Developing and implementing a novel mentorship model (4+ 1) for maternal, newborn and child health in Rwanda

Abstract

Background There are a number of factors that may contribute to high mortality and morbidity of women and newborns in low-income countries. These include a shortage of competent health care providers (HCP) and a lack of sufficient continuous professional development (CPD) opportunities. Strengthening the skills and building the capacity of HCP involved in the provision of maternal, newborn and child health (MNCH) is essential to ensure quality care for mothers, newborns and children. To address this challenge in Rwanda, mentorship of HCPs was identified as an approach that could help build capacity, improve the provision of care and accelerate the reduction in maternal and neonatal mortality and morbidity. In this paper, we describe the development and implementation of a novel mentorship model named Four plus One (4+ 1) for MNCH in Rwanda. Methods The mentorship model built on the basis of inter-professional collaboration (IPC) was developed in early 2017 through consultations with different key actors. The design phase included refresher courses in specific skills and training course on mentoring. Field visits were conducted in 10 hospitals from June 2017 to February 2020. Hospital management teams (MT) were involved in the development and implementation of this mentorship model to ensure ownership of the program. Results Upon completion of planned visits to each hospital, a total of 218 HCPs were involved in the process. Reports prepared by mentors upon each mentorship visit and compiled by Training Support and Access Model (TSAM) for MNCH’CPD team, highlighted the mothers and newborns who were saved by both mentors and mentees. Also, different logbooks of mentees showed how the capacity of staff was strengthened, thereby suggesting effectiveness of the model. Through different mentorship coordination meetings, the model was much appreciated by the MTs of hospitals, especially the IPC component of the model and confirmed the program ‘effectiveness. Conclusion The initiation of a mentorship model built on IPC together with the involvement of the leadership of the hospital may be the cause effect of reduction of specific mortality and improve MNCH in low resource settings even when there are a limited number of specialists in the health facilities.

Telementoring initiative for newborn care providers in Kenya, Pakistan and Tanzania

“…Offering CPD could also be integrated with mentorship, as done in Rwanda. In a study by Ngabonzima et al involving 10 hospitals, a CPD Manager position was created to facilitate the development and implementation of the mentorship model [33].…”

Developing and implementing a model of equitable distribution of mentorship in districts with spatial inequities and maldistribution of human resources for maternal and newborn care in Rwanda

“…Not only will this ensure that health care workers are up to date with the current trends in their fields, but it will also increase job satisfaction and lead to better performance and retention of skilled workers in rural areas, cognizant that job satisfaction is an important determinant of job retention [ 30 ]. It is worth noting that institutionalizing mentorship within HCs and hospitals will speed up their journey towards further reducing maternal and child deaths by 2030 [ 31 ].…”

“…Despite the demonstrated benefits of the mentorship programme, some challenges must be overcomed if the programme is to be effectively integrated into the mainstream health system of the country. These challenges include the limited number of HCPs in health centers and more importantly in hospitals where the mentors are working which does not allow mentoring a big number of mentees at the same time, lack of some essential equipment at health centers and the staff turnover [ 31 ]. Meanwhile, the mentorship can work in response to the limited number of health care providers in health facilities in contrast to the classic training as this takes place within the health facilities while the classic training requires the staff to leave the workplace for a certain period, thus disrupting the existing busy schedule of the facility.…”

Mentors’ perspectives on strengths and weaknesses of a novel clinical mentorship programme in Rwanda: a qualitative study

“…16 The Training, Support and Access Model for Maternal, Newborn and Child Health (TSAM-MNCH) in Rwanda is a partnership project with the primary mission of improving MNCH by working with local partners to improve health service access and delivery. 17 Through its CPD stream, TSAM-MNCH designed and implemented a mentorship programme to increase health practitioners' ability to provide quality care and to bridge the gap between traditional theoretical training and practical training. 17 This mentorship model was adopted from the Reproductive, Maternal, Newborn and Child Health Clinical Mentorship guidelines designed by the Rwandan Ministry of Health to improve the quality of MNCH.…”

“… 17 Through its CPD stream, TSAM-MNCH designed and implemented a mentorship programme to increase health practitioners’ ability to provide quality care and to bridge the gap between traditional theoretical training and practical training. 17 This mentorship model was adopted from the Reproductive, Maternal, Newborn and Child Health Clinical Mentorship guidelines designed by the Rwandan Ministry of Health to improve the quality of MNCH. 18 The TSAM-MNCH mentorship model is unique due to its extensive focus on interprofessional collaboration with the idea that MNCH services are inter-related.…”