Evaluation of the GOAL Clinical Mentorship Pilot Project in Kenema District

Sierra Leone has one of the highest maternal and child mortality rates in the world. Lack of quality and uninterrupted delivery of maternal and child health services have been identified as the main contributing factors. While the high rate of teenage pregnancy and delays in seeking care and reaching the health facility contribute to the problem, pregnant women often do not receive adequate treatment when they visit a health facility. In 2017, it was estimated that 79% of maternal deaths occurred in a health facility, suggestive of poor quality of service delivery. Limited access to training, particularly for rural health care workers, has been identified by various studies as a limiting factor to the delivery of quality health care in Sierra Leone. GOAL designed and piloted an innovative on-the-job package of clinical mentorship to improve service quality and reliability at peripheral health units (PHUs) in rural Kenema. Clinical mentorship is a "professional relationship in which an experienced clinical staff such as a nurse or midwife assists a less experienced person's professional and personal growth". Clinical mentorship has been associated with increased job satisfaction, productivity, and quality of care. The pilot project was implemented to test if the designed package of mentoring interventions delivered by Chiefdom Supervisors and Midwives would improve health worker (HW) knowledge, skills, and quality of maternal and child health. 

Institute for Development (IfD) designed the study to assess the performance of the pilot clinical mentoring project and to evaluate whether the project met the specified objectives. The Organization for Economic Cooperation and Development (OECD) Development Assistance Committee (DAC) Network on Development Evaluation (EvalNet) framework was used by the evaluators as assessment criteria. The OECD/DAC evaluation framework specifies six criteria for assessing project performance-relevance, coherence, effectiveness, efficiency, impact, and sustainability. For each criterion, the framework specifies questions that should be answered to determine project merit against that criterion. We triangulated the project's M&E data with primary qualitative data to answer the evaluation questions.