The Mentor Mothers Program in the Department of Defense in Nigeria: An Evaluation of Healthcare Workers, Mentor Mothers, and Patients' Experiences.
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SUBMITTER: Ibu JM
PROVIDER: S-EPMC8001623 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundIn HIV programs, mentor mothers (MMs) are women living with HIV who provide peer support for other women to navigate HIV care, especially in the prevention of mother-to-child transmission of HIV (PMTCT). Nigeria has significant PMTCT program gaps, and in this resource-constrained setting, lay health workers such as MMs serve as task shifting resources for formal healthcare workers and facility-community liaisons for their clients. However, challenging work conditions including tenuous working relationships with healthcare workers can reduce MMs' impact on PMTCT outcomes. This study explores the experiences and opinions of MMs with respect to their work conditions and relationships with healthcare workers.MethodsThis study was nested in the prospective two-arm Mother Mentor (MoMent) study, which evaluated structured peer support in PMTCT. Thirty-six out of the 38 MMs who were ever engaged in the MoMent study were interviewed in seven focus group discussions, which focused on MM workload and stipends, scope of work, and relationships with healthcare workers. English and English-translated Hausa-language transcripts were manually analyzed by theme and content in a grounded theory approach.ResultsBoth intervention and control-arm MMs reported positive and negative relationships with healthcare workers, modulated by individual healthcare worker and structural factors. Issues with facility-level scope of work, workplace hierarchy, exclusivism and stigma/discrimination from healthcare workers were discussed. MMs identified clarification, formalization, and health system integration of their roles and services as potential mitigations to tenuous relationships with healthcare workers and challenging working conditions.ConclusionsMMs function in multiple roles, as task shifting resources, lay community health workers, and peer counselors. MMs need a more formalized, well-defined niche that is fully integrated into the health system and is responsive to their needs. Additionally, the definition and formalization of MM roles have to take healthcare worker orientation, sensitization, and acceptability into consideration.Trial registrationClinicaltrials.gov number NCT01936753 , registered September 3, 2013.
| S-EPMC6131877 | biostudies-literature
Project description:BackgroundAdolescent maternal healthcare utilisation is low in Nigeria, and little is understood about the pregnancy experiences and drivers of maternal healthcare utilisation among of adolescent girls. This study investigated the pregnancy experiences and maternal healthcare utilisation among adolescent mothers across Nigeria.MethodsThe study used the qualitative design. Urban and rural communities in Ondo, Imo and Katsina states were selected as research sites. Fifty-five in-depth interviews were conducted with adolescent girls who were currently pregnant or had given birth to a child recently, and nineteen in-depth interviews were conducted with older women who were either mothers or guardians of adolescent mothers. Additionally, key informant interviews were conducted with five female community leaders and six senior health workers. The interviews were transcribed, and resulting textual data were analysed via framework thematic analysis using a semantic and deductive approach, with the aid of NVivo software.ResultsThe findings showed that the majority of unmarried participants had unintended pregnancies and stigma against pregnant adolescents was common. Social and financial support from family members, maternal support and influence, as well as healthcare preferences shaped by cultural and religious norms were the major drivers of maternal healthcare use among adolescent mothers, and the choice of their healthcare providers.ConclusionsInterventions to support adolescent mothers and increase maternal healthcare utilisation among them must focus on ensuring the provision of social and financial support for adolescent mothers, and should be culturally sensitive.
