P038W

Intensive Mentorship: An Innovation in Improving Clinical Practice and Patient Outcome in Mansa District of Zambia
by: Martha Ndhlovu, Michelle Wallon, Brenda Mubita, Constance Choka, Kwame Asiedu and Betty Kunda

Introduction/Background
From 20012002, Zambia saw a signicant

Graph of Results
120% 100%

Key To Success
Strong ownership by Mansa DHO. Involvement and collaboration of many district

reduction in its maternal mortality ratio, from 791 to 591 per 100,000 live births. This improvement is credited to the increased investment by the Ministry of Health (MOH), donors and implementing partners in reproductive health programming and emergency obstetric and neonatal care (EmONC), in particular. The majority of such programming has, however, focused on in-service training, with comparatively little focus on post-training supervision and longterm mentorship, which sustain and make costly training investments worthwhile.

80%

60%

partners. Proper training in mentorship skills. Use of anatomic models for on-site clinical simulations.

40%

20%

0% Target MOH staff EmONC Facility births Births facilities attended by trained in PQI facilities receiving and performing all skilled health monthly signal care workers mentorship mentorship functions Women receiving AMTSL in target facilities Deliveries Women with pre-eclampsia with partograph receiving care

Oct - Dec 2011 Oct - Dec 2012

Mansa District Method

Trained team of 16 district mentors in: Mentoring skills Integrated Reproductive Health supervisory

Recognition of best practices

Purpose
To build the capacity of Ministry of Health

and partner staff in Mansa District to conduct targeted, clinical, on-site mentorship in EmONC to ensure that clients receive high-quality, improved services, which will help reduce both maternal and child mortality.

tool and EmONC skills checklists Anatomic models to guide on-site clinical simulations Data collection and support Reporting A team of 2 or 3 mentors visits every delivering facility on a monthly basis. Quarterly Recognition/Clinical Update Meetings held with staff representatives of all facilities: High-performing facilities are recognized and presented with plaque by DMO; all facility staff receive recognition certicate. Recognized staff are highly motivated, and staff from other facilities return to their facilities with motivation to improve service delivery.

Mentorship in session

Mentorship session

Conclusion
Intensive mentorship results in: Immediate and sustained application of skills

Results
Results show that highly motivated nurses and

midwives are now able to perform procedures such as manual removal of the placenta, resuscitation of asphyxiated babies, etc., which previously were referred to a higher level of care.

Funding for the production of this poster was provided by USAID through the Maternal and Child Health Integrated Program (MCHIP) through Cooperative Agreement #GHS-A-00-08-00002-000. The opinions herein are those of the authors and do not necessarily reect the views of USAID.

learned during EmONC training Improved provider condence and morale Health care providers are now managing complications that previously were referred: Improved outcomes for pregnant women Reduced pressure on emergency transport systems and referral facilities