TY - JOUR
T1 - Mentorship and coaching to support strengthening healthcare systems
T2 - Lessons learned across the five Population Health Implementation and Training partnership projects in sub-Saharan Africa
AU - Manzi, Anatole
AU - Hirschhorn, Lisa R.
AU - Sherr, Kenneth
AU - Chirwa, Cindy
AU - Baynes, Colin
AU - Awoonor-Williams, John Koku
AU - Hingora, Ahmed
AU - Mboya, Dominic
AU - Exavery, Amon
AU - Tani, Kassimu
AU - Manzi, Fatuma
AU - Pemba, Senga
AU - Phillips, James
AU - Kante, Almamy Malick
AU - Ramsey, Kate
AU - Bawah, Ayaga
AU - Nimako, Belinda Afriyie
AU - Kanlisi, Nicholas
AU - Jackson, Elizabeth F.
AU - Sheff, Mallory C.
AU - Kyei, Pearl
AU - Asuming, Patrick O.
AU - Biney, Adriana
AU - Chilengi, Roma
AU - Ayles, Helen
AU - Mwanza, Moses
AU - Stringer, Jeffrey
AU - Mulenga, Mary
AU - Musatwe, Dennis
AU - Chisala, Masoso
AU - Lemba, Michael
AU - Mutale, Wilbroad
AU - Drobac, Peter
AU - Rwabukwisi, Felix Cyamatare
AU - Binagwaho, Agnes
AU - Gupta, Neil
AU - Nkikabahizi, Fulgence
AU - Condo, Jeanine
AU - Farmer, Didi Bertrand
AU - Hedt-Gauthier, Bethany
AU - Cuembelo, Fatima
AU - Michel, Catherine
AU - Gimbel, Sarah
AU - Wagenaar, Bradley
AU - Henley, Catherine
AU - Kariaganis, Marina
AU - Manuel, João Luis
AU - Napua, Manuel
AU - Pio, Alusio
N1 - Funding Information:
The publication cost of this article was funded by the African Health Initiative of the Doris Duke Charitable Foundation.
Funding Information:
This work was supported by the African Health Initiative of the Doris Duke Charitable Foundation in Ghana (2009058B), Mozambique (2009059), Rwanda (2009057), Tanzania (2009058A EFJ) and Zambia (2009060). Comic Relief provided additional support in Zambia (146781), Tanzania (112259), and Ghana (112475). Kenneth Sherr was supported by a grant from the Fogarty International Center (US National Institutes of Health [NIH]; K02TW009207). We would also like to thank the members of the AHI PHIT Partnership Collaborative for their contributions to this manuscript. Members include: Ahmed Hingora, Dominic Mboya, Amon Exavery, Kassimu Tani, Fatuma Manzi, Senga Pemba, James Phillips, Almamy Malick Kante, Kate Ramsey, Colin Baynes, John Koku Awoonor-Williams, Ayaga Bawah, Belinda Afriyie Nimako, Nicholas Kanlisi, Elizabeth F. Jackson, Mallory C. Sheff, Pearl Kyei, Patrick O. Asuming, Adriana Biney, Roma Chilengi, Helen Ayles, Moses Mwanza, Cindy Chirwa, Jeffrey Stringer, Mary Mulenga, Dennis Musatwe, Masoso Chisala, Michael Lemba, Wilbroad Mutale, Peter Drobac, Felix Cyamatare Rwabukwisi, Lisa R. Hirschhorn, Agnes Binagwaho, Neil Gupta, Fulgence Nkikabahizi, Anatole Manzi, Jeanine Condo, Didi Bertrand Farmer, Bethany Hedt-Gauthier, Kenneth Sherr, Fatima Cuembelo, Catherine Michel, Sarah Gimbel, Bradley Wagenaar, Catherine Henley, Marina Kariaganis, João Luis Manuel, Manuel Napua, and Alusio Pio.
Publisher Copyright:
© 2017 The Author(s).
PY - 2017/12/21
Y1 - 2017/12/21
N2 - 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.
AB - 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.
KW - Coaching
KW - Ghana
KW - Mentorship
KW - Mozambique
KW - Quality improvement
KW - Rwanda
KW - Tanzania
KW - Zambia
UR - http://www.scopus.com/inward/record.url?scp=85039040179&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85039040179&partnerID=8YFLogxK
U2 - 10.1186/s12913-017-2656-7
DO - 10.1186/s12913-017-2656-7
M3 - Article
C2 - 29297323
AN - SCOPUS:85039040179
SN - 1472-6963
VL - 17
JO - BMC Health Services Research
JF - BMC Health Services Research
M1 - 831
ER -