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Published in: BMC Health Services Research 1/2015

Open Access 01-12-2015 | Research article

An innovation for improving maternal, newborn and child health (MNCH) service delivery in Jigawa State, northern Nigeria: a qualitative study of stakeholders’ perceptions about clinical mentoring

Authors: Ekechi Okereke, Jamilu Tukur, Amina Aminu, Jean Butera, Bello Mohammed, Mustapha Tanko, Ibrahim Yisa, Benson Obonyo, Mike Egboh

Published in: BMC Health Services Research | Issue 1/2015

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Abstract

Background

An effective capacity building process for healthcare workers is required for the delivery of quality health care services. Work-based training can be applied for the capacity building of health care workers while causing minimum disruption to service delivery within health facilities. In 2012, clinical mentoring was introduced into the Jigawa State Health System through collaboration between the Jigawa State Ministry of Health and the Partnership for Transforming Health Systems Phase 2 (PATHS2). This study evaluates the perceptions of different stakeholders about clinical mentoring as a strategy for improving maternal, newborn and child health service delivery in Jigawa State, northern Nigeria.

Methods

Interviews were conducted in February 2013 with different stakeholders within Jigawa State in Northern Nigeria. There were semi-structured interviews with 33 mentored health care workers as well as the health facility departmental heads for Obstetrics and Pediatrics in the selected clinical mentoring health facilities. In-depth interviews were also conducted with the clinical mentors and two senior government health officials working within the Jigawa State Ministry of Health. The qualitative data were audio-recorded; transcribed and thematically analysed.

Results

The study findings suggest that clinical mentoring improved service delivery within the clinical mentoring health facilities. Significant improvements in the professional capacity of mentored health workers were observed by clinical mentors, heads of departments and the mentored health workers. Best practices were introduced with the support of the clinical mentors such as appropriate baseline investigations for pediatric patients, the use of magnesium sulphate and misoprostol for the management of eclampsia and post-partum hemorrhage respectively. Government health officials indicate that clinical mentoring has led to more emphasis on the need for the provision of better quality health services.

