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      A scoping review of mentorship of health personnel to improve the quality of health care in low and middle-income countries

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          Abstract

          Background

          Most Low and Middle-Income Countries are facing a crisis in human resources for health which compromises their ability to meet health related targets outlined by the Sustainable Development Goals. The crisis is not limited to the availability of health personnel but also the quality of care and the training and development of the workforce. To address these challenges, evidence based education strategies are urgently required. Mentorship has been found to improve health personnel performance in High-Income Countries however, little is known about its role in Low and Middle-Income Countries. To address this gap in understanding, we conducted a scoping review of the current literature.

          Methods

          CINAHL, EMBASE and OVID Medline were systematically searched along with grey literature for peer-reviewed research papers specific to the research question. A six-step scoping review framework was utilised to identify the relevant literature and summarise the pertinent findings.

          Results

          The initial search identified 592 records, and five papers, reporting on four studies, were retained for data charting and extraction. All four studies described a positive effect of mentorship on the quality of care outcomes. The results are collated according to features of the intervention including mentor training, mentor-mentee ratios, mentorship model, intervention intensity and key findings in terms of outcome measures.

          Conclusions

          This review identifies a paucity of evidence of mentorship in this context however, current evidence supports the assertion that effective mentorship contributes to the improvement of certain quality of care outcomes. The features of successful mentorship interventions are outlined and the implications are discussed in the context of existing evidence.

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          Most cited references15

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          Knowledge transfer for the management of dementia: a cluster-randomised trial of blended learning in general practice

          Background The implementation of new medical knowledge into general practice is a complex process. Blended learning may offer an effective and efficient educational intervention to reduce the knowledge-to-practice gap. The aim of this study was to compare knowledge acquisition about dementia management between a blended learning approach using online modules in addition to quality circles (QCs) and QCs alone. Methods In this cluster-randomised trial with QCs as clusters and general practitioners (GPs) as participants, 389 GPs from 26 QCs in the western part of Germany were invited to participate. Data on the GPs' knowledge were obtained at three points in time by means of a questionnaire survey. Primary outcome was the knowledge gain before and after the interventions. A subgroup analysis of the users of the online modules was performed. Results 166 GPs were available for analysis and filled out a knowledge test at least two times. A significant increase of knowledge was found in both groups that indicated positive learning effects of both approaches. However, there was no significant difference between the groups. A subgroup analysis of the GPs who self-reported that they had actually used the online modules showed that they had a significant increase in their knowledge scores. Conclusion A blended learning approach was not superior to a QCs approach for improving knowledge about dementia management. However, a subgroup of GPs who were motivated to actually use the online modules had a gain in knowledge. Trial registration Current Controlled Trials ISRCTN36550981.
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            Nurse mentorship to improve the quality of health care delivery in rural Rwanda.

            Quality of care at rural health centers in Rwanda is often limited by gaps in individual nurses' knowledge and skills, as well as systems-level issues, such as supply and human resource management. Typically, nurse training is largely didactic and supervision infrequent. Partners In Health and the Rwandan Ministry of Health (MOH) collaborated to implement the nurse-focused Mentoring and Enhanced Supervision at Health Centers (MESH) program. Rwandan nurse-mentors trained in quality improvement and mentoring techniques were integrated into the MOH's district supervisory team to provide ongoing, on-site individual mentorship to health center nurses and to drive systems-level quality improvement activities. The program targeted 21 health centers in two rural districts and supported implementation of MOH evidence-based protocols. Initial results demonstrate significant improvement in a number of quality-of-care indicators. Emphasis on individual provider and systems-level issues, integration within MOH systems, and continuous monitoring efforts were instrumental to these early successes. Copyright © 2013 Elsevier Inc. All rights reserved.
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              The World Health Report 2008: Primary Health Care: Now More Than Ever

              (2008)
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                Author and article information

                Contributors
                patricia.schwerdtle@monash.edu
                julia.morphet@monash.edu
                helen.hall@monash.edu
                Journal
                Global Health
                Global Health
                Globalization and Health
                BioMed Central (London )
                1744-8603
                3 October 2017
                3 October 2017
                2017
                : 13
                : 77
                Affiliations
                [1 ]ISNI 0000 0004 1936 7857, GRID grid.1002.3, Nursing & Midwifery, Faculty of Medicine, Nursing and Health Sciences, , Monash University, ; Clayton, VIC Australia
                [2 ]ISNI 0000 0000 9295 3933, GRID grid.419789.a, Monash Emergency Research Collaborative, , Nursing & Midwifery, Monash Health, ; Clayton, Dandenong Australia
                [3 ]Medecins Sans Frontieres, Sydney, NSW Australia
                Article
                301
                10.1186/s12992-017-0301-1
                5627414
                28974233
                98824dc8-64b6-4571-9262-340b7a7443eb
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 15 May 2017
                : 12 September 2017
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Health & Social care
                mentorship,health personnel,lmics,quality of care,scoping review
                Health & Social care
                mentorship, health personnel, lmics, quality of care, scoping review

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