A collaborative learning approach to improving health worker performance in adolescent sexual and reproductive health service provision: a descriptive feasibility study in six health zones in the Democratic Republic of the Congo

Odimba, Sylvie Olela; Squires, Frances; Ferenchick, Erin; Mbassi, Symplice Mbola; Chick, Paul; Plesons, Marina; Chandra-Mouli, Venkatraman

doi:10.1080/16549716.2021.1985228

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…Our findings offer evidence of the acceptability of a collaborative learning approach to improve knowledge and skills among health service providers, strengthen the friendliness of SRH services provided to adolescents, and improve communication and trust between health service providers, adolescents, and community members. Our finding aligned with the evidence on the 'client-oriented, provider-efficient' (COPE) process for quality improvement where collaborative learning approaches were used in Congo, and it improved health service provider performance in many areas, including respectful care, information provision, personal communication, privacy, and clinical skills [26].…”

Section: Discussionsupporting

confidence: 81%

“…Despite the clear acceptability, our findings show that external factors such as funds limited the intervention coverage, and the collaborative learning strategies may face sustainability challenges, including clarity about continuous funding, a view also shared in an earlier study [ 26 ]. However, the benefits of the informal sharing and learning processes in this context, notwithstanding the novelty, build on the evidence that collaborative learning approaches may address the challenges in ensuring quality SRH services for adolescents [ 25 , 26 ]. Indeed, the experiences with collaborative learning highlight the need for a comprehensive approach to performance improvement that goes beyond training to improve health service provider knowledge, skills, attitudes, and motivation.…”

Section: Discussionmentioning

confidence: 65%

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Acceptability of a community-embedded intervention for improving adolescent sexual and reproductive health in south-east Nigeria: A qualitative study

Eze,

Okeke,

Ekwueme

et al. 2023

PLoS ONE

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Introduction Adolescents have limited access to quality sexual and reproductive health (SRH) services that are key to healthy sexual lives in many low and middle-income countries such as Nigeria. Hence, context-specific interventions are required to increase adolescents’ access to and utilisation of SRH. This paper provides new knowledge on the acceptability of a community-embedded intervention to improve access to SRH information and services for adolescents in Ebonyi state, southeast Nigeria. Methods A community-embedded intervention was implemented for six months in selected communities. Thereafter the intervention was assessed for its acceptability using a total of 30 in-depth interviews and 18 focus group discussions conducted with policymakers, health service providers, school teachers, community gatekeepers, parents and adolescents who were purposively selected as relevant stakeholders on adolescent SRH. The interview transcripts were coded in NVivo 12 using a coding framework structured according to four key constructs of the theoretical framework for acceptability (TFA): affective attitude, intervention coherence, perceived effectiveness, and self-efficacy. The outputs of the coded transcripts were analysed, and the emergent themes from each of the four constructs of the TFA were identified. Results The intervention was acceptable to the stakeholders, from the findings of its positive effects, appropriateness, and positive impact on sexual behaviour. Policymakers were happy to be included in collaborating with multiple stakeholders to co-create multi-faceted interventions relevant to their work (positive affective attitude). The stakeholders understood how the interventions work and perceived them as appropriate at individual and community levels, with adequate and non-complex tools adaptable to different levels of stakeholders (intervention coherence). The intervention promoted mutualistic relations across stakeholders and sectors, including creating multiple platforms to reach the target audience, positive change in sexual behaviour, and cross-learning among policymakers, community gatekeepers, service providers, and adolescents (intervention effectiveness), which empowered them to have the confidence to provide and access SRH information and services (self-efficacy). Conclusions Community-embedded interventions were acceptable as strong mechanisms for improving adolescents’ access to SRH in the communities. Policymakers should promote the community-embedded strategy for holistic health promotion of adolescents.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 65%

Acceptability of a community-embedded intervention for improving adolescent sexual and reproductive health in south-east Nigeria: A qualitative study

Eze,

Okeke,

Ekwueme

et al. 2023

PLoS ONE

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“…This involves a review of documentation from implementing partners RENADEF and Cordaid of the costs of each activity to contribute to an understanding of the cost of each component of the packages of interventions. Initial startup costs for the collaborative learning component of the project have been detailed elsewhere [ 23 ].…”

