competence Evaluation Tool. Data analysis was performed using descriptive statistics and Pearson's correlation analysis. The results revealed that 68.3% of the participants experienced high stress levels, with a mean PSS score of 28.4 ± 4.2. Clinical competence scores were lowest in managing obstetric emergencies, with a mean score of 3.1 out of 5.0. A statistically significant negative correlation was found between perceived stress and clinical competence (r = -0.48, p < 0.01). Lack of senior mentorship and inadequate medical supplies were identified as the primary structural drivers of stress. Elevated stress significantly impairs the clinical confidence and competence of newly graduated midwives in rural settings. Targeted workplace orientation, institutionalized mentorship structures, and improved resource allocation are urgently required to mitigate stress and safeguard maternal healthcare delivery.

Keywords: Clinical Competence; Midwifery Graduates; Perceived Stress; Rural Hospitals; Maternal Health; Mentorship.

Manuscript Timeline: Received January 10, 2026; Revised March 14, 2026; Accepted March 28, 2026; Published April 15, 2026.

Citation: Bello, A. O., & Okafor, C. K. (2026). Clinical Competence and Perceived Stress Among Newly Graduated Midwives in Rural Public Hospitals. African Journal of Nursing and Midwifery, 14(4), 12–21.

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