Table 3 Design and preparation of African Health Initiative mentorship and coaching interventions

Priority areas

Emergency referral, perinatal intervention, IMCI, capacity building, management

Maternal, Newborn and Child Health (MNCH), malaria, pharmacy management

MNCH care, Integrated Management of Adult and Adolescent Illness (IMAI), HIV, Noncommunicable Diseases (NCD), QI, data utilization

Training and curriculum, supervision checklist

IMAI, IMCI, Emergency Obstetric and Neonatal Care (EmONC), HIV, mentorship, leadership

Method of measuring performance

Mortality metrics, fertility rates, facility surveys

Standardized performance review matrices, observation, supervision guides

Observation checklist, Facility surveys

Case management observation tool, interviews

Chart reviews, observation tools, electronic medical record reports

Indicators

Service utilization, QI indicators, leadership management

Service utilization for MNCH and malaria services, pharmacy management

Quality of MNCH, HIV, IMAI, NCD care compared to clinical guidelines, knowledge assessment

Quality of c-IMCI service provision compared to clinical guidelines, training evaluation

Service utilization and quality of IMAI, IMCI, HIV services compared to clinical guidelines

Mentors/Coaches

Senior/experienced public health officials and clinical practitioners identified prior to intervention

Public health officials and nurses with 10 to over 25 years of experience working in, or supporting, provincial teams identified prior to intervention

Nurses and midwives with specialized skills hired at the district hospital as part of intervention

CHW supervisors in village, facility managers hired as part of intervention with at least 2 years of clinical training

Clinical officers, nurses/midwives, pharmacy technologists hired as part of intervention

Mentor training

Used Ghana’s national Leadership Development Program (LDP) to build leadership capacity in budget management and resource allocation [43]

Iterative 2-day cycles, repeated on average every 6 months, with supervision visits in between meetings

Data-driven identification of areas for improvement in service provision; development and implementation of action plans to address weaknesses

Initial workshop in clinical mentorship and QI, didactic training in area of focus, ongoing supervision by mentor supervisor and clinical supervisors

Week long session for training and curriculum, and field visits to WAJA in field practicum to test and finalize supervision checklists

Mentors were trained in basic clinical packages, and were coached by experts from the University of Alabama to enhance their clinical skills (such as physical examination, ordering and interpretation of lab tests, and differential diagnosis).

Recipients of mentorship and/or coaching intervention

Community Health Officers (CHO)

Health system managers, principally at the district and facility levels

Health Center Nurses and Managers

Community Health Workers (WAJA)

Nurses, clinical officers, environmental health technologists, program officers, CHW, TBA, clinic support workers

Didactic training for recipients of mentorship and coaching intervention

18-month pre-service training and 6 months for Community Health Officers

In-service trainings based on MOH training, curriculum on using data for decision-making, linking service utilization patterns to resource planning, evaluating small-scale service delivery

Ensure mentees at the health center are trained in standard MOH packages (HIV care, EmONC, IMCI, NCDs, Essential Newborn Care)

Family planning education, supply chain management STI/HIV prevention education, safe motherhood and essential newborn care counseling and c-IMCI,

Month-long:

Week 1 & 2: diagnosis and management of clinical presentations, clinical protocols

Week 3: Patient registration and triage, clinical forms, data entry, medical record keeping

Week 4: Same as 3 + antenatal care, postnatal care, danger signs assessment