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Background: East African countries continue to face high maternal and neonatal mortality due to limited healthcare services and a shortage of trained professionals. Strengthening midwifery services is critical to improving outcomes. In response, an internet-based Capacity Building Program (CBP), based on the MIDWIZE midwifery-led care framework, was launched in 2020 across Ethiopia, Kenya, Malawi, Somalia, and Uganda to enhance the leadership capacity of Public Health Officials (PHO) in implementing evidence-based care.

Aim: This study evaluated the CBP’s effectiveness and impact in strengthening midwifery leaders’ ability and capacity to coordinate and lead Quality Improvement (QI) projects in maternal, newborn and child health (MNCH).

Methods: A convergent mixed-methods design was employed, with data collected via pre- and post-program structured questionnaires from 2020 to 2023. Quantitative data were analysed using descriptive statistics, and qualitative data through inductive analysis using Systematic Text Condensation (STC).

Results: The program significantly improved participants’ QI proficiency (from 30.56% to 57.53%) and expertise in project coordination (5.63% to 33.8%).Confidence in leading QI initiatives also increased (p < 0.0001). Qualitative findings highlighted greater empowerment, collaboration, and organizational support.

Conclusion and clinical implications: The CBP effectively strengthened midwifery leadership capacity in QI. The program's clinical significance lies in its demonstrated ability to enhance leadership and QI competencies among midwifery leaders, highlighting the role of strong leadership in advancing health outcomes. Integrating such training into routine professional development, with institutional support, can sustain its impact.