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.

Autor: Ngabonzima A; Economic Community for Central African States (ECCAS), Libreville, Gabon. ngabanac2@gmail.com., Kenyon C; Neonatal - Perinatal Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada., Kpienbaareh D; Department of Geography and Environment, University of Western Ontario, Ontario, N6A 5C1, London, Canada., Luginaah I; Department of Geography and Environment, University of Western Ontario, Ontario, N6A 5C1, London, Canada., Mukunde G; Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, N6A 5C1, London, Ontario, Canada., Hategeka C; Centre for Health Services and Policy Research, School of Population and Public Health, Faculty of Medicine, University of British Columbia, BC, Vancouver, Canada., Cechetto DF; Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, N6A 5C1, London, Ontario, Canada.
Jazyk: angličtina
Zdroj: BMC health services research [BMC Health Serv Res] 2021 Jul 27; Vol. 21 (1), pp. 744. Date of Electronic Publication: 2021 Jul 27.
DOI: 10.1186/s12913-021-06764-y
Abstrakt: Background: The shortage of health care providers (HCPs) and inequity in their distribution along with the lack of sufficient and equal professional development opportunities in low-income countries contribute to the high mortality and morbidity of women and newborns. Strengthening skills and building the capacity of all HCPs involved in Maternal and Newborn Health (MNH) is essential to ensuring that mothers and newborns receive the required care in the period around birth. The Training, Support, and Access Model (TSAM) project identified onsite mentorship at primary care Health Centers (HCs) as an approach that could help reduce mortality and morbidity through capacity building of HCPs in Rwanda. This paper presents the results and lessons learnt through the design and implementation of a mentorship model and highlights some implications for future research.
Methods: The design phase started with an assessment of the status of training in HCs to inform the selection of Hospital-Based Mentors (HBMs). These HBMs took different courses to become mentors. A clear process was established for engaging all stakeholders and to ensure ownership of the model. Then the HBMs conducted monthly visits to all 68 TSAM assigned HCs for 18 months and were extended later in 43 HCs of South. Upon completion of 6 visits, mentees were requested to assist their peers who are not participating in the mentoring programme through a process of peer mentoring to ensure sustainability after the project ends.
Results: The onsite mentorship in HCs by the HBMs led to equal training of HCPs across all HCs regardless of the location of the HC. Research on this mentorship showed that the training improved the knowledge and self-efficacy of HCPs in managing postpartum haemorrhage (PPH) and newborn resuscitation. The lessons learned include that well trained midwives can conduct successful mentorships at lower levels in the healthcare system. The key challenge was the inconsistency of mentees due to a shortage of HCPs at the HC level.
Conclusions: The initiation of onsite mentorship in HCs by HBMs with the support of the district health leaders resulted in consistent and equal mentoring at all HCs including those located in remote areas.
(© 2021. The Author(s).)
Databáze: MEDLINE
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