Table 4 Implementation of African Health Initiative mentorship and coaching intervention
| Â | Ghana | Mozambique | Rwanda | Tanzania | Zambia |
|---|---|---|---|---|---|
Supervisory structure for mentoring intervention | Weekly field supportive supervision, visits from regional supervisors Peer mentoring exchanges, developed supervisory approaches [42] | District performance review and enhancement meetings where health facility and district staff are supported to collate and report key performance indicators. This includes 1–2 day one-on-one meetings with facility and district staff for coaching on synthesizing and interpreting secular trends in performance indicators. Ongoing post-performance review meeting coaching via quarterly supportive supervision visits from provincial and district health systems managers, including ongoing mentorship from PHIT teams embedded in provincial health department. | After mentee’s clinical training, mentors visit each health facility every 4–6 weeks to provide mentorship in each clinical domain. Mentors conduct coaching sessions with health facility staff as needed and work with health facility leadership to address systems-gaps. Quarterly debriefing meeting to discuss quality improvement indicators. | Comprehensive training for CHW that lasts 9 months, covering biology, clinical skills. Train CHWs, provide resources for facility/supply chain at district level. Mentoring occurs through facility supervision Travel to sites monthly during first 3 months, switch to quarterly supervision afterwards. | Comprehensive training (1 month intensive on-site), on-site mentoring (month 2), monthly supervision visits by QI team (month 3 onwards) to review medical records, assess accuracy of diagnosis |
Number of mentors | 17 | 14 | 10 | 30 facility managers 50 village supervisors | 18 |
Clinician/mentor ratioa | 2.3 | NA | 12 | 4.8 | 9.3 |
Data use | Peer exchange, weekly clinical audit meetings [42] | Used in two-day performance meetings | Quarterly internal debriefing meetings, district data sharing meetings | Village supervisors track performance management. Used evaluation data from QoC study and 3-monthly longitudinal data system (Health and Demographic Surveillance Systems) on households | Shared through facility and national level meetings, QI team meetings |
Frequency of mentorship | Monthly | Biannual | Every 4–6 weeks | Facility managers: Biannual Village supervisors: Monthly | Monthly |