Evaluation of Clinical Mentoring in MSF’s Non-Communicable Disease Project in Embu, Kenya

Introduction

In March 2017, Médecins Sans Frontières' Operational Centre Brussels (MSF-OCB) in collaboration with the Division of Non-Communicable Diseases and the Embu County Ministry of Health (MoH), started in Embu County a project aimed at reducing mortality and morbidity linked to Non-Communicable Diseases (NCDs). This project includes a strong component on reinforcing the skills and competencies of the care providers, and of Clinical Mentoring (CM), has been chosen as the learning implementation strategy. The mentoring activities within this project are being implemented based on the current MSF mentoring framework (described in the MSF “Clinical Mentoring Program Guide”).

The mentoring framework implemented by MSF in Embu has been designed mainly as a CM process. It focuses on developing MoH clinical staff - Nurses and Clinical Officers, as well as Community Health Volunteers (CHVs) – to better deal with patients with four NCDs – hypertension, diabetes mellitus, asthma and COPD, and epilepsy. The approach consists initially of two modules designed around the four main NCDs referred to above.

This report describes an evaluation of the mentoring component of the NCD project within Embu, Kenya. The evaluation intervention was designed to assess the appropriateness and effectiveness of the defined mentoring framework as a learning and teaching process within this context. This included addressing three main objectives:

- To assess the extent to which the approach used in Embu has been sufficiently adapted to the local context,

- To examine the extent to which the mentees’ medical competences (knowledge, skills, and attitudes) have improved, and

- To explore how the mentoring component of the project is currently being implemented and to identify possible improvements/ amendments.

The data collection was undertaken in two visits to Embu, one in July/August in 2019 (hereinafter referred to as V1) and the second in February in 2020 (hereinafter referred to as V2). Both quantitative and qualitative data were collected from mentors, mentees, MoH officials, MSF staff and patients. The methods used were interviews, focus groups, direct observation, and analysis of objective assessments of mentees knowledge skills and attitudes. Purposive sampling was used to determine who would participate in the evaluation and data was collected until saturation was reached.