scholarly journals The impact of training on perceived performance in reproductive, maternal, and newborn health service delivery among healthcare workers in Tanzania: A baseline- and endline-survey

2021 ◽  
Author(s):  
Tumbwene Mwansisya ◽  
Columba Mbekenga ◽  
Kahabi Isangula ◽  
Loveluck Mwasha ◽  
Stewart Mbelwa ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Newborn Health ◽  
Training Needs ◽  
Needs Analysis ◽  
Maternal And Newborn Health ◽  
Perceived Performance ◽  
Perceived Importance ◽  
And Performance ◽  
Clinical Mentorship ◽  
Maternal And Newborn

Abstract BackgroundDelivery of quality reproductive health services has been documented to depend on the availability of healthcare workers who are adequately supported with appropriate training. However, unmet training needs among healthcare workers in reproductive, maternal, and newborn health (RMNH) in low-income countries remain disproportionately high. This study investigated the effectiveness of trainings with onsite clinical mentorship towards perceived importance and performance in RMNH among healthcare workers in Mwanza Region of Tanzania.MethodsThe study used a quasi-experimental design using single group pre-and post-intervention evaluation strategy. The training needs of healthcare workers from the selected health facilities were assessed, skills gaps identified and ranked according to priority. Training courses that addressed skills gaps were developed and delivered with adaptations of the national guidelines followed by onsite clinical mentorship for one year. The baseline and endline survey were conducted at 3 years interval to assess change in HCWs on their perceived importance and performance on different aspects of RMNH care. Independent samples t-tests were used to compare differences in perceived performance in selected training areas between baseline and endline. Significance was set at p < 0.05.ResultsTNA was administered to 152 and 216 healthcare workers at baseline and endline respectively. In total, 141 (65%) of the 216 end line survey participants had received at least one IMPACT project training course and at least three mentorship visits. Participants were matched on their age and duration in RMNH services, but differed in age and duration of employment. Comparison between baseline and endline by using the training needs analysis questionnaire scores showed statistically significant positive changes (p ≤ .05) in most training needs analysis items, except for some items including those related to research capacity and provision of health education for cancer.ConclusionsThe findings revealed that the training and onsite clinical mentorship program that address the actual needs of healthcare workers to have significant positive changes in perceived performance in a wide range of RMNH services. However, further studies with rigorous designs are warranted to evaluate the long-term effect of such training programs on RMNH outcomes.

scholarly journals Translation and validation of Training Needs Analysis Questionnaire among reproductive, maternal and newborn health workers in Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tumbwene Mwansisya ◽  
Columba Mbekenga ◽  
Kahabi Isangula ◽  
Loveluck Mwasha ◽  
Eunice Pallangyo ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Professional Training ◽  
Health Workers ◽  
Newborn Health ◽  
Training Needs ◽  
Assessment Tools ◽  
Needs Analysis ◽  
Maternal And Newborn Health ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background Continuous professional development (CPD) has been reported to enhance healthcare workers’ knowledge and skills, improve retention and recruitment, improve the quality of patient care, and reduce patient mortality. Therefore, validated training needs assessment tools are important to facilitate the design of effective CPD programs. Methods A cross-sectional survey was conducted using self-administered questionnaires. Participants were healthcare workers in reproductive, maternal, and neonatal health (RMNH) from seven hospitals, 12 health centers, and 17 dispensaries in eight districts of Mwanza Region, Tanzania. The training needs analysis (TNA) tool that was used for data collection was adapted and translated into Kiswahili from English version of the Hennessy-Hicks’ Training Need Analysis Questionnaire (TNAQ). Results In total, 153 healthcare workers participated in this study. Most participants were female 83 % (n = 127), and 76 % (n = 115) were nurses. The average age was 39 years, and the mean duration working in RMNH was 7.9 years. The reliability of the adapted TNAQ was 0.954. Assessment of construct validity indicated that the comparative fit index was equal to 1. Conclusions The adapted TNAQ appears to be reliable and valid for identifying professional training needs among healthcare workers in RMNH settings in Mwanza Region, Tanzania. Further studies with larger sample sizes are needed to test the use of the TNAQ in broader healthcare systems and settings.

scholarly journals Training Needs Assessment of Health Care Professionals in Reproductive, Maternal and Newborn Health in a Low-Income Setting in Tanzania

2021 ◽  
Author(s):  
Columba Mbekenga ◽  
Eunice Pallangyo ◽  
Tumbwene E. Mwansisya ◽  
Kahabi Isangula ◽  
Loveluck Mwasha ◽  
...  
Keyword(s):  
Health Care ◽  
Needs Assessment ◽  
Low Income ◽  
Newborn Health ◽  
Training Needs ◽  
Health Facilities ◽  
Maternal And Newborn Health ◽  
Training Needs Assessment ◽  
Low Income Setting ◽  
Maternal And Newborn