| S-EPMC10199580 | biostudies-literature
Project description:Rationale and Objective The ‘PEER-HD’ multicenter study tests the effectiveness of peer mentorship to reduce hospitalizations in patients receiving maintenance hemodialysis. In this study, we describe the feasibility, efficacy, and acceptability of the mentor training program. Study Design Educational program evaluation including the following aspects: (1) description of training content, (2) quantitative analysis of feasibility and acceptability of the program, and (3) quantitative pre-post analysis of efficacy of the training to impart knowledge and self-efficacy. Setting and Participants Data were collected using baseline clinical and sociodemographic questionnaires from mentor participants enrolled in Bronx, NY, and Nashville, TN, themselves receiving maintenance hemodialysis. Analytical Approach The outcome variables were the following: (1) feasibility measured by training module attendance and completion, (2) efficacy of the program to impart knowledge and self-efficacy measured by kidney knowledge and self-efficacy surveys, and (3) acceptability as measured by an 11-item survey of trainer performance and module content. Results The PEER-HD training program included 4 2-hour modules that covered topics including dialysis-specific knowledge and mentorship skills. Of the 16 mentor participants, 14 completed the training program. There was complete attendance to all training modules, though some patients required flexibility in scheduling and format. Performance on posttraining quizzes was consistent with high knowledge (mean scores ranged from 82.0%-90.0% correct). Mean dialysis-specific knowledge scores trended higher post training than at baseline though this difference was not statistically significant (90.0% vs 78.1%; P = 0.1). No change in mean self-efficacy scores was demonstrated from before to after training, among mentor participants (P = 0.2). Program evaluation assessments of acceptability were favorable [mean of all patient scores (0-4) within each module ranged from 3.43-3.93]. Limitations Small sample size. Conclusions The PEER-HD mentor training program required accommodation to patients’ schedules but was feasible. Participants rated the program favorably, and although the comparison of performance on knowledge assessments post- and pre-program showed uptake of knowledge, this was not statistically significant. Graphical abstract
| S-EPMC10149397 | biostudies-literature
Project description:ObjectivesThere is an increasing mental health disease burden in mothers with infants and young children, especially in low- and middle-income countries such as Nigeria. Children of distressed mothers suffer early-life exposure from the effects of maternal distress which contributes to the risk of physical and mental health problems in their childhood and beyond. This study explored mental health lived experiences of mothers in Jos, Nigeria.MethodsPurposive and Snowball sampling techniques were adopted, and a total of 40 mothers participated with 8 to 11 participants in one of the four focus group discussions. Participants were between the ages of 18 and 43 years, self-identified as mothers with each having a child between the ages of 3 and 48 months. Each focus group lasted approximately 60 minutes and was audio-recorded. Interviews were transcribed verbatim and analysed using interpretative phenomenological analysis.ResultsThree overarching themes emerged from the data set such as (1) experience of persisting psychological distress from the time of labour/birth; (2) cultural practices that influence feelings; and (3) anxiety due to limited knowledge about childcare, access to support and healthy food.ConclusionMaternal mental health in Nigeria is under-researched and distressed mothers have limited knowledge about evidence-based early child development. The study recommends developing and testing culturally appropriate parenting interventions in Jos, Nigeria. This is likely to be beneficial for the mother and may also improve child health outcomes.
| S-EPMC8040383 | biostudies-literature
Project description:BackgroundThe Coronavirus Disease 2019 (COVID-19) has severely challenged healthcare delivery systems worldwide. Healthcare Workers were unable to assess and manage the cases due to limited knowledge of treating the virus and inadequate infrastructure. Digital interventions played a crucial role in the training of healthcare workers to get through the pandemic. Project Extension for Community Healthcare Outcomes (ECHO) initiated the COVID-ECHO telementoring program for strengthening the knowledge and skills of healthcare workers. The study aimed at assessing the effects of the ECHO telementoring model in the capacity building of healthcare workers in the context of COVID-19 in India.MethodWe adopted a mixed-method approach with a parallel combination design. A quantitative survey was used to measure changes in the knowledge and self-efficacy among doctors and nurses. In-depth Interviews were used for qualitative exploration of perceptions and experiences of all the study participants. Student t-test and ANOVA were used to assess significant differences between mean scores across participant characteristics for different themes. Statistical significance was set at p < 0.05. In-depth Interviews were analyzed using Framework Analysis. The evaluation followed the first five levels of Moore's model.ResultsThe results highlighted the strengthening of knowledge and skills of healthcare workers in the assessment and management of COVID-19 after the ECHO training. Learning and performance ratings were high as 96% reported an increase in knowledge and 98% were able to apply it in their clinical practices. The key challenges identified were technical issues like internet connectivity and lack of interaction due to limited visual connection. The hybrid sessions, use of video camera, feedback mechanism, and inclusion of Continuing Medical Education were recommended by participants to improve the model.ConclusionsThe findings of this study are an important addition to the pre-existing literature supporting the replicability of the ECHO model in the upskilling of healthcare professionals working in underserved and remote areas, not only in the context of COVID-19 but also in other public health domains. To enhance the effectiveness of this ECHO model, the study findings may be used to refine the model and improve the areas of concern.
