How Effective are Mentoring Programs for Improving Health Worker Competence and Institutional Performance in Africa? A Systematic Review of Quantitative Evidence
Received 4 September 2019
Accepted for publication 27 November 2019
Published 5 December 2019 Volume 2019:12 Pages 989—1005
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Garumma Tolu Feyissa,1,2 Dina Balabanova,3 Mirkuzie Woldie2,4
1Department of Health, Behavior and Society, Jimma University, Jimma, Ethiopia; 2Ethiopian Evidence Based Healthcare: JBI Center of Excellence, Jimma University, Jimma, Ethiopia; 3Department of Health Policy and Management, London School of Hygiene and Tropical Medicine, London, UK; 4Department of Global Health and Population, T.H. Chan Harvard School of Public Health, Addis Ababa, Ethiopia
Correspondence: Garumma Tolu Feyissa
Department of Health, Behavior and Society, Jimma University, P.o.box 378, Jimma, Ethiopia
Introduction: Mentoring programs are frequently recommended as innovative and low-cost solutions, and these have been implemented in many healthcare institutions to tackle multiple human resource-related challenges. This review sought to locate, appraise and describe the literature reporting on mentorship programs that were designed to improve healthcare worker competence and institutional performance in Africa.
Methods: This review searched and synthesized reports from studies that assessed the effectiveness of mentorship programs among healthcare workers in Africa. We searched for studies reported in the English language in EMBASE, CINAHL, COCHRANE and MEDLINE. Additional search was conducted in Google Scholar.
Results: We included 30 papers reporting on 24 studies. Diverse approaches of mentorship were reported: a) placing a mentor in health facility for a period of time (embedded mentor), b) visits by a mobile mentor, c) a mentoring approach involving a team of mobile multidisciplinary mentors, d) facility twinning, and e) within-facility mentorship by a focal person or a manager.
Implication for practice: Mentoring interventions were effective in improving the clinical management of infectious diseases, maternal, neonatal and childhood illnesses. Mentoring interventions were also found to improve managerial performance (accounting, human resources, monitoring and evaluation, and transportation management) of health institutions. Additionally, mentoring had improved laboratory accreditation scores. Mentoring interventions may be used to increase adherence of health professionals to guidelines, standards, and protocols. While different types of interventions (embedded mentoring, visits by mobile mentors, facility twinning and within-facility mentorship by a focal person) were reported to be effective, there is no evidence to recommend one model of mentoring over other types of mentoring.
Implications for research: Further research—experimental methods measuring the impact of different mentoring formats and longitudinal studies establishing their long-term effectiveness—is required to compare the effectiveness and cost-effectiveness of different models of mentoring. Further studies are needed to explore why and how different mentoring programs succeed and the meaningfulness of mentoring programs for the different stakeholders are also required.
Keywords: mentoring, Africa, institutional performance, health worker competence, systematic review
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