The effect of catchment based mentorship on quality of maternal and newborn care in primary health care facilities in Tigray Region, Northern Ethiopia: A controlled quasi-experimental study

In Ethiopia, quality of maternal and newborn care is poor. This situation has persisted, despite the wide implementation of several capacity building-oriented interventions including clinical mentoring for skilled birth attendants that were anticipated to translate in to high-quality maternal and ne...

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Bibliographic Details
Published in:	PloS one 2022-11, Vol.17 (11), p.e0277207-e0277207
Main Authors:	Weldearegay, Haftom Gebrehiwot, Kahsay, Alemayehu Bayray, Godefay, Hagos, Petrucka, Pammla, Medhanyie, Araya Abrha
Format:	Article
Language:	eng
Subjects:	Attended births Biology and Life Sciences Birth Births Catchments Childbirth & labor Complications Data collection Ethiopia Female Health care Health care delivery Health care facilities Health care policy Health facilities Health services Humans Infant mortality Infant, Newborn Intervention Job satisfaction Low income groups Maternal child nursing Maternal Health Services Medicine and Health Sciences Mentors Midwifery Mothers Neonates Newborn babies People and Places Pregnancy Primary care Primary Health Care Quality of Health Care Quasi-experimental methods Sample size Sampling techniques Social Sciences Sustainable development System effectiveness Womens health
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Summary:	In Ethiopia, quality of maternal and newborn care is poor. This situation has persisted, despite the wide implementation of several capacity building-oriented interventions including clinical mentoring for skilled birth attendants that were anticipated to translate in to high-quality maternal and newborn care on each encounter. The effectiveness of mentoring programs is not yet well documented in the research literature. Therefore, we evaluated the effect of a catchment based clinical mentorship in improving the quality of maternal and newborn care in primary level facilities of Tigray, Northern Ethiopia. We conducted a controlled quasi-experimental pre-post study among 19 primary health care facilities, with 10 facilities assigned to the group where the catchment based clinical mentorship program was implemented (intervention group), and 9 facilities to the control group. We assigned the group based on administrative criteria, number of deliveries in each facility, accessibility, and ease of implementation of the intervention. A sample of 1320 women(662 at baseline; 658 at post intervention) and 233 skilled birth attendants(121 at baseline and 112 at end line) were included. We collected data from mothers, skilled birth attendants and facilities. The first round of data collection (baseline) took place two weeks prior the inauguration of the intervention, 05 October to 04 November 2019. The end line data collection occurred from 22 May to 03 July 2020. The primary Outcome was "receipt quality of maternal/newborn care". We analyzed the data using difference in differences (DiD) and logistic regression with Generalized Estimating Equation. The level of significance of predictors was declared at p-value less than 0.05in the multivariable analysis. We deployed a team of local clinical mentors working at primary hospitals to provide clinical mentorship, and direct feedback in routine and emergency obstetrical and newborn care to the mentees (all skilled birth attendants performing maternal and newborn health services) functioning in their catchment rural health centers for duration of six months. While visiting a facility, mentors remain at the facility each lasting at least five to seven days per month, over the course of intervention period. A significantly higher proportion of women at intervention facilities received quality of care services, compared with women at comparison facilities. (DiD = 18.4%, p
ISSN:	1932-6203 1932-6203