Improvement and retention of emergency obstetrics and neonatal care knowledge and skills in a hospital mentorship program in Lilongwe, Malawi

Abstract

Objective To evaluate whether a hospital-based mentoring program could significantly increase short- and longer-term emergency obstetrics and neonatal care (EmONC) knowledge and skills among health providers. Methods In a prospective before-and-after study, 20 mentors were trained using a specially-created EmONC mentoring and training program at Bwaila Hospital in Lilongwe, Malawi. The mentors then trained an additional 114 providers as mentees in the curriculum. Mentors and mentees were asked to complete a test before initiation of the training (Pre-Test), immediately after training (Post-Test 1), and at least 6 months after training (Post-Test 2) to assess written and practical EmONC knowledge and skills. Mean scores were then compared. Results Scores increased significantly between the Pre-Test and Post-Test 1 for both written (n=134; difference 22.9%, P<0.001) and practical (n=125; difference 29.5%, P<0.001) tests. Scores were still significantly higher in Post-Test 2 than in the Pre-Test for written (n=111; difference 21.0%, P<0.001) and practical (n=103; difference 29.3%, P<0.001) tests. Conclusion A hospital-based mentoring program can result in both short- and longer-term improvement in EmONC knowledge and skills. Further research is required to assess whether this leads to behavioral changes that improve maternal and neonatal outcomes.

Retention of knowledge and skills after Emergency Obstetric Care training: A multi-country longitudinal study

“…These relate to training packages including; all component of EmOC [ 6 , 7 , 14 , 15 ] or only some components [ 16 – 18 ]. Study designs used include: RCT [ 6 , 17 , 19 ] before and after studies [ 7 , 14 , 15 ] and a systematic review [ 16 ] with varying periods of follow-up including; three months [ 15 ], six months [ 6 , 7 , 17 ], nine months [ 14 ], 12 months [ 16 ] and 24 months [ 16 ]. Two studies assessed knowledge only (15,19), skills only [ 17 ] and four studies assessed both knowledge and skills [ 6 , 7 , 14 , 16 ].…”

“…Study designs used include: RCT [ 6 , 17 , 19 ] before and after studies [ 7 , 14 , 15 ] and a systematic review [ 16 ] with varying periods of follow-up including; three months [ 15 ], six months [ 6 , 7 , 17 ], nine months [ 14 ], 12 months [ 16 ] and 24 months [ 16 ]. Two studies assessed knowledge only (15,19), skills only [ 17 ] and four studies assessed both knowledge and skills [ 6 , 7 , 14 , 16 ]. However, to the best of our knowledge, this is the first multi-country study and the first to account for potential confounding factors.…”

“…Two studies evaluated retention of knowledge and skills after in-service training that included all components of EmOC. A randomised controlled trial including 36 health care providers conducted in Pakistan reported knowledge was retained at 6 months [ 6 ] while Tang et al (2016) in a before after study (n = 134) reported retention of knowledge and skills at 3 months but not at 6 months post training [ 7 ]. None of these studies accounted for potential confounding factors.…”

Obstetrics knowledge and skills training as a catalyst for change

“…The literature mainly reports a significant increase after training, [11][12][13] as did our study. Some studies also report on knowledge and/or skills retention after a certain period of time, [14][15][16] with some studies recommending the continuation of training and an investigation into the frequency and intensity of follow-up training. [16] While the ESMOE training programme is effective in improving knowledge and skills, it is clear that the baseline knowledge and skills of the delegates were low.…”

Using a peer mentorship approach improved the use of neonatal continuous positive airway pressure and related outcomes in Malawi

“…5,6 Where mentorship has been conducted in a supportive framework, it has been shown to encourage staff to engage in identifying and addressing problems to improve outcomes at their healthcare facility. [7][8][9][10] The collaborative nature of mentorship has the potential to increase health providers' knowledge, skills and confidence. 6 This study examined the effectiveness of the CPAP mentorship programme by analysing changes in the staff's CPAP knowledge and skills, CPAP usage and the survival rates for neonates treated with CPAP before and after mentorship.…”