Implementation of the Caring for Providers to Improve Patient Experience intervention in Migori County, Kenya: Challenges, successes, and lessons

Abstract

Key drivers of poor person-centered maternal care (PCMC)—respectful and responsive care—include provider stress and bias. The Caring for Providers to Improve Patient Experience (CPIPE) intervention is a 5-component intervention including provider training, peer support, mentorship, embedded champions, and leadership engagement that addresses these drivers. This report describes the CPIPE implementation, challenges, and successes to demonstrate its feasibility and acceptability. CPIPE was piloted over 6 months in two health facilities in Migori County. Didactic and interactive content to promote PCMC and address stress, burnout, difficult situations, and bias, was delivered during a 2-day training. Facility-based embedded champions then led monthly refreshers and facilitated peer support groups. Twenty-four mentors provided mentorship across various topics with paired mentees, and facility and county leadership were engaged through a Community Advisory Board. Challenges included limited training time, hierarchical facility culture which hindered cross-cadre activities, varying levels of site engagement, competing demands, and leadership changes. Successes included high participation and engagement; positive perceptions about the intervention activities; provider commitments to stress management, bias mitigation, and provision of equitable PCMC; and leadership commitment to address sources of stress and provide mental health support for providers. CPIPE is an innovative and practical intervention that centers the experiences of the providers and the care of vulnerable women. The pilot’s success underscores the timeliness, relevance, feasibility, and acceptability of similar interventions in resource-constrained settings. CPIPE advances the evidence base for interventions to improve patient and provider experiences of maternal care.