title: Nurse mentorship to improve the quality of health care delivery in rural Rwanda.
abstract: Quality of care at rural health centers in Rwanda is often limited by gaps in individual nurses' knowledge and skills, as well as systems-level issues, such as supply and human resource management. Typically, nurse training is largely didactic and supervision infrequent. Partners In Health and the Rwandan Ministry of Health (MOH) collaborated to implement the nurse-focused Mentoring and Enhanced Supervision at Health Centers (MESH) program. Rwandan nurse-mentors trained in quality improvement and mentoring techniques were integrated into the MOH's district supervisory team to provide ongoing, on-site individual mentorship to health center nurses and to drive systems-level quality improvement activities. The program targeted 21 health centers in two rural districts and supported implementation of MOH evidence-based protocols. Initial results demonstrate significant improvement in a number of quality-of-care indicators. Emphasis on individual provider and systems-level issues, integration within MOH systems, and continuous monitoring efforts were instrumental to these early successes.
authors.affiliation: Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda. mangano2020@gmail.com
authors.forename: Manzi
authors.initials: M
authors.lastname: Anatole
authors.forename: Hema
authors.initials: H
authors.lastname: Magge
authors.forename: Vanessa
authors.initials: V
authors.lastname: Redditt
authors.forename: Adolphe
authors.initials: A
authors.lastname: Karamaga
authors.forename: Saleh
authors.initials: S
authors.lastname: Niyonzima
authors.forename: Peter
authors.initials: P
authors.lastname: Drobac
authors.forename: Joia S
authors.initials: JS
authors.lastname: Mukherjee
authors.forename: Joseph
authors.initials: J
authors.lastname: Ntaganira
authors.forename: Laetitia
authors.initials: L
authors.lastname: Nyirazinyoye
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Hirschhorn
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D004506:Education, Nursing / Q000458:organization & administration*; D006801:Humans; D008611:Mentors; D015397:Program Evaluation; D058996:Quality Improvement / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*; D012432:Rwanda