title: An innovation for improving maternal, newborn and child health (MNCH) service delivery in Jigawa State, northern Nigeria: a qualitative study of stakeholders' perceptions about clinical mentoring.
abstract: BACKGROUND
  An effective capacity building process for healthcare workers is required for the delivery of quality health care services. Work-based training can be applied for the capacity building of health care workers while causing minimum disruption to service delivery within health facilities. In 2012, clinical mentoring was introduced into the Jigawa State Health System through collaboration between the Jigawa State Ministry of Health and the Partnership for Transforming Health Systems Phase 2 (PATHS2). This study evaluates the perceptions of different stakeholders about clinical mentoring as a strategy for improving maternal, newborn and child health service delivery in Jigawa State, northern Nigeria.
  
  
  METHODS
  Interviews were conducted in February 2013 with different stakeholders within Jigawa State in Northern Nigeria. There were semi-structured interviews with 33 mentored health care workers as well as the health facility departmental heads for Obstetrics and Pediatrics in the selected clinical mentoring health facilities. In-depth interviews were also conducted with the clinical mentors and two senior government health officials working within the Jigawa State Ministry of Health. The qualitative data were audio-recorded; transcribed and thematically analysed.
  
  
  RESULTS
  The study findings suggest that clinical mentoring improved service delivery within the clinical mentoring health facilities. Significant improvements in the professional capacity of mentored health workers were observed by clinical mentors, heads of departments and the mentored health workers. Best practices were introduced with the support of the clinical mentors such as appropriate baseline investigations for pediatric patients, the use of magnesium sulphate and misoprostol for the management of eclampsia and post-partum hemorrhage respectively. Government health officials indicate that clinical mentoring has led to more emphasis on the need for the provision of better quality health services.
  
  
  CONCLUSIONS
  Stakeholders report that the introduction of clinical mentoring into the Jigawa State health system gave rise to an improved capacity of the mentored health care workers to deliver better quality maternal, newborn and child health services. It is anticipated that with a scale up of clinical mentoring, health outcomes will also significantly improve across northern Nigeria.
authors: Abt Associates Nigeria, Partnership for Transforming Health Systems Phase 2, (PATHS2), Abuja, Nigeria. eokereke78@gmail.com.
authors: Ekechi
authors: E
authors: Okereke
authors: Department of Obstetrics and Gynaecology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria. jtukur@yahoo.com.
authors: Jamilu
authors: J
authors: Tukur
authors: Abt Associates Nigeria, Partnership for Transforming Health Systems Phase 2, (PATHS2), Abuja, Nigeria. a.aminu@paths2.org.
authors: Amina
authors: A
authors: Aminu
authors: Abt Associates Nigeria, Partnership for Transforming Health Systems Phase 2, (PATHS2), Abuja, Nigeria. damas_b@yahoo.fr.
authors: Jean
authors: J
authors: Butera
authors: Abt Associates Nigeria, Partnership for Transforming Health Systems Phase 2, (PATHS2), Abuja, Nigeria. drbelloim@gmail.com.
authors: Bello
authors: B
authors: Mohammed
authors: Abt Associates Nigeria, Partnership for Transforming Health Systems Phase 2, (PATHS2), Abuja, Nigeria. tankomustapha@yahoo.com.
authors: Mustapha
authors: M
authors: Tanko
authors: Abt Associates Nigeria, Partnership for Transforming Health Systems Phase 2, (PATHS2), Abuja, Nigeria. i.yisa@paths2.org.
authors: Ibrahim
authors: I
authors: Yisa
authors: Abt Associates Nigeria, Partnership for Transforming Health Systems Phase 2, (PATHS2), Abuja, Nigeria. b.obonyo@paths2.org.
authors: Benson
authors: B
authors: Obonyo
authors: Abt Associates Nigeria, Partnership for Transforming Health Systems Phase 2, (PATHS2), Abuja, Nigeria. m.egboh@paths2.org.
authors: Mike
authors: M
authors: Egboh
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D057191:Capacity Building / Q000458:organization & administration*; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002675:Child, Preschool; D002983:Clinical Competence; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D006282:Health Personnel / Q000193:education* / Q000523:psychology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008427:Maternal Health Services / Q000458:organization & administration*; D008611:Mentors; D008875:Middle Aged; D009549:Nigeria; D009936:Organizational Innovation; D009937:Organizational Objectives; D011247:Pregnancy; D036301:Qualitative Research; D011787:Quality of Health Care / Q000458:organization & administration*; D055815:Young Adult