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Table 5 Short-term outcomes following 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

  Improvements in Knowledge Improvements in Quality of Service Delivery Improvements in M&E Improved Motivation of Health Workforce Challenges
Ghana Improved overall knowledge in tasks performed by Community Health Officers through observations and responses to questions Emergency referral project - increases access to care, pushes services to community level [43] Improved data literacy skills among health workers Health workers invested in scaling up program [42] Staff turnover, not strong M&E, difficult to stick to planned check-ins
Mozambique   Median data concordance improved from 56% between 2009 and 2010 (baseline period) to 87% at the end of the intervention (2012–2013) [26]. Better understanding of data, increased ownership, increased recognition of the importance of data sharing/feedback Strong government involvement at all levels of the provincial health system, leads to more accountability and ownership, and better oversight by system managers Low baseline computer and data analysis skills among front-line staff; conflicting priorities among limited number of provincial managers; difficulties in supporting (financially/logistically) facility and district action plans
Rwanda Used pre/post-tests to assess knowledge changes and retention over time [district reports] Increase in correct danger sign assessment in IMCI visits (from 47% to 99.8%) [27]. And increase in correct diagnosis from 56% to 91 [54]. Better data literacy among providers and mentors. Improvement in data quality [55] Coaching leads to interactive, collaborative capacity building, active listening and relationships, support (not policing), real-time feedback that lead to increased motivation [55]. High demand for M&E support (data entry, analysis, reporting), difficult to stick to quarterly schedule, high turnover of health center staff, poor health facility infrastructure, logistical challenges (transport) limited mentoring time
Tanzania Conducted evaluation of training program to identify processes that could be improved, found that correct IMCI diagnosis was satisfactory Quality of care was ensured through measurements of correct diagnosis and treatment of under-5 illness by WAJA. 73% of 300 WAJA consultations were correctly diagnosed as measured against an IMCI-trained medical professional. 84% of 86 children diagnosed with malaria were treated correctly by WAJA.   Both clinical supervisors and WAJA cite their relationships as intrinsic motivators for better performance Village CHW supervisors did not feel adequately compensated, tension because they were volunteers v. paid CHW. Challenges in ensuring visits to CHW from facilities.
Zambia   Improved patient-provider interaction, better outcomes, improved clinical judgement/case management, improvement in management of malaria according to protocols. Increased use of Electronic Medical Record system, increases in data use and feedback [38]. Local ownership and collaboration, increased trust from clinical workers of QI teams, increased support for work load [38]. Shortage of qualified staff, MoH staff/volunteer attrition, poor health facility infrastructure, misunderstanding of mentor’s role by mentee, resistance to change