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

From: Mentorship and coaching to support strengthening healthcare systems: lessons learned across the five Population Health Implementation and Training partnership projects in sub-Saharan Africa

  Ghana Mozambique Rwanda Tanzania Zambia
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