Posts or Comments 04 December 2021

Archive for "Mentoring"



Education &Health Education &Learning/Training &Mentoring &Nigeria Bill Brieger | 29 Dec 2020

Prof Adetokunbo O Lucas, 1931-2020, Public Health and Tropical Disease Pioneer

Forty-five years ago, this week I arrived in Ibadan Nigeria to visit my MPH classmate, Joshua Adeniyi, and meet the faculty of the newly established African Regional Health Education Centre (ARHEC). A highlight of those meetings was seeing Prof Ade Lucas who as head of the Department of Preventive and Social Medicine (PSM), which housed ARHEC), had supported the partnership of the University of Ibadan, Federal Ministry of Health, and the World Health Organization that created ARHEC as the first Africa-based professional postgraduate training program in public health education. Prof Lucas had created a multidisciplinary environment where Public Health Education could thrive.

I was convinced to join the faculty of OSM and ARHEC, and by the time I returned in October 1976, Prof Lucas had taken up the directorship of The Special Program of Research and Training in Tropical Diseases (TDR), which was initially sponsored by WHO, the World Bank and UNDP. Fortunately, Prof Lucas continued to mentor the ARHEC faculty and by encouraging us to apply for TDR grants ensured that I was well on my way in building a career around social and behavioral interventions to control tropical diseases.

Unfortunately, Prof Lucas left us finally on 25 December 2020. Below are the postings of colleagues to commemorate his life. Idowu Olayinka of the Nigerian Academy of Science outlined some of the many accomplishments of Prof Lucas as follows:

  • He was an outstanding medical scientist.
  • Former Professor and Head Department of Preventive and Social Medicine at the University of Ibadan.
  • Founding Director, WHO Special Programme for Research and Training in Tropical Diseases.
  • Former Programme Chair, Carnegie Foundation.
  • Former Professor of International Health, Harvard University.
  • He was the first person ever to receive, in 1995, the highest academic honour of the University of Ibadan, Honorary Fellowship of UI, FUI.

The Provost of the College of Medicine, University of Ibadan, Prof Olayinka Omigbodun adds more to the list. “His achievements and accomplishments are too numerous to list here. These have been documented very well in many books, reports, and newspapers. He was the author of numerous books and articles in refereed public health journals. He was an author of many books including “A Short Textbook of Preventive Medicine for the Tropics”. Books have been written about him including his own autobiography (It Was the Best of Times: From Local to Global Health (2010,” and a biography “The Man: Adetokunbo Lucas” (2011).”

“A recipient of many honorary degrees from Emory University, Tulane University, and University of Ibadan he was also a recipient of academic honors from Harvard where he was a professor of Public health, he was bestowed with numerous awards including Prince Mahidol Award (1999), the Centenary Medal for Life-Time Achievements in Tropical Medicine (2007) and from the National Foundation for Infectious Diseases (NFID) (5 March 2013), to name a few.”

“There can be no question about Prof Lucas being a distinguished teacher of many students was who have become distinguished in their own rights. He was a global leader in Medical Research that has impacted many populations, especially in Africa. The footprints are notable and impactful.”

“When my children and grandchildren ask me who my best teachers while in the Medical School (or thereafter) were, I always list some top 10 teachers to those who imparted knowledge, affected my ambition to be “like them”, impressed me with statements and instructions that continued to ring in my ears till today, or demonstrated acts of exemplary kindness and character, indicated personal interest in my progress and success in life, and showed loving friendship to someone who was once their student or junior colleague. Professor Lucas was one of them.” The Provost refers people to a memorial website that has been created to share tributes, photographs and other memories.

Colleagues who worked with Professor Lucas in TDR or knew him because of TDR have shared their reflections. Jamie Guth said, “Prof Lucas was an amazing man. I felt privileged to have known him and experience the impact of what he started with TDR at WHO – now several generations of top scientists across Africa and many other countries finding solutions to infectious diseases.”

Jane Kayondo Frances Kengeya reacted with, “A giant has fallen. His legacy will live on through those he taught, mentored, influenced, supported and loved. Let’s celebrate his life and thank God that we had a chance to know him. May his soul Rest In eternal peace. May his family and close friends receive the grace to endure the loss.”

Mohamnadou Jabur Cham, observed that, “His contributions to the RCS within TDR were not only impressively significant but indeed phenomenal. An envious legacy especially for young scientists from disadvantaged countries. Adieu Prof. till we meet again.”

