Grace Birungi Baguma2026-06-282026-06-282026-04-30https://hdl.handle.net/20.500.11951/2175PostgraduateBackground Maternal and neonatal mortality remain major challenges in Uganda, where midwives are central to delivering safe, essential care. Evidence on their knowledge and practice is limited, yet critical for improving outcomes in resource-constrained settings. Methods A cross-sectional study was conducted among 66 purposively sampled midwives at a regional referral hospital in Central Uganda. Guided by the Knowledge–Practice dimensions of the KAP framework, knowledge was assessed using multiple-choice questions aligned to the WHO Safe Childbirth Checklist pause points, while practice was measured with a four-point Likert scale on self-reported frequency of essential care. Direct observations and structured checklists validated responses. Descriptive statistics summarised knowledge and practice, while ANOVA and chi-square tests examined differences across stages and associations between knowledge and practice. Results Knowledge was highest before pushing (M = 83.3, SD = 7.5) and lowest immediately after birth (M = 65.2, SD = 9.6), with significant variation across stages, F(3, 164) = 15.40, p < .001. Practice scores were consistently high, peaking immediately after birth (M = 3.72, SD = 0.50). Knowledge and practice were positively associated, χ²(1, N = 66) = 5.10, p = .024. Conclusion Midwives demonstrated strong intrapartum knowledge and practice, but gaps in postpartum discharge education, recognition of danger signs, and emergency preparedness remain. Strengthening stage-specific training and supportive supervision will address these gaps at the bedside, while embedding the WHO Safe Childbirth Checklist into national guidelines can standardise care and improve accountability. Sustained investment in resources and monitoring frameworks is essential to empower midwives and enhance maternal and newborn outcomes in low-resource settings. Overall Message Midwives in Uganda provide strong intrapartum care, but targeted training, supervision, and WHO Safe Childbirth Checklist use are vital to strengthen postpartum care and emergency preparedness.enThesis