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

Anatole Manzi, Lisa R. Hirschhorn, Kenneth Sherr, Cindy Chirwa, Colin Baynes, John Koku Awoonor-Williams, Ahmed Hingora, Dominic Mboya, Amon Exavery, Kassimu Tani, Fatuma Manzi, Senga Pemba, James Phillips, Almamy Malick Kante, Kate Ramsey, Ayaga Bawah, Belinda Afriyie Nimako, Nicholas Kanlisi, Elizabeth F. Jackson, Mallory C. SheffPearl Kyei, Patrick O. Asuming, Adriana Biney, Roma Chilengi, Helen Ayles, Moses Mwanza, Jeffrey Stringer, Mary Mulenga, Dennis Musatwe, Masoso Chisala, Michael Lemba, Wilbroad Mutale, Peter Drobac, Felix Cyamatare Rwabukwisi, Agnes Binagwaho, Neil Gupta, Fulgence Nkikabahizi, Jeanine Condo, Didi Bertrand Farmer, Bethany Hedt-Gauthier, Fatima Cuembelo, Catherine Michel, Sarah Gimbel, Bradley Wagenaar, Catherine Henley, Marina Kariaganis, João Luis Manuel, Manuel Napua, Alusio Pio

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Background: Despite global efforts to increase health workforce capacity through training and guidelines, challenges remain in bridging the gap between knowledge and quality clinical practice and addressing health system deficiencies preventing health workers from providing high quality care. In many developing countries, supervision activities focus on data collection, auditing and report completion rather than catalyzing learning and supporting system quality improvement. To address this gap, mentorship and coaching interventions were implemented in projects in five African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) as components of health systems strengthening (HSS) strategies funded through the Doris Duke Charitable Foundation's African Health Initiative. We report on lessons learned from a cross-country evaluation. Methods: The evaluation was designed based on a conceptual model derived from the project-specific interventions. Semi-structured interviews were administered to key informants to capture data in six categories: 1) mentorship and coaching goals, 2) selection and training of mentors and coaches, 3) integration with the existing systems, 4) monitoring and evaluation, 5) reported outcomes, and 6) challenges and successes. A review of project-published articles and technical reports from the individual projects supplemented interview information. Results: Although there was heterogeneity in the approaches to mentorship and coaching and targeted areas of the country projects, all led to improvements in core health system areas, including quality of clinical care, data-driven decision making, leadership and accountability, and staff satisfaction. Adaptation of approaches to reflect local context encouraged their adoption and improved their effectiveness and sustainability. Conclusion: We found that incorporating mentorship and coaching activities into HSS strategies was associated with improvements in quality of care and health systems, and mentorship and coaching represents an important component of HSS activities designed to improve not just coverage, but even further effective coverage, in achieving Universal Health Care.

Original languageEnglish (US)
Article number831
JournalBMC health services research
StatePublished - Dec 21 2017


  • Coaching
  • Ghana
  • Mentorship
  • Mozambique
  • Quality improvement
  • Rwanda
  • Tanzania
  • Zambia

ASJC Scopus subject areas

  • Health Policy


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