Conclusion

Stakeholders report that the introduction of clinical mentoring into the Jigawa State health system gave rise to an improved capacity of the mentored health care workers to deliver better quality maternal, newborn and child health services. It is anticipated that with a scale up of clinical mentoring, health outcomes will also significantly improve across northern Nigeria.
Literature
1.
go back to reference Rowe AK, de Savigny D, Lanata CF, Victora CG. How can we achieve and maintain high-quality performance of health workers in low-resource settings? Lancet. 2005;366:1026–35.CrossRefPubMed Rowe AK, de Savigny D, Lanata CF, Victora CG. How can we achieve and maintain high-quality performance of health workers in low-resource settings? Lancet. 2005;366:1026–35.CrossRefPubMed
2.
go back to reference Hawe P, King L, Noort M, Gifford SM, Lloyd B. Working visibly: health workers talk about capacity building in health promotion. Health Promot Int. 1998;13(4):285–95.CrossRef Hawe P, King L, Noort M, Gifford SM, Lloyd B. Working visibly: health workers talk about capacity building in health promotion. Health Promot Int. 1998;13(4):285–95.CrossRef
3.
go back to reference Frehywot S, Vovides Y, Talib Z, Mikhail N, Ross H, Wohltjen H, et al. E-learning in medical education in resource constrained low- and middle-income countries. Hum Resour Health. 2013;11:4.CrossRefPubMedPubMedCentral Frehywot S, Vovides Y, Talib Z, Mikhail N, Ross H, Wohltjen H, et al. E-learning in medical education in resource constrained low- and middle-income countries. Hum Resour Health. 2013;11:4.CrossRefPubMedPubMedCentral
5.
go back to reference Matovu J, Wanyenze RK, Mawemuko S, Okui O, Bazeyo W, Serwadda D. Strengthening health workforce capacity through work-based training. BMC Int Health Hum Rights. 2013;13:8. doi:10.1186/1472-698X-13-8.CrossRefPubMedPubMedCentral Matovu J, Wanyenze RK, Mawemuko S, Okui O, Bazeyo W, Serwadda D. Strengthening health workforce capacity through work-based training. BMC Int Health Hum Rights. 2013;13:8. doi:10.1186/1472-698X-13-8.CrossRefPubMedPubMedCentral
7.
go back to reference Williams C. Understanding the essential elements of work-based learning and its relevance to everyday clinical practice. J Nurs Manag. 2010;18(6):624–32.CrossRefPubMed Williams C. Understanding the essential elements of work-based learning and its relevance to everyday clinical practice. J Nurs Manag. 2010;18(6):624–32.CrossRefPubMed
8.
go back to reference Patel MS, Phillips C. Strengthening field-based training in low and middle-income countries to build to build public health capacity: Lessons from Australia’s Master of Applied Epidemiology program. Aust New Zeal Health Pol. 2009;6:5.CrossRef Patel MS, Phillips C. Strengthening field-based training in low and middle-income countries to build to build public health capacity: Lessons from Australia’s Master of Applied Epidemiology program. Aust New Zeal Health Pol. 2009;6:5.CrossRef
9.
go back to reference Davis DA, Thomson MA, Oxman AD, Haynes BB. Changing physician performance: A systematic review of the effect of continuing medical education strategies. JAMA. 1995;274(9):700–5.CrossRefPubMed Davis DA, Thomson MA, Oxman AD, Haynes BB. Changing physician performance: A systematic review of the effect of continuing medical education strategies. JAMA. 1995;274(9):700–5.CrossRefPubMed
10.
go back to reference WHO: WHO recommendations for clinical mentoring to support scale-up of HIV care, antiretroviral therapy and prevention in resource-constrained settings. Geneva: 2006. WHO: WHO recommendations for clinical mentoring to support scale-up of HIV care, antiretroviral therapy and prevention in resource-constrained settings. Geneva: 2006.
11.
go back to reference Murray M. Beyond the myths and magic of mentoring. How to facilitate an effective mentoring program. San Francisco; CA: Jossey-Bass Publishers; 1991. Murray M. Beyond the myths and magic of mentoring. How to facilitate an effective mentoring program. San Francisco; CA: Jossey-Bass Publishers; 1991.
12.
go back to reference Crisp B, Swerissen H, Duckett SJ. Four approaches to capacity building in health: consequences for measurement and accountability. Health Promot Int. 2000;15(2):99–107.CrossRef Crisp B, Swerissen H, Duckett SJ. Four approaches to capacity building in health: consequences for measurement and accountability. Health Promot Int. 2000;15(2):99–107.CrossRef
13.
go back to reference National Population Commission (NPC) [Nigeria] & ICF Macro. Nigeria Demographic and Health Survey 2008. Abuja: NPC, ICF Macro; 2009. National Population Commission (NPC) [Nigeria] & ICF Macro. Nigeria Demographic and Health Survey 2008. Abuja: NPC, ICF Macro; 2009.
14.
go back to reference Abimbola S, Okoli U, Olubajo O, Abdullahi MJ, Pate MA. The Midwives Service Scheme in Nigeria. PLoS Med. 2012;9:5.CrossRef Abimbola S, Okoli U, Olubajo O, Abdullahi MJ, Pate MA. The Midwives Service Scheme in Nigeria. PLoS Med. 2012;9:5.CrossRef
16.
go back to reference Doctor HV, Bairagi R, Findley SE, Helleringer S, Tukur D. Northern Nigeria Maternal, Newborn and Child Health Programme: Selected Analyses from Population-Based Baseline Survey. Open Demography J. 2011;4:11–21.CrossRef Doctor HV, Bairagi R, Findley SE, Helleringer S, Tukur D. Northern Nigeria Maternal, Newborn and Child Health Programme: Selected Analyses from Population-Based Baseline Survey. Open Demography J. 2011;4:11–21.CrossRef
