Abstract
BackgroundMentoring is a required component of health systems strengthening technical assistance interventions in low- and middle-income countries (LMICs). Mentoring is useful because it does not necessarily compromise service delivery and promotes the sharing of newly acquired knowledge and skills. However, there is a lack of research on the implementation of mentoring in the context of the HIV epidemic in southern Africa.ObjectivesThis qualitative evaluation focussed on understanding the implementation process of targeted mentoring for clinical practice, data management and pharmacy management, at public health care facilities in South Africa; and on identifying critical factors influencing the effectiveness of mentoring as a technical assistance intervention in this context.MethodsPurposive sampling was used to select participants from public health facilities in three South African Provinces. Participants were invited to take part in structured interviews. Datawere analysed using thematic analysis, and two core themes were identified: mentoring as knowledge and skills transfer; and mentoring as psychosocial support.ResultsIn terms of knowledge and skills transfer, the sequential implementation of proactive and reactive mentoring was critical. Initial proactive mentoring involved mentors initiating training and developing professional relationships with mentees. Thereafter, a reactive mentoring phase allowed mentees to request support when required. This enabled mentors to leverage real-world problems faced by health workers to support their implementation of new knowledge and skills. The availability and accessibility of mentors alongside the relationships between mentors and mentees provided psychosocial support for health care workers which facilitated their self-efficacy in implementing new knowledge and skills.ConclusionThese findings suggest that the success of mentoring programmes in LMICs may require specific attention to both knowledge transfer and the management of interpersonal relationships.
Highlights
The mentoring of clinical staff has become an important aspect of the human immunodeficiency virus (HIV) response in many low- and middle-income countries (LMICs)
Mentoring was provided to nurses to assist with the implementation of nurse initiated and managed antiretroviral therapy (ART) (NIMART); to data capturers and administrators to assist with managing the ART programmes reporting requirements; and to pharmacy staff to support efficient stock control and pharmacy management
For professional nurses being trained to initiate ART, an important feature of the mentoring visits was having nurse-mentors accompany them during consultations with patients
Summary
The mentoring of clinical staff has become an important aspect of the human immunodeficiency virus (HIV) response in many low- and middle-income countries (LMICs). Using mentors to support local staff enables implementing agencies and governments to target specific cadres of health workers to develop and entrench the skills and knowledge required to successfully implement interventions.[1] Mentoring has played an important role in supporting task shifting of particular functions from doctors to mid-level staff such as nurses, counsellors and medical officers.[1] Using mentoring as a component of technical assistance interventions is beneficial because it does not compromise service delivery and promotes the sharing of newly acquired knowledge and skills.[2] Ndwiga et al note that workplace mentorship has been found to increase confidence and self-esteem, decrease stress and conflict, and improve job satisfaction among mentees.[2]. Mentoring is a required component of health systems strengthening technical assistance interventions in low- and middle-income countries (LMICs).
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