<b>Introduction</b><b>: </b>Ultrasound is an essential component of antenatal care. Midwives provide most of the antenatal care but they do not perform ultrasound as it has been beyond their scope of practice. This leaves many women in Low and Middle-Income Countries without access to ultrasound scanning. The aim of this study was to identify competencies in ultrasound scanning in midwifery education. <b>Methods</b><b>: </b>A desk review and needs assessment were conducted between July and October 2023. Articles and curricula on the internet, Google scholar and PubMed were searched for content on ultrasound scanning competencies. A Google form consisting of 20 questions was administered via email and WhatsApp to 135 participants. Descriptive statistics were used to analyse data. <b>Results</b><b>:</b><b> </b>The desk review showed that it is feasible to train midwives in ultrasound scanning. The training programs for midwives in obstetric ultrasound were conducted for 1 week to 3 months with most of them running for 4 weeks. Content included introduction to general principles of ultrasound, physics, basic knowledge in embryology, obstetrics, anatomy, measuring foetal biometry, estimating amniotic fluid and gestational age. Experts like sonographers trained midwives. Theory and hands on were the teaching methods used. Written and practical assessments were conducted. Needs assessment revealed that majority of participants 71 (53%) knew about basic ultrasound training for midwives. All participants (100%) said it is necessary to train midwives in basic ultrasound scan in Zambia. Some content should include, anatomy, measuring foetal biometry, assessing amniotic fluid level, and gestational age determination. Most participants 91 (67%) suggested that the appropriate duration of training is 4 - 6 weeks. <b>Conclusion</b><b>:</b><b> </b>Empowering every midwife with ultrasound scanning skills will enable early detection of any abnormality among pregnant women and prompt intervention to save lives.
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