| S-EPMC9264289 | biostudies-literature
Project description:The Canada Prenatal Nutrition Program (CPNP) provides a variety of health and nutrition supports to vulnerable mothers and strongly promotes breastfeeding but does not have a formal framework for postnatal lactation support. Breastfeeding duration and exclusivity rates in Canada fall well below global recommendations, particularly among socially and economically vulnerable women. We aimed to explore CPNP participant experiences with breastfeeding and with a novel community lactation support program in Toronto, Canada that included access to certified lactation consultants and an electric breast pump, if needed. Four semistructured focus groups and 21 individual interviews (n = 46 women) were conducted between September and December 2017. Data were analysed using inductive thematic analysis. Study participants reported a strong desire to breastfeed but a lack of preparation for breastfeeding-associated challenges. Three main challenges were identified by study participants: physical (e.g., pain and low milk supply), practical (e.g., cost of breastfeeding support and maternal time pressures), and breastfeeding self-efficacy (e.g., concern about milk supply and conflicting information). Mothers reported that the free lactation support helped to address breastfeeding challenges. In their view, the key element of success with the new program was the in-home visit by the lactation consultant, who was highly skilled and provided care in a non-judgmental manner. They reported this support would have been otherwise unavailable due to cost or travel logistics. This study suggests value in exploring the addition of postnatal lactation support to the well-established national CPNP as a means to improve breastfeeding duration and exclusivity among vulnerable women.
| S-EPMC7296823 | biostudies-literature
Project description:Introduction:While residents must meet standardized educational milestones to graduate, individualized mentorship and guidance can help them achieve personal and career goals. A novel mentor, advisor, and coach (MAC) program was created for residents of the Yale University Traditional Internal Medicine Residency Program to help them attain these goals. Methods:Internal medicine faculty were recruited into the MAC program and matched with residents, with each faculty paired with one to three mentees. A structured roadmap was used to guide program content (including topics of mentoring, advising, and coaching), and meetings were individualized to cater to the needs of residents. During the 2017-2018 academic year, online surveys and focus groups were used to obtain feedback from participants. Results:Survey responses were obtained from 50 of the 116 residents (43%) and 21 of the 49 MAC faculty (43%). Thirteen residents and five MAC faculty participated in in-person focus groups. Most participants (92% of interns, 83% of residents, and 95% of MAC faculty) felt the program was beneficial and should continue. Individualized relationships and meeting content were key to the program's success. Areas for improvement included clarification of the program's purpose and each party's responsibilities in scheduling meetings. MAC faculty also requested faculty development tools to help them meet expectations of being a MAC. Discussion:The MAC program provided a successful avenue for mentorship and guidance for residents. Central themes to enhance participants' experience were individualization and flexibility, mutual agreement of the ground rules, and enhanced communication from program leadership.
| S-EPMC7666835 | biostudies-literature
Project description:BackgroundAdolescents should have access to high quality and responsive sexual and reproductive health, however, it is unclear to what extent the national policy on health and development of adolescent is implemented by health care workers in Plateau State. This study assessed the general availability of sexual and reproductive health services, the delivery of responsive adolescent sexual and reproductive health services and health care worker?s understanding of what constitutes adolescent responsive sexual and reproductive health services.MethodsUsing a cross sectional design, we interviewed 409 health care workers selected through a multistage sampling technique, across six Local Government Areas of Plateau State, Nigeria using an interviewer-administered survey questionnaire.ResultsThe most available sexual and reproductive health services was antenatal and delivery care (69.2%), contraception 25.9% and 14.9% reported post abortion care. Only 1.2% indicated the availability of the four recommended essential sexual and reproductive health services (counselling/information provision, provision of contraceptives, testing/treatment for sexually transmitted infection (STI) /HIV and post abortion care) in their facilities. Little over half (58.4%) felt their facilities were adequate in meeting the sexual and reproductive health needs of adolescent and this was associated with delivery of post abortion care (AOR=3.612; CI=1.886-6.917; p = .001) and providing sexual and reproductive health services to adolescents without parental consent (AOR=3.612; CI=1.886-6.917; p = .001). Most health care workers had poor understanding of adolescent responsiveness of sexual and reproductive health services, understanding better among health workers who provided services without parental consent and in a separate room for privacy and confidentiality.ConclusionWe conclude that adolescent sexual and reproductive health services is not yet as stipulated in the national policy in Plateau State, Nigeria and in general, health workers have poor understanding of what it means to provide adolescent-responsive services.
