MCSP Mentoring for HCD: Implementation Principles and Lessons Learned

The Maternal and Child Survival Program (MCSP) has developed implementation principles and guidance for mentoring as an HCD approach in health programming in LMICs. MCSP defines human capacity development as the process used to develop individual and team abilities to set goals and strengthen and maintain the competencies required for individual and team roles. Mentoring is not a new method of HCD in health programming, but definitions of mentoring are different in different contexts. The evidence available from the literature and MCSP interventions provides some insights for ongoing and future programming. MCSP defines mentoring as the process through which an experienced and empathetic person who is proficient in her/his content area (a mentor) teaches and coaches another individual (mentee) or group of individuals (mentees), in person and/or virtually, to ensure competent workplace performance and provide ongoing professional development. The MCSP mentoring principles emphasize the importance of mentors being proficient in the content area for which they provide mentoring, working in person and/or virtually with individuals and/or teams, and developing rapport and building relationships with those they mentor. The rationale for mentoring is based on the recognition that historical approaches to training and supervision have not resulted in their desired changes in provider performance, quality of care, and health outcomes. A 2016 review of national surveys in sub-Saharan Africa found that these traditional interventions were associated with only modest improvements. In addition, a robust systematic review identified a greater effect in improving a health care provider's performance when training was combined with other structural interventions, including supervision, performance and quality improvement, and community engagement. MCSP program representatives reported the following reasons for using a mentoring approach: targeted identification of skills gaps, dedicated support and feedback to address those gaps, the benefit of working with providers on the job rather than offsite, perceived improvements in provider confidence and performance, and the ability to monitor skills and competencies acquired through traditional training interventions. The MCSP mentoring principles emphasize the importance of mentoring complementing other interventions, such as formal supervisory systems, quality improvement efforts, and/or instructor-led training, irrespective of training setting. Mentors must be proficient in the content area for which they provide mentoring, and they work in person and/or virtually with individuals and/or teams to build skills to ensure competent workplace performance and respectful provision of high-quality care in the workplace. Mentoring is often combined with other HCD interventions, such as quality improvement, on-the-job or facility-based (in-service) training, or supportive supervision. The evidence on the effectiveness of mentoring in LMICs is limited, and it is often difficult to attribute improvements specifically to a mentoring intervention. However, the MCSP mentoring principles provide a framework for implementing mentoring as an HCD approach in health programming in LMICs. The MCSP mentoring principles are designed to be flexible and adaptable to different contexts and settings. They emphasize the importance of mentors being proficient in the content area for which they provide mentoring, working in person and/or virtually with individuals and/or teams, and developing rapport and building relationships with those they mentor. The principles also emphasize the importance of mentoring being goal-based and having a formal ending point, the achievement of performance goals. The MCSP mentoring principles are intended to provide guidance for programs implementing mentoring as an HCD approach in health programming in LMICs. They are based on the recognition that mentoring is a critical approach to improve health care provider performance and quality of care, and they provide a framework for implementing mentoring in a way that is effective and sustainable.