We trust that the legacy of Professor Ade Lucas will live on in the many people he has taught and mentored and the many careers he has helped launch in public health, preventive medicine and tropical disease control.

Malaria in Pregnancy &Mentoring &mHealth Bill Brieger | 18 Nov 2020

Mentorship to Strengthen Quality of Malaria Case Management & Malaria in Pregnancy, Zimbabwe

Gilson Mandigo et al. examine how mentoring can be achieved from a distance in Zimbabwe. Their presentation at the 69th Annual Meeting of American Society of Tropical Medicine and Hygiene of “Mentorship to Strengthen Quality of Malaria Case Management And Malaria in Pregnancy (MIP) in Zimbabwe: Lessons Learned From One Year of Implementation” is shared below.

Despite significant investment in training and supervision of facility-based health workers in Zimbabwe, persistent malaria case management and MIP gaps remain. National Malaria Control Program and US President’s Malaria Initiative developed and implemented a mentorship intervention in five high burden malaria districts to motivate provider performance and improve quality services.

From June 2018 – June 2019, 25 health workers proficient in malaria service delivery were selected and trained in clinical mentorship. These individuals mentored 98 providers at 25 facilities, covering clinical case reviews, bedside coaching, simulations, and records review. USAID’s Zimbabwe Assistance Project in Malaria subsequently assessed the mentorship program through review of patient records, feedback from mentors and mentees, and engagement of stakeholders.

Record review compared practices before and after implementation, using a checklist that noted completeness and appropriateness of case management across multiple parameters, including physical examination, diagnosis, classification and treatment. Mentored facilities documented improvements in recommended practices across registers: 58% to 63% for outpatient clinical settings, 53% to 64% for integrated management of neonatal and childhood illnesses, and 72% to 76% for antenatal care.

A phone-based e-survey of 49 mentees and 21 mentors elicited positive feedback on the mentorship approach: 62% of mentors were “very satisfied” with the program, 67% reported quality improvement and 86% benefited from learning new skills. Among mentees:

  • 60% were “very satisfied”,
  • 67% said that the program has improved service quality and
  • 97% benefited from learning new skills

Common challenges included mentor transportation, mentee availability, and commodity availability. Through a review meeting, stakeholders recommended the intervention continue, as it was acceptable, feasible and achieved promising results. Recommendations include prioritizing high-volume facilities, integrating management of mentorship into District Health Executive functions and use of low-cost communication platforms to aid virtual mentorship.

Authors and Affiliations

Gilson Mandigo(1), Anthony Chisada(1), Noe Rakotondrajaona(2), Paul Matsvimbo(3), Christie Billingsley(4), Chantelle Allen(5), Katherine Wolf(5), Patience Dhliwayo(3). 1.ZAPIM/Jhpiego, Harare, Zimbabwe, 2.ZAPIM/Abt, Harare, Zimbabwe, 3.MOHCC, Harare, Zimbabwe, 4.PMI, Harare, Zimbabwe, 5.Jhpiego HQ, Baltimore, MD, United States

coronavirus &COVID-19 &Mentoring Bill Brieger | 16 Nov 2020

Remote mentoring to ensure continuity of malaria service delivery during the COVID-19 pandemic in Zimbabwe, Cote d’Ivoire, and Cameroon

Katherine Wolf and colleagues address the need for mentoring in malaria programs across three countries when COVID-19 restricts travel and in-person work. They presented at the 69th Annual Meeting of American Society of Tropical Medicine and Hygiene and share the information below on e-mentoring.

After the COVID-19 pandemic emerged in March 2020, global health experts warned that significant disruptions to malaria programs could lead to a doubling of malaria deaths in 2020, with a major spike overwhelming fragile health systems. To ensure the continuity and safety of malaria service delivery during the pandemic and associated lockdowns, Zimbabwe, Cote d’Ivoire (CI), and Cameroon transitioned from in-person, facility-based mentorship for health care providers to phone-based e-mentorship.

Working with the 3 National Malaria Control Programs, an e-mentoring package was developed and provided to mentors including technical guidance on malaria service delivery during COVID-19, a sample call guide, and a call tracker. Mentorship calls focused on continuity of malaria service delivery and applying WHO and PMI COVID-related guidance on triaging of patients and infection control measures.

