Mentoring approaches in a safe surgery program in Tanzania: Lessons learned during COVID-19 and recommendations for the future.

Capacity building Health systems Maternal health Mentorship Obstetrics Surgery

Journal

Surgery open science
ISSN: 2589-8450
Titre abrégé: Surg Open Sci
Pays: United States
ID NLM: 101768812

Informations de publication

Date de publication:
Aug 2023
Historique:
received: 28 04 2023
accepted: 18 07 2023
medline: 14 8 2023
pubmed: 14 8 2023
entrez: 14 8 2023
Statut: epublish

Résumé

COVID-19 has dramatically affected the delivery of health care and technical assistance. This is true in Tanzania, where maternal mortality and surgical infection rates are significantly higher than in high-income countries. This paper describes lessons learned about the optimal application of in-person and virtual mentorship in the Safe Surgery 2020 program to improve the quality of surgical services in Tanzania before and after the COVID-19 pandemic. From January 2018 through December 2020, Safe Surgery 2020 supported 40 health facilities in Tanzania's Lake Zone to improve the quality of surgical care. A blended surgical mentorship model, employing both onsite and virtual mentorship, was central to the program's capacity development approach. With COVID-19, the program pivoted to full virtual mentorship. Through continuous learning and adaptation processes, including a human-centered design workshop, surveys assessing mentors' confidence with different competencies, and focus group discussions with mentors, mentees and safe surgery program staff, the program distilled the optimal use of mentorship models. Developing complex surgical skills, addressing contextual considerations, problem-solving, and building trusting relationships were best suited to in-person mentorship, whereas virtual mentorship was most effective in supporting mentees' quality improvement projects, data use, case discussions, and reinforcing clinical practices. Leading successful virtual learning required enhanced facilitation skills and active engagement of health facility leadership. In-person and virtual mentorship offer distinct benefits and complement each other when combined. Investing more in-person mentorship at the beginning of programs allows for the establishment of trust that is foundational to effective mentorship.

Sections du résumé

Background UNASSIGNED
COVID-19 has dramatically affected the delivery of health care and technical assistance. This is true in Tanzania, where maternal mortality and surgical infection rates are significantly higher than in high-income countries. This paper describes lessons learned about the optimal application of in-person and virtual mentorship in the Safe Surgery 2020 program to improve the quality of surgical services in Tanzania before and after the COVID-19 pandemic.
Methods UNASSIGNED
From January 2018 through December 2020, Safe Surgery 2020 supported 40 health facilities in Tanzania's Lake Zone to improve the quality of surgical care. A blended surgical mentorship model, employing both onsite and virtual mentorship, was central to the program's capacity development approach. With COVID-19, the program pivoted to full virtual mentorship. Through continuous learning and adaptation processes, including a human-centered design workshop, surveys assessing mentors' confidence with different competencies, and focus group discussions with mentors, mentees and safe surgery program staff, the program distilled the optimal use of mentorship models.
Results UNASSIGNED
Developing complex surgical skills, addressing contextual considerations, problem-solving, and building trusting relationships were best suited to in-person mentorship, whereas virtual mentorship was most effective in supporting mentees' quality improvement projects, data use, case discussions, and reinforcing clinical practices. Leading successful virtual learning required enhanced facilitation skills and active engagement of health facility leadership.
Conclusions UNASSIGNED
In-person and virtual mentorship offer distinct benefits and complement each other when combined. Investing more in-person mentorship at the beginning of programs allows for the establishment of trust that is foundational to effective mentorship.

Identifiants

pubmed: 37577254
doi: 10.1016/j.sopen.2023.07.014
pii: S2589-8450(23)00049-0
pmc: PMC10413135
doi:

Types de publication

Journal Article

Langues

eng

Pagination

109-113

Informations de copyright

© 2023 Jhpiego Corporation.

Déclaration de conflit d'intérêts

The Program in Global Surgery and Social Change, Jhpiego, and Assist International received funding from the GE Foundation for the Safe Surgery 2020 project. Laura Fitzgerald, Leopold Tibyehabwa, John Varallo, Edwin Ernest, Margaret Mary Bertram, Shehnaz Alidina, Stella Mshana, Dorcas Simba, Kevin Charles, Victoria Smith, Monica Cainer, Augustino Hellar, and Adam Katoto had financial support from GE Foundation for the submitted work. Laura Fitzgerald, Leopold Tibyehabwa, John Varallo, Edwin Ernest, Margaret Mary Bertram, Stella Mshana, Dorcas Simba, Kevin Charles, Augustino Hellar, and Adam Katoto declare financial support from ELMA Philanthropies. Anmol Patted has nothing to declare.

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Auteurs

Laura Fitzgerald (L)

Jhpiego, 1615 Thames St, Baltimore, MD, United States.

Leopold Tibyehabwa (L)

Safe Surgery 2020 Project, Jhpiego Tanzania, Dar es Salaam, Tanzania.

John Varallo (J)

Jhpiego, 1615 Thames St, Baltimore, MD, United States.

Edwin Ernest (E)

Safe Surgery 2020 Project, Jhpiego Tanzania, Dar es Salaam, Tanzania.

Anmol Patted (A)

Jhpiego, 1615 Thames St, Baltimore, MD, United States.

Margaret Mary Bertram (MM)

Jhpiego, 1615 Thames St, Baltimore, MD, United States.

Shehnaz Alidina (S)

Harvard T. H. Chan School of Public Health, Boston, MA, United States1Current affiliation.
Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States2Former affiliation.

Stella Mshana (S)

Safe Surgery 2020 Project, Jhpiego Tanzania, Mara, Tanzania.

Adam Katoto (A)

Safe Surgery 2020 Project, Jhpiego Tanzania, Kagera, Tanzania.

Dorcas Simba (D)

Safe Surgery 2020 Project, Jhpiego Tanzania, Dar es Salaam, Tanzania.

Kevin Charles (K)

Assist International, Dar es Salaam, Tanzania.

Victoria Smith (V)

Assist International, Ripon, CA, United States.

Monica Cainer (M)

Assist International, Ripon, CA, United States.

Augustino Hellar (A)

Safe Surgery 2020 Project, Jhpiego Tanzania, Dar es Salaam, Tanzania.

Classifications MeSH