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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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