High maternal and newborn mortality rates remain a global health issue. Every day
approximately 800 women die from complications related to pregnancy. Ninety-nine percent of
maternal deaths occur in low and middle income countries. In 2013, 62% of maternal deaths took
place in Sub-Saharan Africa. The Advanced Life Support in Obstetrics Educational Program
(ALSO®) is an internationally recognized continuous professional development course aimed at
increasing the knowledge, skills, competence and confidence of health professionals to manage
obstetric emergencies. The purpose of this qualitative descriptive study was to explore
midwives’ experiences of translating the knowledge and skills acquired from participating in the
ALSO® program into their professional practice in Rwanda. A purposive sample of nine
midwives was recruited and participated in semi-structured interviews directed at understanding
their experience of implementing new knowledge and skills into practice. All interviews were
audio-recorded and transcribed verbatim. Content analysis revealed five themes: improved
midwifery practice, availability of resources, inter-professional collaboration, job satisfaction
and autonomy for midwifery practice. The results indicated that although midwives reported
increased knowledge, skills and confidence in management of obstetric emergencies, their ability
to change practice was often hampered by non-conducive work environments, a shortage of
health care providers, and insufficient equipment and materials. These findings can serve to
inform ALSO® course module review and development, midwifery education development, and
health human resources policy and planning that will address obstetrical and newborn education
needs and health service delivery in Rwanda.