From April to June, Zimbabwe reached 134 providers in 24 of 25 health facilities that previously received in-person mentorship. CI reached 41 providers in 33 facilities, where mentors already worked with staff in-person. Cameroon reached 179 providers in 116 lower performing facilities. In Zimbabwe, e-mentorship identified malaria commodity shortfalls and over-stocking, and facilitated re-distribution. Mentors advocated successfully for provision of PPE.

E-mentorship identified a facility that had incorrectly stopped providing routine services; mentors were able to clarify COVID-related guidance from central authorities and assist in re-establishing routine services. In CI, the most frequently discussed topics were malaria commodities and case management. In Cameroon, frequent stockouts reported were better understood, and national stakeholders contacted for better solutions, including redeployment of medicines and commodities from overstocked sites to stocked-out areas.

All 3 countries demonstrated that e-mentorship successfully offers health care providers support and guidance to deliver quality malaria services during a crisis. Lessons learned can be applied in the context of natural disasters, political instability, and other potential disruptions to malaria programs.

Authors and Affiliations

Katherine Wolf1, Chantelle Allen2, Gilson Mandigo3, Leocadia Mangwanya3, Cyprien Noble1, Eric Tchinda4, Mathurin Dodo5, Arthur Konan1, Jacques Kouakou6, Lolade Oseni1
1Jhpiego/Impact Malaria, Baltimore, MD, United States, 2Jhpiego, Baltimore, MD, United States, 3ZAPIM/Jhpiego, Harare, Zimbabwe, 4Jhpiego/Impact Malaria, Kribi, Cameroon, 5Jhpiego/Impact Malaria, Ouagadougou, Burkina Faso, 6Jhpiego/Impact Malaria, Abidjan, Côte D’Ivoire

Mentoring &mHealth &Training &Uncategorized Bill Brieger | 25 Nov 2019

mMentoring, a New Approach to Improve Malaria Care in Burkina Faso

Moumouni Bonkoungou,* Ousmane Badolo, Youssouf Sawadogo, Stanislas Nebie, Thierry Ouedraogo, Yacouba Sawadogo, William Brieger, Gladys Tetteh, and Blami Dao presented their work on “mMentoring, a New Approach to Improve Malaria Care in Burkina Faso” at the 68th Annual Meeting of the American Society of Tropical Medicine and Hygiene as seen below.

Malaria is the leading cause of consultation (43.3%), hospitalization (44.1%) and death (16.1 %) in Burkina Faso. In the Sahel Region, the case fatality proportion due to malaria is 2% compared to 0.8% for the national average. This region is most affected by malaria than others. Also, the Sahel Region is currently experiencing high levels of insecurity making movement of health teams difficult and unsafe.

mMentoring is the use of mobile technology to ensure capacity building and continuing education among health staff. The process started by a workshop to develop messages, and briefing of the main actors.

Each week, messages and quizzes (An automatic answer is sent to each quiz) are sent to 753 providers (nurses, midwives, medical doctors) of the 115 health centers in the Sahel Region. Each month, messages are revised by a team at national level before being sent.

The messages sent were related to several key malaria prevention and control interventions, such as case definition, parasitological diagnosis, clinical case management of simple and severe cases, intermittent preventive treatment in pregnancy (IPTp), pre-referral treatment with rectal artesunate in children under 5 years, insecticide-treated bed nets.

After 10 months of implementation, 64 reinforcement messages on case management and prevention guideline and 63 quizzes were sent. Proportion of correct responses to the quizzes ranged from 43% and 96%. The lowest scores related to topics on management of severe cases while the highest were related to diagnosis of malaria.

The participation rate (number of respondents of the 753 targeted health workers) is on average 22% with 71% of participants from primary health facilities. Also, we notice IPT3 increased from 14.8% in the quarter 3 of 2017 to 45.6% in the same quarter of 2018 (with mMentoring).

The rate of performance of rapid diagnostic tests (RDTs) rose from 67.5% to 77.8%. The case fatality rate during this quarter of 2017 was 3.3% and 1.8% in 2018. As a real platform for continuing training, it would be wise to extend this approach to other regions of the country and also to other health actors like community health workers.

 

 

 

 

 

*Affiliations: PMI Improving Malaria Care Project, Ouagadougou, Burkina Faso, Ministry of Health, National Malaria Control Program, Ouagadougou, Burkina Faso, Johns Hopkins University, Baltimore, MD, United States, Jhpiego Baltimore, Baltimore, MD, United States