The Role of Intensive Mentorship in EmONC - Improved Quality of Care

7/29/2019 The Role of Intensive Mentorship in EmONC - Improved Quality of Care

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The Role of Intensive Mentorship in

EmONC Improved Quality of Care

The MCHIP Approach in Mansa Zambia

Saving Mothers, Giving Life

Martha Ndhlovu

January 2013


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What is mentorship?

Mentorship is the process where-by anexperienced, highly regarded and empathetic

person (mentor) guides another individual

(mentee) in the development and re-

examination of their own ideas, learning and

personal and professional development.

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What is mentorship?

Mentoring is a challenging task that requiresflexibility, excellent communication and

relationship-building skills and the ability to

cope with rapid change of direction, inaddition to possessing up-to-date clinical

knowledge and teaching skills

Different from traditional supervision

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How do facility staff react to the arrival of

traditional supervisors?

THE TRADITIONAL

SUPERVISORS

LET S RUN,THOSE

GUYS ARE

HERE AGAIN

TS RURAL HEALTH CENTRE


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How do staff react to the supportive

mentors?

PARADISE

HEALTH CENTRE

SUPPORTIVE

MENTOR

MIKE,

WELCOME !

WE ARE GLAD

TO SEE YOU

HI !

EVERYONE


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Target Providers for Mentorship Visits

Health care workers who have received in-service EmONC and HBB training

Other health care workers, who have notreceived any specific in-service training butare working in specific focus areas

(e.g., child health, obstetrics and gynaecology)

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Mentorship Design

1) Trained team of 16 Mansa Districtmentors in:

Mentoring skills IRH Supervisory Tool & EmONC Skills Checklists Anatomic models to guide on-site clinical simulations Data collection and support

Reporting2) Team of 2-3 mentors visiting everydelivering

facility on a monthlybasis

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At each visit, mentors:

1) Set objectives for the mentorship visit2) Assist the health center to service any back-up of

clients in order that the providers have time to sit withthe mentor

3) Review the SM Register, delivery client files andpartographs and discuss with the providers what is

going well and challenges experienced

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Mentorship Visits


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At each visit, mentors:

4) Observe client care (if there are active cases), usingIRH Supervisory Tool as standards-based guide

5) Review basic EmONC skills on anatomic models, usingskills checklist6) At visit conclusion, together with the mentee:

Review objectives to determine if they were met If objectives not met, identify reason Deter interventions to address objectives Agree on timeline to meet objectives Agree on responsible person to meet objectives

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Mentorship Visits (contd)


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Mentorship in Action

Mentor demonstrates HBB Mentee conducts return demo

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Quarterly Recognition Meetings

Quarterly Recognition/Clinical Update Meetingsheld with staff representatives of all facilities

High-performing facilities are recognized andpresented with plaque by DMO; allfacility staffreceive recognition certificate

Recognized staff are highly motivated and stafffrom other facilities return to their facilities withmotivation to improve service delivery

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Receiving certificates Plaques for deserving centers

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Quarterly Recognition Meetings


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Impact of Mentorship

Immediate & sustained application of skillslearned during EmONC training

Improved provider confidence and morale HCs now managing complications which

previously were referred (e.g., manual removal

of placenta, MVA)

Improved outcomes for pregnant women Reduced pressure on emergency transport systems

and referral facilities

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Impact (cont d)

Increased use of the partograph (0.06% to29%). 78% correctly filled

Improved documentation in service deliveryregisters

AMTSL applied in 88% ofdeliveries, even with 3-fold

increase in number of facilitydeliveries since October 2011.

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Keys to Success

Strong ownership by Mansa DHO Involvement and collaboration of many

district partners DHO, PHO, Mansa GH,

ZPCT II, ZISSP and UNFPA

Proper training in mentorshipskills

Use of anatomic models foron-site clinical simulations

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The Role of Intensive Mentorship in EmONC - Improved Quality of Care