Abstract Background: Healthcare delivery globally and particularly in low-income setting is challenged by multiple, complex and dynamic problems. The reproductive, maternal and newborn health (RMNH) care is among the most affected areas resulting into high maternal and neonatal mortality and morbidity across the Sub Saharan region and Tanzania in particular. However, under-investment in adequate training and capacity development among health care workers (HCWs) is reported worldwide and contributes to the critical shortages, and lack of adequate knowledge and skills among HCWs. The aim of this study was to assess the training needs among HCWs of RMNH care in selected health facilities of Mwanza, Tanzania. Methods: A cross-sectional descriptive and analytic survey using a self- administered questionnaire was conducted in 36 out of 80 health care facilities included in Improving Access to Reproductive, Maternal and Newborn Health in Mwanza, Tanzania (IMPACT) project within the 8 councils of Mwanza region in Tanzania. The training needs assessment (TNA) tool adapted from the Hennessy-Hicks’ Training Needs Assessment Questionnaire (TNAQ) was used for data collection. The HCWs rated on the importance of their task and their current performance of the task. The differences in scores were calculated to identify the greatest training needs.Results: Out of 153 HCWs who responded to the TNA questionnaire, majority were registered (n=62) and enrolled (n=43) nurses. Ninety percent (n= 137) were from government-owned health facilities, mostly from hospitals 68 (45%). Training needs were high in 16 areas (out of 49) including cervical cancer screening and care; accessing research resources; basic and comprehensive emergency obstetric and newborn care; and sexual and gender-based violence. The overall perceived importance of the training needs was significantly associated with perceived performance of tasks related to RMNH services (Pearson Correlation (r) = .256; p <001).Conclusions: The study highlights 16 (out of 49) training gaps as perceived by HCWs in RMNH in Tanzania. The utilization of findings from the TNA has great potential to facilitate designing of effective trainings for local RMNH services delivery hence improve the overall quality of care.

scholarly journals Training Needs Assessment of Health Care Professionals in Reproductive, Maternal and Newborn Health in a Low-Income Setting in Tanzania

2020 ◽  
Author(s):  
Columba Mbekenga ◽  
Eunice Pallangyo ◽  
Tumbwene Mwansisya ◽  
Kahabi Isangula ◽  
Loveluck Mwasha ◽  
...  
Keyword(s):  
Health Care ◽  
Needs Assessment ◽  
Low Income ◽  
Newborn Health ◽  
Training Needs ◽  
Health Facilities ◽  
Maternal And Newborn Health ◽  
Training Needs Assessment ◽  
Low Income Setting ◽  
Maternal And Newborn

Abstract BackgroundHealthcare delivery globally and particularly in low-income setting is challenged by multiple, complex and dynamic problems. The reproductive, maternal and newborn health (RMNH) care is among the most affected areas resulting into high maternal and neonatal mortality and morbidity across the Sub Saharan region and Tanzania in particular. However, under-investment in adequate education and training of health care providers (HCPs) is reported worldwide and contributes to the critical shortages, and lack of adequate knowledge and skills among HCPs. The aim of this study was to assess the training needs among HCPs of RMNH care in selected health facilities of Mwanza, Tanzania. MethodsA cross-sectional descriptive and analytic survey using a self- administered questionnaire was conducted in 36 out of 80 health care facilities included in the Government of Canada and Aga Khan Foundation Canada funded Improving Access to Reproductive, Maternal and Newborn Health in Mwanza, Tanzania (IMPACT) project within the 8 Councils of Mwanza region in Tanzania. The training needs assessment (TNA) tool adapted from the Hennessy-Hicks’ Training Needs Assessment Questionnaire (TNAQ) instrument was used for data collection. The HCPs provided ratings on the importance of their task and their current performance of the task. The differences in scores were calculated to identify the greatest training needs. ResultsOut of 153 HCPs who responded to the TNA questionnaire, majority were registered (n=62) and enrolled (n=43) nurses. Ninety percent (n= 137) were from government-owned health facilities, mostly from hospitals 68 (45%). Training needs were high in 16 areas (out of 49) including cervical cancer screening and care; accessing research resources; basic and comprehensive emergency obstetric and newborn care; and sexual and gender-based violence. The overall perceived importance of the training needs was significantly associated with perceived performance of tasks related to RMNH services (Pearson Correlation (r) = .256; p <001).ConclusionsThe study highlights 16 (out of 49) training gaps as perceived by HCPs working in RMNH in Tanzania. The utilization of findings from the TNA has great potential to facilitate designing of effective trainings for local RMNH services delivery hence improve the overall quality of care.

scholarly journals Improving the quality of maternal and newborn health outcomes through a clinical mentorship program in the Democratic Republic of the Congo: study protocol

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Xu Xiong ◽  
Rebecca Carter ◽  
Paul-Samson Lusamba-Dikassa ◽  
Elvis C. Kuburhanwa ◽  
Francine Kimanuka ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Scientific Evidence ◽  
Newborn Care ◽  
Newborn Health ◽  
Maternal And Newborn Health ◽  
Mentorship Program ◽  
Republic Of The Congo ◽  
Clinical Mentorship ◽  
Maternal And Newborn

