Utilizing peer-mentoring for capability-building in Kenyan integrated HIV health and sexual reproductive health services

Ndwiga, C., Abuya, T., Mutemwa, R., Kimani, J., Colombini, M., Mayhew, S., . . . Warren, C. (2014). Exploring experiences in peer mentoring as a strategy for capacity building in sexual reproductive health and HIV service integration in Kenya. BMC Health Services Research, 14(1), 98.

Summarized by Ariel Ervin

Notes of Interest:

• Outlines providers’ mentoring experiences as a mechanism for capacity building within the Integra Initiative (they created, experimented on, and modified peer mentorship protocols to help better service providers’ understanding, capabilities, and expertise to offer integrated HIV and sexual and reproductive health services).
• Service providers that specialized in supplying PNC or FP services were chosen to participate in a mentorship training program and then, in turn, help their peers grow in the context of SRH-HIV integration.
• Qualitative in-depth interviews were conducted in order to examine the provider’s attitudes and experiences concerning peer mentoring.
• They discovered that mentoring is a helpful way to train both mentees and mentors.
• The participants agreed that willingness for teamwork and having amicable relationships are two big factors in having a successful mentorship.
• Throughout the program, mentee participants stated that they became more capable, more knowledgeable, confident, and being a team player in providing integrated HIV and SRH services.
• Ngwiga et al. (2014) also observed that their participants correlate mentoring with an increased variety of resources and the demand for them.

Introduction (Reprinted from the Abstract)

Background

The Integra Initiative designed, tested, and adapted protocols for peer mentorship in order to improve service providers’ skills, knowledge, and capacity to provide quality integrated HIV and sexual and reproductive health (SRH) services. This paper describes providers’ experiences in mentoring as a method of capacity building. Service providers who were skilled in the provision of FP or PNC services were selected to undergo a mentorship training program and to subsequently build the capacity of their peers in SRH-HIV integration.

Methods

A qualitative assessment was conducted to assess provider experiences and perceptions about peer mentoring. In-depth interviews were conducted with twelve mentors and twenty-three mentees who were trained in SRH and HIV integration. Interviews were recorded, transcribed, and imported to NVivo 9 for analysis. Thematic analysis methods were used to develop a coding framework from the research questions and other emerging themes.

Results

Mentorship was perceived as a feasible and acceptable method of training among mentors and mentees. Both mentors and mentees agreed that the success of peer mentoring largely depended on cordial relationship and consensus to work together to achieve a specific set of skills. Mentees reported improved knowledge, skills, self-confidence, and team work in delivering integrated SRH and HIV services as benefits associated with mentoring. They also associated mentoring with an increase in the range of services available and the number of clients seeking those services. Successful mentorship was conditional upon facility management support, sufficient supplies and commodities, a positive work environment, and mentors selection.

Conclusion

Mentoring was perceived by both mentors and mentees as a sustainable method for capacity building, which increased providers’ ability to offer a wide range of and improved access to integrated SRH and HIV services.

 

Implications (Reprinted from the Discussion)

The findings further demonstrate that in a few isolated cases mentoring sessions would reduce manpower (since two providers -mentor and mentee would be with the same clients) and this disrupted services delivery at the facilities, countering the intended effects of the mentoring approach. However, mentoring resulted in improved scope of services as the provider offered a wider range of services after the mentoring process was completed. The findings also demonstrate that mentoring as an approach can be used to improve providers’ technical skills that are one of the major challenges in human resources for health. Mentorship created a sustained mechanism of capacity building for knowledge and skills in RH/HIV integration despite the low staffing levels. It ensures continuity of services and learning at the same time for the staff and thus can be applicable in low resources settings.

A sense of motivation and willingness to improve skills among mentees and mentors cultivated positive learning environments in facilities. It also developed healthy relationships among providers prospectively leading to increased confidence in performing the skills and commitment to providing quality services. In other studies that examined factors associated with working environment and job retention of health care providers education achieved while on the job was found to be associated with job satisfaction. The provision of learning opportunities through mentoring decreases provider anxiety about the future, satisfies career development needs, and creates a high level of job satisfaction.

Mentoring also encouraged performance feedback, intra-staff communication, and prompted opportunities for facility staff to offer the necessary support. These on-the-job features are critical for enabling service providers to establish a sense of organizational identity and belonging, which increases staff retention.

 

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