Nurse mentor training program to improve quality of maternal and newborn care at primary health centres: process evaluation

Authors : Washington M, Jayanna K, Bhat S, Thomas A, Rao S, Perumal G, Cunningham T, Bradley J, Avery L, Fisher E, Mony PK

Publication Year : 2016

Abstract :

Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form the frontline of health care workforce have limited access to enhancing their clinical knowledge and competencies. To address this gap, a new cadre of nurse mentors (NMs) for the public health system were trained by specialists from a teaching hospital in a special 5-week training course. This included 54 hours of theory and 110 hours of practical in clinical obstetric and newborn care, apart from mentoring, quality improvement and health systems issues. The nurse mentors were assigned to support staff nurses in the primary health care centres (PHCs) in eight northern Karnataka districts. Each NM covered 6-8 PHCs monthly for 2 - 3 days and thus a total of 385 PHCs were reached. They received support in the field through supportive supervision visits done by the specialists who had trained them, as well as by refresher training and clinical postings to the district hospitals. This paper presents impact of the training program on change in immediate and long term knowledge and competency scores of nurse mentors. Their baseline knowledge scores changed from 44.3 ± 12.7 to 72.1 ± 13.8 immediately after the training in obstetric and from 18.2 ± 19.1 to 66.4 ± 14.9 in newborn (p < 0.0001) content areas. Knowledge scores increased significantly for obstetric content (p < 0.05) after a period of 1 year but were sustained for newborn content (p > 0.05). Skills score soon after training increased from 62.2 ± 13.2 to 69.6 ± 12.5 in obstetric after a 1 year period and from 52.6 ± 9.3; 63.5 ± 14.4 in newborn (p < 0.001) content areas respectively. These findings have implications for those interested in improving quality of maternal and child care through nurse-dependent health delivery systems.