Abstract Background The Democratic Republic of the Congo (DRC) boasts one of the highest rates of institutional deliveries in sub-Saharan Africa (80%), with eight out of every ten births also assisted by a skilled provider. However, the maternal and neonatal mortality are still among the highest in the world, which demonstrates the poor in-facility quality of maternal and newborn care. The objective of this ongoing project is to design, implement, and evaluate a clinical mentorship program in 72 health facilities in two rural provinces of Kwango and Kwilu, DRC. Methods This is an ongoing quasi-experimental study. In the 72 facilities, 48 facilities were assigned to the group where the clinical mentorship program is being implemented (intervention group), and 24 facilities were assigned to the group where the clinical mentorship program is not being implemented (control group). The groups were selected and assigned based on administrative criteria, taking into account the number of deliveries in each facility, the coverage of health zones, accessibility, and ease of implementation of a clinical mentorship program. The main activities are organizing and training a national team of mentors (including senior midwives, obstetricians, and pediatricians) in clinical mentoring, deploying them to mentor all health providers (mentees) performing maternal and newborn health (MNH) services, and providing in-service training in routine and Emergency Obstetrical and Newborn Care (EmONC) to the mentees in health facilities over an 18-month period. Baseline and endline assessments are carried out to evaluate the effectiveness of the clinical mentorship program on the quality of MNH care and the effective coverage of key interventions to reduce maternal and neonatal mortality. Findings will be disseminated nationwide and internationally, as scientific evidence is scarce. A national strategy, guidelines, and tools for clinical mentorship in MNH will be developed for replication in other provinces, thus benefitting the entire country. Discussion This is the largest project on clinical mentorship aimed to improving the quality of MNH care in Africa. This program is expected to generate one of the first pieces of scientific evidence on the effectiveness of a clinical mentorship program in MNH on a scientifically designed and sustainable model.

scholarly journals Maternal and newborn health risks of climate change: A call for awareness and global action

2021 ◽  
Author(s):  
Nathalie Roos ◽  
Sari Kovats ◽  
Shakoor Hajat ◽  
Veronique Filippi ◽  
Matthew Chersich ◽  
...  
Keyword(s):  
Climate Change ◽  
Health Risks ◽  
Newborn Health ◽  
Maternal And Newborn Health ◽  
Global Action ◽  
Maternal And Newborn

scholarly journals Intersectional (in) equities in contact coverage of maternal and newborn health services in Nepal: insights from a nationwide cross-sectional household survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Resham B. Khatri ◽  
Yibeltal Alemu ◽  
Melinda M. Protani ◽  
Rajendra Karkee ◽  
Jo Durham
Keyword(s):  
Institutional Delivery ◽  
Secondary Analysis ◽  
Newborn Health ◽  
Household Survey ◽  
Universal Coverage ◽  
Maternal And Newborn Health ◽  
Multiple Forms ◽  
Wealth Status ◽  
Cross Sectional ◽  
Maternal And Newborn

Abstract Background Persistent inequities in coverage of maternal and newborn health (MNH) services continue to pose a major challenge to the health-care system in Nepal. This paper uses a novel composite indicator of intersectional (dis) advantages to examine how different (in) equity markers intersect to create (in) equities in contact coverage of MNH services across the continuum of care (CoC) in Nepal. Methods A secondary analysis was conducted among 1978 women aged 15–49 years who had a live birth in the two years preceding the survey. Data were derived from the Nepal Demographic and Health Survey (NDHS) 2016. The three outcome variables included were 1) at least four antenatal care (4ANC) visits, 2) institutional delivery, and 3) postnatal care (PNC) consult for newborns and mothers within 48 h of childbirth. Independent variables were wealth status, education, ethnicity, languages, residence, and marginalisation status. Intersectional (dis) advantages were created using three socioeconomic variables (wealth status, level of education and ethnicity of women). Binomial logistic regression analysis was employed to identify the patterns of (in) equities in contact coverage of MNH services across the CoC. Results The contact coverage of 4ANC visits, institutional delivery, and PNC visit was 72, 64, and 51% respectively. Relative to women with triple disadvantage, the odds of contact coverage of 4ANC visits was more than five-fold higher (Adjusted Odds Ratio (aOR) = 5.51; 95% CI: 2.85, 10.64) among women with triple forms of advantages (literate and advantaged ethnicity and higher wealth status). Women with triple advantages were seven-fold more likely to give birth in a health institution (aOR = 7.32; 95% CI: 3.66, 14.63). They were also four times more likely (aOR = 4.18; 95% CI: 2.40, 7.28) to receive PNC visit compared to their triple disadvantaged counterparts. Conclusions The contact coverage of routine MNH visits was low among women with social disadvantages and lowest among women with multiple forms of socioeconomic disadvantages. Tracking health service coverage among women with multiple forms of (dis) advantage can provide crucial information for designing contextual and targeted approaches to actions towards universal coverage of MNH services and improving health equity.

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