| S-EPMC10040103 | biostudies-literature
Project description:BackgroundSevere acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection is a global pandemic. Healthcare workers' (HCWs) role in patient management is predisposing and can serve as means of hospitals and community transmission. This study evaluated HCWs' knowledge, attitude, and practice towards COVID-19 in Nigeria.Methodswe carried out a cross-sectional survey among HCWs during the COVID-19 outbreak in Nigeria from March to June 2020. The study assessed 346 HCWs for Knowledge, attitude, and practice by using an online (Google form) self-administered questionnaire, based on a convinience sampling technique Data were retrieved and analyzed using descriptive statistics. Chi-Square and one-way ANOVA were used to measure association and difference among demographic variables. The relationship between knowledge, attitude, and practice was measured using Spearman's rho correlation test.Resultsthe mean knowledge score of the HCWs was 7.1 on a scale of 0-8. The correct overall rate of the knowledge questionnaire was 88.75%. Knowledge was gained mainly from television (35.0%) and social media (35.0%). The mean attitude score on a scale of 0-6 was 5.31 ± 0.39. Most (92.5%) participants were confident that Nigerian medical scientists would win the war against COVID-19. The majority (92.2%) of the respondents thought that SARS-CoV-2 was not a biological weapon. About 1 out of 5 respondents held that faith healing or prayer is the only cure for COVID-19. A vast majority of the HCWs were taking precautionary measures such as avoiding crowded places (94.2%), washing of hands (96.0%), and the use of personal protective equipment (91.6%) against SARS-CoV-2 infection. Nevertheless, only 3 out of 5 HCWs used a face mask when leaving home. There was a significant (p = 0.046) positive correlation (0.584) between knowledge and attitude.Conclusionour results showed that HCWs in Nigeria had excellent knowledge and possessed a positive attitude and good practice towards COVID-19. However; there were areas where poor knowledge, negative attitudes and unacceptable practices were observed. We recommend continuous public health education of HCWs on SARS-COV-2 infection control and prevention.
| S-EPMC7673666 | biostudies-literature
Project description:Healthcare workers (HCWs) face an unprecedented higher risk of COVID-19 infection due to their work and exposure. In this study, we aim to examine the associated risk factors for COVID-19 infection among HCWs in North-East Nigeria. We used data collected retrospectively among a cohort of clinical and non-clinical HCWs in six healthcare facilities in Adamawa State, Nigeria. We estimated the marginal probability of COVID-19 infection among HWCs using alternating logistic regression via the generalized estimating equations (GEE) approach. Among the 318 HCWs, 178 (55.97%) were males, mean (±SD) age was 36.81 (±8.98), 237 (74.76%) were clinical, and 80 (25.24) were non-clinical staff. The overall prevalence of COVID-19 was 16.67% among HCWs. After adjusting for other variables in the model, our results showed that clinical staff had a 5-fold higher risk of COVID-19 infection than non-clinical staff (aOR = 5.07, 95% CI: 1.32-19.52). Moreover, significant exposure risk factors for COVID-19 infection for HCWs increase with age, time spent attending to patients, caring for COVID-19 patients, and having worked with COVID-19 samples, while the risk decreases with the use of an N95 mask. Our findings suggested that the burden of COVID-19 infection is higher for clinical staff than non-clinical staff, and increasing age contributed to the increased risk.
| S-EPMC9601610 | biostudies-literature