Section: Study Design and Methodsmentioning

confidence: 99%

Improving health worker motivation and performance to deliver adolescent sexual and reproductive health services in the Democratic Republic of Congo: study design of implementation research to assess the feasibility, acceptability, and effectiveness of a package of interventions

Bastien

Ferenchick²,

Mbassi

et al. 2022

Global Health Action

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During its last funding cycle from 2018–2020, the Global Fund in collaboration with the Ministry of Health, World Health Organization, and implementing partners Cordaid and Santé Rural (SANRU), implemented a multi-sectoral, contextualized approach to improve the sexual and reproductive health of adolescent girls and young women in two regions in the Democratic Republic of the Congo, which included community-based, school-based and health facility-based actions. This implementation research focuses on the health-facility component. The objective of this research is to evaluate the feasibility, acceptability, and effectiveness of a package of interventions to improve health workers’ knowledge, skills, and attitudes in providing sexual and reproductive health services to adolescents, whilst concomitantly creating an enabling work environment for building health workers’ motivation. The package includes a combination of job descriptions, training and refresher training, desk reference tools, and collaborative learning. The package did not focus on improving amenities, providing or repairing equipment, or providing medicines and supplies. The underlying theoretical framework informing the project and the implementation research draws from Social Network Theory, Diffusion of Innovations and Normalization Process Theory. Qualitative and quantitative process and outcome data from in-depth interviews and focus group discussions with health workers and health managers, field notes, monitoring reports, costing sheets, and health worker surveys, adolescent mystery client assessments, and exit interviews with adolescents will be collected as part of a time-series study. The findings from this implementation research will be utilized to inform future adaptations and/or scale-up of the package of interventions to improve health worker motivation and performance in the Democratic Republic of the Congo and elsewhere. The findings will also contribute to advancing the use of theoretical approaches within the field of implementation research.

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Professional Nurses’ Perceptions of Providing Contraceptives to Adolescents at Primary Healthcare Facilities in Lesotho

Mohai,

Rabie,

Neethling

et al. 2023

TOPHJ

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Background: High adolescent pregnancy rates are evident in most countries, especially low- and middle-income countries like Lesotho, where contraceptive services are available at public facilities at no cost, yet adolescents still have a significant unmet need for contraception. In Lesotho, professional nurses are at the forefront of primary healthcare, including the provision of contraceptive services. Objectives: The objective of this study is to explore and describe professional nurses’ perceptions of providing contraceptives to adolescents at Primary Health Care facilities in Lesotho. Methods: A qualitative research strategy with exploratory and descriptive approaches was used. Purposive sampling of four primary healthcare facilities and an all-inclusive sampling of professional nurses employed at these primary healthcare facilities in the Mafeteng district of Lesotho were employed. Semi-structured open-ended interviews were done with 12 participants using an interview schedule. Data were analysed using qualitative content analysis. Results: Six categories with their respective themes emerged. The categories included: perceptions of contraception use, perceptions of consulting adolescents at primary healthcare facilities, perceptions of adolescent pregnancy, advice to adolescents using contraception, challenges to effective service provision, and improvement of service provision. Conclusion: Professional nurses were aware of the adolescents’ unmet need for contraception and their hesitancy when seeking contraceptive services. However, professional nurses support and encourage contraception use during adolescence because the early onset of sexual activity and adolescent pregnancy cannot be denied. Professional Nurses are faced with challenges in the Primary Health Care facility that have hindered their service provision, which needs to be addressed to improve service provision.

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A collaborative learning approach to improving health worker performance in adolescent sexual and reproductive health service provision: a descriptive feasibility study in six health zones in the Democratic Republic of the Congo

Cited by 3 publications

References 16 publications

Acceptability of a community-embedded intervention for improving adolescent sexual and reproductive health in south-east Nigeria: A qualitative study

Acceptability of a community-embedded intervention for improving adolescent sexual and reproductive health in south-east Nigeria: A qualitative study

Improving health worker motivation and performance to deliver adolescent sexual and reproductive health services in the Democratic Republic of Congo: study design of implementation research to assess the feasibility, acceptability, and effectiveness of a package of interventions

Professional Nurses’ Perceptions of Providing Contraceptives to Adolescents at Primary Healthcare Facilities in Lesotho

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