1. Improving the Quality of EmONC Services through Intensive Mentorship –
The MCHIP Approach
Saving Mothers, Giving Life Endeavor
1 November, 2012
The Maternal and Child Health Integrated Program is USAID’s Global Flagship Program for MCH. We are present in more than 30 countries and have been in Zambia under SMGL since October 2011.
Under SMGL, MCHIP is the primary clinical implementing partner in Mansa District for EmONC and HBB, and in all four districts for HBB.

2. Mentorship Design Trained team of 16 Mansa District mentors in:
Mentoring skills
IRH Supervisory Tool & EmONC Skills Checklists
Anatomic models to guide on-site clinical simulations
Data collection and support
Reporting
Team of 2-3 mentors visiting every delivering facility on a monthly basis
Hold Quarterly Recognition/Clinical Update Meetings with staff representatives of all facilities
Also providing supportive infrastructure: EmONC equipment and soon, solar lighting, repair of radios

3. Impact of mentorship
Immediate & sustained application of skills learned during EmONC training
Improved provider confidence and morale
HCs now managing complications which previously were referred (e.g., manual removal of placenta, MVA)
Improved outcomes for pregnant women
Reduced pressure on emergency transport systems and referral facilities
Senama clinic now performs all basic EmONC functions on site

4. Impact (cont’d) Increased use of the partograph (0.06% to 15%)
Improved documentation in service delivery registers
AMTSL applied in 85% of deliveries, even with 3-fold increase in number of facility deliveries since October 2011.
Increase in facility deliveries: Oct-Dec 2011= 913; Jul-Sept 2012=3,194
Although we have seen a significant increase in use of the partograph, it remains a
challenging area. At our Sept Clinical Update Meeting....
Nurse Chansa is now working in Samfya district and has communicated that she has continued using the skill and has been orienting other providers.
Now MCHIP mentors have been receiving calls from Samfya inquiring and informing them of the progress there.

5. Best Practices Strong leadership and ownership by Mansa DHO
Involvement and collaboration of many district partners – DHO, PHO, Mansa GH, ZPCT II, ZISSP and UNFPA
Use of anatomic models for on-site clinical simulations
While monthly mentorship may not be able to be sustained post-SMGL, the intensive nature of the mentorship is building a strong & diverse base of mentoring skills within the district, which can be drawn upon in the future. There is also now a strong base of EmONC knowledge and skills among Mansa District providers.

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