Assessment of the impact of mentorship/supportive supervision to support health care workers learning

INTERVENTION: Randomisation is based on the 4 geographical provinces in Sierra Leone (north, south, east and west). Each province is randomly allocated a number and 2 provinces randomly selected to either the control group (north and east province) or intervention group (south and west province). 250 health workers (in 7 districts) of the 500 trained receive mentoring/supportive supervision (intervention group) and 250 will not (control group). All participants in both the control and intervention group participate in seven two day training modules, evenly spaced over an eight month period. Participants in the control and intervention groups are asked to complete knowledge and skills tests immediately prior to and after each training module. The seven 2‐day RMNCAH modules based on the Sierra Leone basic package of essential health services (BPEHS) to improve reproductive, maternal, newborn, adolescent and child health (RMNCAH) services are antenatal care, care during labour and delivery, emergency obstetric and newborn care, postnatal care, family planning, adolescent sexual and reproductive health, and nutrition. Participants from the intervention group receive 10 mentorship visits over the same eight month period. Participants are asked to keep a diary of each visit to record number, duration, purpose, challenges, and practice developments at each visit. Mentors are asked to keep a log of all visits, including number of visits, duration, frequency, content and activities undertaken at each visit. Participants from both the control and intervention groups are asked to complete knowledge and skills tests on modules 1 and 2 at three and 6 six months post baseline (the date of the training module) to assess retention of knowledge and skills. Study participants in both study arms are reassessed at three and six‐month post training. At the three and six‐month reassessment points, all those who participated in the tests were then debriefed as a group, during which poorly perform CONDITION: In service training of primary health care workers providing maternal and newborn care in the clusters and centres included. ; Pregnancy and Childbirth ; Maternal and newborn care PRIMARY OUTCOME: Changes in Knowledge and skills are measured using the 7 pre and post training module test and the knowledge and skills retention tests at 3 and 6 months post baseline for modules 1 and 2 only. SECONDARY OUTCOME: 1. Number and frequency of supervision/mentoring sessions is measured using the log book kept by the mentor and diary kept by the participant at eight months; 2. Factors affecting retention of knowledge and skills is measured using both quantitative and qualitative data from the mentor log book and participant diary at 8 months (the end of the mentorship period); 3. Satisfaction of supervision measured using qualitative data from the mentor log book and participant diaries at 8 months; INCLUSION CRITERIA: 1. Health care providers of any gender and age who have attended the in ‐service capacity building training programme 2. District health management team supervisors working with health care providers at primary health care level in 4 provinces