• Sustainable Development Goal :3 - Good Health & Well-Being
• Gender Equality Marker :Gender Responsive (GE2)
• Testing Country :Nigeria
• Testing Period :15 months
• Amount :$250,000

The MADE Initiative, a randomized controlled non-inferiority trial, was conducted at two Midwifery Schools in Benue State Nigeria in September and October of 2021. The purpose of a non-inferiority trial is to prove innovation equivalence. The digital format of the CNIS Fundamental Intervention Referral and Safe Transfer (FIRST) Course for Midwives;  was compared to small-group structured teaching of the FIRST course. The overall evaluation of both digital and small-group learning was based on six modular tests, a comprehensive post-test, and an Objective Structured Clinical Examination (OSCE). Performance comparison of digital learning 76.23 (74.4, 78.06) and for small group learning 75.5 (74.06,76.93) (p = 0.247) confirmed that digital learning was not inferior to structured small group learning. Both small-group and digital learning showed a 20% increase over the baseline. The conclusion of the MADE-Initiative is that digital learning is an excellent means to augment knowledge, thinking, case studies and technical skill acquisition in midwifery. Digital is as effective and requires fewer teachers than small-group learning. The finding of non-inferiority for digital learning may be applicable  to other disciplines and should be evaluated widely in other clinical education programs.