A cascade model of mentorship for frontline health workers in rural health facilities in Eastern Uganda: processes, achievements and lessons
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Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
Global Health Action
Abstract
There is increasing demand for trainers to shift from traditional didactic training
to innovative approaches that are more results-oriented. Mentorship is one such approach
that could bridge the clinical knowledge gap among health workers.
Objectives: This paper describes the experiences of an attempt to improve health-worker
performance in maternal and newborn health in three rural districts through a mentoring
process using the cascade model. The paper further highlights achievements and lessons
learnt during implementation of the cascade model.
Methods: The cascade model started with initial training of health workers from three
districts of Pallisa, Kibuku and Kamuli from where potential local mentors were selected for
further training and mentorship by central mentors. These local mentors then went on to
conduct mentorship visits supported by the external mentors. The mentorship process
concentrated on partograph use, newborn resuscitation, prevention and management of
Post-Partum Haemorrhage (PPH), including active management of third stage of labour,
preeclampsia management and management of the sick newborn. Data for this paper was
obtained from key informant interviews with district-level managers and local mentors.
Results: Mentorship improved several aspects of health-care delivery, ranging from improved
competencies and responsiveness to emergencies and health-worker professionalism. In
addition, due to better district leadership for Maternal and Newborn Health (MNH), there
were improved supplies/medicine availability, team work and innovative local problem-solving
approaches. Health workers were ultimately empowered to perform better.
Conclusions: The study demonstrated that it is possible to improve the competencies of frontline
health workers through performance enhancement for MNH services using locally built capacity
in clinical mentorship for Emergency Obstetric and Newborn Care (EmONC). The cascade
mentoring process needed strong external mentorship support at the start to ensure improved
capacity among local mentors to provide mentorship among local district staff.
Description
Keywords
Maternal health, Mentorship, Newborn, Health workers, Implementation science
Citation
Judith Ajeani, Richard Mangwi Ayiasi, Moses Tetui, Elizabeth Ekirapa-Kiracho, Gertrude Namazzi, Rornald Muhumuza Kananura, Suzanne Namusoke Kiwanuka & Jolly Beyeza- Kashesya (2017) A cascade model of mentorship for frontline health workers in rural health facilities in Eastern Uganda: processes, achievements and lessons, Global Health Action, 10:sup4, 1345497, DOI: 10.1080/16549716.2017.1345497