From Activity to Policy and Practice: Emergency Obstetric and Neonatal Care mentorship for healthcare providers in Kenya

Blog 16 May 2023


Irene Nyaoke, Senior Technical Officer - Liverpool School of Tropical Medicine (LSTM) Kenya
Martin Eyinda, Technical Officer – Liverpool School of Tropical Medicine (LSTM) Kenya
Onesmus Muchemi, Technical Officer – Liverpool School of Tropical Medicine (LSTM) Kenya
Lucy Nyaga, Country Director- Liverpool School of Tropical Medicine (LSTM) Kenya
Rael Mutai, Regional Technical Advisor- Liverpool School of Tropical Medicine (LSTM) Kenya
Fiona Dickinson, Post Doc Research Associate-Liverpool School of Tropical Medicine (LSTM) United Kingdom
Helen Allott, Senior Specialist - Liverpool School of Tropical Medicine (LSTM) United Kingdom
Charles Ameh, Professor Global Health, Head Emergency Obstetric and Quality of Care Unit, Liverpool School of Tropical Medicine (LSTM) United Kingdom.
Hellen Mutsi – Program Officer – Division of Reproductive & Maternal Health – Ministry of Health (Kenya)

The government of Kenya has committed to reduce maternal mortality ratio (MMR) from 362 deaths in 2014 to 113 deaths per 100,000 live births  by 2030 (Kenya Health Policy 2014 - 2030). Latest estimates show that the MMR is 355 deaths per 100,000  live births (KNBS, 2019), with  wide disparities across the counties. Emergency Obstetric and Neonatal Care (EmONC) has been identified by Government of Kenya as a high-impact intervention for reducing preventable maternal and perinatal mortality.

To contribute to reducing maternal and perinatal morbidity and mortality in Kenya (ICPD25_objective and commitment on zero preventable maternal and perinatal mortality), Liverpool School of Tropical Medicine (LSTM) implemented a four-year (2019-2023) Maternal and Newborn Health (MNH) programme, with support of the British government, through the UK Aid. The programme collaboratively institutionalised high-impact interventions (including EmONC mentorship) into national and county health systems, using cost-effective and efficient approaches.

Mentorship is a developmental relationship in which an individual with more experience in a particular field provides supportive guidance and support to someone with less experience and knowledge. In 2020, LSTM and other MNH partners supported a Ministry of Health-led process to develop a national EmONC training and mentorship package, which was launched and disseminated in 2022. LSTM’s experience and technical expertise in implementing EmONC mentorship in Kenya, contributed contextual insights to the national mentorship package. The package was piloted in five LSTM-supported counties (Garissa, Uasin Gishu, Vihiga, Kilifi and Taita Taveta) and comprises of two training manuals i.e., mentor and mentee (See Fig 1 below), as well as mentee logbooks and assessment materials.

Snapshot of National EmONC training and Mentorship Package (L- Mentee & R- Mentor manuals 2022)

The LSTM-supported MNH program, with funding from UKAID, contributed to the establishment of EmONC mentorship for frontline health care providers working in maternity units at 26 health facilities across 5 focal counties of Garissa, Vihiga, Uasin Gishu, Kilifi and Taita Taveta. Following EmONC training, mentors were identified at facility-level, trained and supported to mentor their colleagues using the National package.

Monthly trends of Health Care Providers’ attendance during EmONC mentorship (LSTM program)

Towards the end of LSTM program in March 2023, a two-day national Knowledge Management and Learning (KML) event, held in Nairobi (6th – 7th Mar 2023), highlighted best practices and lessons learnt from the program’s implementation. The event brought together national and county government stakeholders, other donors, researchers, medical regulatory and training institutions, professional associations, and MNH implementing partners. One sustainability measure in the program, which has been adopted by county health governments, is facility based EmONC mentorship for HCPs.

Speaking at the event, the national Ministry of Health (Division of Reproductive and Maternal Health - DRMH) presented plans to scale EmONC mentorship across all 47 counties in Kenya.

“As MoH we are championing retention of knowledge, skills and competencies through ongoing EmONC mentorship for HCPs, having a mentorship structure at National, County, subcounty and facility levels”. Hellen Mutsi, National MoH – DRMH

In collaboration with the British High Commission, LSTM appreciated various strategic partnerships by awarding certificates of recognition to: National MoH - Department of Family health,  Kenya Obstetrical and Gynaecological Society, University of Nairobi, Moi University, Nursing Council of Kenya, Kenya Medical training College, Clinical Officers’ Council, Midwives Association of Kenya, and County Health departments (and RH Coordinators) of Uasin Gishu, Vihiga, Garissa, Kilifi and Taita Taveta.

Sustainable partnership awards - MNH stakeholders receive certificates of recognition from LSTM and British High Commission at an Award giving ceremony during KML event (March 2023)

LSTM, through UK Aid funding for the MNH program in Kenya, has laid the foundations for the Activity of EmONC mentorship for HCPs in Kenya, contributed to Policy development of the National EmONC mentorship package, and supported counties and health facilities to demonstrate mentorship Practice in a Sustainable manner.