17.
go back to reference Workneh G, Scherzer L, Kirk B, Draper HR, Anabwani G, Wanless RS, et al. Evaluation of the effectiveness of an outreach clinical mentoring programme in support of paediatric HIV care scale-up in Botswana. AIDS Care. 2013;25(1):11–9. doi:10.1080/09540121.2012.674096.CrossRefPubMed Workneh G, Scherzer L, Kirk B, Draper HR, Anabwani G, Wanless RS, et al. Evaluation of the effectiveness of an outreach clinical mentoring programme in support of paediatric HIV care scale-up in Botswana. AIDS Care. 2013;25(1):11–9. doi:10.1080/09540121.2012.674096.CrossRefPubMed
18.
go back to reference Bergh A, Rooyen E, Pattinson RC. Scaling up kangaroo mother care in South Africa: ‘on-site’ versus’off-site’ educational facilitation. Hum Resour Health. 2008;6:13. doi:10. 1186/1478-4491-6-13.CrossRefPubMedPubMedCentral Bergh A, Rooyen E, Pattinson RC. Scaling up kangaroo mother care in South Africa: ‘on-site’ versus’off-site’ educational facilitation. Hum Resour Health. 2008;6:13. doi:10. 1186/1478-4491-6-13.CrossRefPubMedPubMedCentral
19.
go back to reference Özek B, Saat Z, TugayTemiz A, Kinzie B. On the job training through follow up visits to improve the quality of family planning services. Eur J Contracept Reprod Health Care. 1998;3(4):201–6.CrossRefPubMed Özek B, Saat Z, TugayTemiz A, Kinzie B. On the job training through follow up visits to improve the quality of family planning services. Eur J Contracept Reprod Health Care. 1998;3(4):201–6.CrossRefPubMed
20.
go back to reference Ibrahim S, Cadmus SI, Umoh JU, Ajogi I, Farouk UM, Abubakar UB, et al. Tuberculosis in Humans and Cattle in Jigawa State, Nigeria: Risk Factors Analysis. Vet Med Int. 2012;2012:865924. doi:10.1155/2012/865924. Epub 2012 Jul 12.CrossRefPubMedPubMedCentral Ibrahim S, Cadmus SI, Umoh JU, Ajogi I, Farouk UM, Abubakar UB, et al. Tuberculosis in Humans and Cattle in Jigawa State, Nigeria: Risk Factors Analysis. Vet Med Int. 2012;2012:865924. doi:10.1155/2012/865924. Epub 2012 Jul 12.CrossRefPubMedPubMedCentral
21.
go back to reference National Population Commission (NPC) [Nigeria]. Final Results of the 2006 National Population and Housing Census of Nigeria. Abuja, Nigeria: National Population Commission; 2009. National Population Commission (NPC) [Nigeria]. Final Results of the 2006 National Population and Housing Census of Nigeria. Abuja, Nigeria: National Population Commission; 2009.
22.
go back to reference Segall M. District health systems in a neoliberal world: a review of five key policy areas. Int J Health Plann Manage. 2003;18 Suppl 1:S5–26.CrossRefPubMed Segall M. District health systems in a neoliberal world: a review of five key policy areas. Int J Health Plann Manage. 2003;18 Suppl 1:S5–26.CrossRefPubMed
23.
go back to reference Tukur J, Jido TA, Awolaja BS. Maternal mortality in rural Northern Nigeria. Trop Doct. 2008;37:1. doi:10.1258/td.2006.006356. Tukur J, Jido TA, Awolaja BS. Maternal mortality in rural Northern Nigeria. Trop Doct. 2008;37:1. doi:10.1258/td.2006.006356.
24.
go back to reference Yumkella F. Retention of Health Care workers in Low-Resource settings: Challenges and Responses. IntraHealth International: Capacity Project Technical Brief No. 1 Chapel Hill, NC; 2006. Yumkella F. Retention of Health Care workers in Low-Resource settings: Challenges and Responses. IntraHealth International: Capacity Project Technical Brief No. 1 Chapel Hill, NC; 2006.
25.
go back to reference Rowe LA, Brillant SB, Cleveland E, Dahn BT, Ramanadhan S, Podesta M, et al. Building capacity in health facility management: guiding principles for skills transfer in Liberia. Hum Resour Health. 2010;8:5.CrossRefPubMedPubMedCentral Rowe LA, Brillant SB, Cleveland E, Dahn BT, Ramanadhan S, Podesta M, et al. Building capacity in health facility management: guiding principles for skills transfer in Liberia. Hum Resour Health. 2010;8:5.CrossRefPubMedPubMedCentral
26.
go back to reference Conn CP, Jenkins P, Touray SO. Strengthening health management experience of district teams in The Gambia. Health Policy Plan. 1996;11:64–71.CrossRefPubMed Conn CP, Jenkins P, Touray SO. Strengthening health management experience of district teams in The Gambia. Health Policy Plan. 1996;11:64–71.CrossRefPubMed
27.
28.
go back to reference Ofor-Adjei D, Arhinful DK. Effect of training on the clinical management of malaria by medical assistants in Ghana. Soc Sci Med. 1996;42:1169–76.CrossRef Ofor-Adjei D, Arhinful DK. Effect of training on the clinical management of malaria by medical assistants in Ghana. Soc Sci Med. 1996;42:1169–76.CrossRef
29.
go back to reference Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients’ care. Lancet. 2003;362(9391):1225–30.CrossRefPubMed Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients’ care. Lancet. 2003;362(9391):1225–30.CrossRefPubMed
Metadata
Title
An innovation for improving maternal, newborn and child health (MNCH) service delivery in Jigawa State, northern Nigeria: a qualitative study of stakeholders’ perceptions about clinical mentoring
Authors
Ekechi Okereke
Jamilu Tukur
Amina Aminu
Jean Butera
Bello Mohammed
Mustapha Tanko
Ibrahim Yisa
Benson Obonyo
Mike Egboh
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-0724-4

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