The Effectiveness of Modified Early Obstetric Warning System Training on Midwives' Knowledge and Interpersonal Skills for Early Detection of Maternal Complications in Indonesia.

Background: The maternal mortality rate in Indonesia is still high. Efforts are needed to increase the capacity of midwives. The study aims to evaluate the effectiveness of Modified Early Obstetric Warning System (MEOWS) training on midwives' knowledge and interpersonal skills, while also assessing the feasibility of employing MEOWS training, as perceived by participants. Materials and Methods: We used a mixed-methods study. The study was carried out from November to December 2022 in Indonesia. A purposive sampling technique was employed to select 60 midwives for the quantitative study and 20 midwives for the qualitative study, equally divided between the blended and online groups. The intervention consisted of 82 sessions that were equal for both groups, with each session lasting 45 minutes. Quantitative data were collected using questionnaires and Likert scales, while qualitative data were gathered through focus group discussions. Quantitative data were analyzed using t-tests, while thematic content analysis was employed for the qualitative data. Results: Significant improvements in midwives' knowledge were seen in both groups. The mean (SD) knowledge was 97.10 (5.80) in the intervention group and 94.00 (8.80) in the control group (p = 0.12). Midwives reported greater engagement with blended training, perceiving it as feasible and valuable, and expressing eagerness for its implementation to enhance early detection of maternal complications. Conclusions: While both blended and online training effectively enhanced knowledge and self-efficacy in the early detection of maternal complications, participants found blended training to be more practical. Continuous evaluation is necessary for the retention of knowledge over time.