Liverpool School of Tropical Medicine (LSTM) with funding from Foreign, Commonwealth and Development Office (FCDO) is implementing a four-year programme with a capacity-strengthening component of in-service healthcare providers (HCPs) through Emergency Obstetric and Newborn Care (EmONC) training and post-training mentorship. Ministry of Health (MoH) in Kenya identified EmONC as one of the high impact interventions to reduce maternal and newborn morbidity and mortality.
LSTM in partnership with MoH and five county health departments (including Vihiga) is supporting EmONC mentorship in Kenya; strengthening the capacity of HCPs to mentor their peers within the health facilities. In 2020, the programme trained 111 mentors in EmONC mentorship skills who have continued to conduct health-facility based mentorship for HCPs monthly despite several challenges such as COVID-19 disruption, high staff turnover of mentors, HCP industrial action, reduction programmed funded tea and snacks during group mentoring sessions, among others (See Fig 1 above).
As LSTM transitions with the programme ending in Mar 2023, Vihiga county has adopted EmONC mentorship into routine health facility activities, extending this beyond the five LSTM focal facilities to 18 county priority facilities.
During the Knowledge Management and Learning event held in Vihiga (1st – 2nd Nov 2022), LSTM in partnership with Vihiga county recognised outstanding performance of mentors and health facilities in EmONC mentorship (2020 to 2022). Vihiga, the second smallest county in Kenya is one of 47 counties, and branded as a county of culture and diversity. It is home to different communities originating from various parts of Kenya. The award ceremony was conducted at a dinner hosted by the Governor of Vihiga county, His Excellency (H.E.) Wilber Khasilwa Ottichilo.
The ‘best-performing health facility in EmONC mentorship’ was awarded to Vihiga County referral hospital (Fig 2 below), for having had the highest attendance of HCPs during mentorship. The facility not only sustained continuity of mentorship during the period when LSTM tailed off support with tea and snacks for mentees; but also performed the highest number of EmONC signal functions in the county as reported from quarterly EmONC functionality assessments.
“Vihiga CRH has not only demonstrated leadership, but also consistency, institutionalisation, and sustainability of EmONC mentorship approach”
Prof. Charles Ameh – Team lead LSTM EmONC & QoC unit
The winner of ‘best EmONC mentor’ award in Vihiga was Caleb Maloba (Fig 3 below), Subcounty Reproductive Health (RH) coordinator-Hamisi Subcounty for his outstanding commitment to mentor HCPs even beyond his subcounty. He is described by his supervisor as the ‘go-to-person’ on mentorship, … “experienced, competent and always willing to serve,” said Veronica Musiega, a County Heath Management Team member. His mentees attest to his ‘skilful style’ of teaching that makes the procedures look easy. LSTM technical team affirmed his commitment to the programme, highly active on the mentors’ WhatsApp community of practice forum, sharing real-time updates of mentorship activities and encouraging other mentors. In his own words, during an interview at the award ceremony, he said “This award means so much to me. I feel humbled, motivated, and appreciated as I am one among many good mentors doing a great job to reduce preventable maternal and perinatal deaths in the county. I am driven to even do better.”
The ‘best trainer’ award went to Dr. Maureen Okango, an obstetrician-gynaecologist at Vihiga CRH and a graduate of the fellowship of fistula surgery (FIGO). All EmONC mentors were individually recognised for their role and received LSTM branded medical scrubs (See Fig 3 above).
In his remarks, H.E Ottichilo, the Governor of Vihiga commended LSTM program for its positive impact in Vihiga. “It is evident on the ground that Vihiga has made big strides in MNH because of this program.” He promised a smooth transition, so that the county can continue with the excellent work that LSTM had started. For sustainability, he also instructed the Chief Officer - Health to ensure these interventions (including staff recognition for outstanding performance) are budgeted for in the county workplans.
“… Whatever You Appreciate will Appreciate and whatever you do not appreciate will begin to depreciate,” Vihiga County will adopt this approach to recognising the contribution of our health workers to improved quality of care for our women and newborns
Dr. Anyiendah Chief Officer of health – Vihiga county
The representatives of FCDO, also acknowledged the fantastic job that LSTM has done in Vihiga, having been a key Maternal and Newborn health partner in the cause to reduce excess maternal and perinatal morbidity and mortality in Kenya.
While LSTM EmONC program comes to an end in March 2023, EmONC mentorship has been institutionalised in Vihiga as a strategy for HCPs to advance their EmONC knowledge, skills, attitudes, and competencies facilitated by mentors within health facilities. It is a good practice for the county leadership to periodically recognise outstanding performance of mentors because not only does this motivate, but also challenges mentors to even perform better; knowing that their efforts are not in vain. This subsequently results in a more competent health care workforce that delivers quality care for mothers and babies. And the reverse is also true.