Using a peer mentorship approach improved the use of neonatal continuous positive airway pressure and related outcomes in Malawi

Abstract

Aim This study evaluated whether peer mentorship was an effective and sustainable way of improving and maintaining knowledge and skills on neonatal continuous positive airway pressure (CPAP) in a low‐resource setting with a high turnover of healthcare providers. Methods The Malawi Ministry of Health recruited five nurses with considerable CPAP experience and provided them with mentorship training from July to August 2014. The mentors then provided 1‐week on‐site mentorship for 113 colleagues at 10 secondary and one tertiary hospital where gaps in neonatal CPAP use had been identified. CPAP competencies and outcomes were compared 3 months before and after each mentorship. Results In the 3 months before and after mentorship, the average CPAP competency score increased from 32 ± 4% to 97 ± 2%, while CPAP usage increased from 7% to 23% among eligible neonates. Survival following CPAP mentorship increased from 23% to 35%, but this was not significant due to the small sample size. Both mentees and mentors reported useful transfers of knowledge and skills when using CPAP. Conclusion Mentorship effectively bridged the knowledge and skills gaps among health workers and increased CPAP use, competency scores and survival rates.

Integrated Management of Childhood Illnesses (IMCI): a mixed-methods study on implementation, knowledge and resource availability in Malawi

“…30 The WHO recommends following up 4 weeks after the initial IMCI training course to help reinforce the skills learnt, and continued supervision. 31 There are examples of successful mentorship within child health, 32 33 and community case management in Malawi. However, as lacking supervision and mentorship was raised by healthcare workers in the FGDs, work is needed on effective adoption at frontline facilities.…”

Peer mentorship in the scale‐up of neonatal continuous positive airway pressure in Malawi

“…This requires well-trained emergency care workers. In this issue, Asibon et al 7 The deployment of low-cost CPAP in Malawi followed remarkable results obtained in a quasi-randomised study of CPAP vs standard nasal oxygen conducted in the neonatal unit of the referral hospital of southern Malawi. In that study, CPAP was found to be highly efficacious with survival of 71% vs 44% in controls.…”

“…This requires well‐trained emergency care workers. In this issue, Asibon et al 7 describe a peer mentorship approach to in‐service training of health workers as part of the deployment of CPAP in Malawi. They report impressive 3‐month before‐and‐after increases in the competence of mentored nurses and CPAP use.…”

What do we mean by individual capacity strengthening for primary health care in low- and middle-income countries? A systematic scoping review to improve conceptual clarity

“…In the 18 studies which measured skills alongside knowledge, capacity strengthening was conceptualised as both increases in content knowledge and observed practice, over a range of topics ranging from health promotion [32] to disease surveillance [33], and infection control [34]. One study related to ability to coach clinical skills and quality improvement [35], and another to the management of substance use conditions [36], with all other studies related to more technical skills, such as breast ultrasound interpretation [37], surveillance [33] and neonatal continuous positive airway pressure [38].…”

“…The majority of studies (n = 36) measured outcomes in terms of a percentage change in the domain between pre-and post-intervention-whether objective or subjective-and the statistical significance of this change. Fourteen studies combined this with observation and six relied on observation alone to observe changes in knowledge, skills or practice [31,38,[68][69][70][71]. In some cases, strengthened capacity through observation was rated as a percentage improvement [31], and in other cases, it was simply observed [57].…”