“I feel a sense of pride to introduce myself as the Nurse Mentor of CHC Akrabad, because a Nurse Mentor plays a very important role in enhancing the capacities of the labour room staff to effectively manage maternal and neonatal complications, ultimately saving lives of mothers and children.“
“After the introduction of the Nurse Mentoring Program, I have observed a positive change in the skills and practices of the labour room staff here. Earlier, women coming for delivery used to be taken to the labour room directly, but now, they are taken to the triage area first, where after a quick history taking, check-up and bedside tests, a decision is taken as to whether to shift the patient to the labour room or refer to a higher facility. Moreover, identification and follow up of high risk pregnancy women is now done more systematically.
I also got opportunities to build my competencies and in case of any queries, I consult the district team during the monthly district review meetings.”
Archana, Nurse Mentor
Block Akrabad, District Aligarh, Uttar Pradesh
In 2014, the Government of Uttar Pradesh (GoUP), with the support of the UP TSU, implemented by India Health Action Trust (IHAT), in partnership with the University of Manitoba, launched the Nurse Mentoring program in 25 high priority districts (HPDs) of the state. Based on the initial success of the program, GoUP scaled up the program across 820 blocks and 79 District Hospitals (DH). The government transitioned from the dedicated model to a nominated model of nurse mentoring at the block level. The Nurse Mentors were trained in Daksh, Dakshata and Mentoring Methodology1 modules. As an incentive for additional responsibilities, in addition to their routine labour room duties, they are provided with a monthly honorarium of ₹ 5000/-.
While the entire program has been transitioned to GoUP, UP TSU continues its support in strengthening the ongoing activities under the program across the state. Below is a photo story of the Nurse Mentoring Program in Aligarh District of Uttar Pradesh.
GoUP appointed eight Nurse Mentors for 12 blocks in Aligarh district between December 2017 and June 2018.
During the transition of the Nurse Mentoring Program from UP TSU to GoUP, UP TSU conducted meetings in July 2022 with the Additional Director (AD) – Health, Aligarh Division and Chief Medical Officer (CMO), Additional Chief Medical Officer (ACMO), District Project Manager (DPM) of Aligarh district and also with the Nurse Mentors of the district to understand the challenges they faced and to listen to their suggestions to improve the program. During these meetings, it was suggested that there was a need to re-orient the nurse mentors on their roles and responsibilities, including regularizing honorarium to the Nurse Mentors, along with filling up the vacant positions and thus streamlining the entire system.
UP TSU supported GoUP in the appointment of Nurse Mentors at the locations where the positions of Nurse Mentors were vacant and also accelerated the procurement of mannequins and other equipment as per the specification of the Mini Skill Lab Guideline. Further, UP TSU also oriented the Nurse Mentors on their roles and responsibilities and use of mannequins for mentoring activities. After the orientation, the Nurse Mentors started organizing labour room as per guidelines, filling cycle-wise LaQshya checklists, preparing the facility action plan, gap closure related to logistics, equipments, drugs, commodities, etc. and improving documentation in their respective facilities. Under the supervision of the CMO/ ACMO Reproductive and Child Health, supported by the District Program Manager (DPM), District Senior Specialist (DSS) and District Nursing Specialist (DNS), reviews of the activities of the nurse mentoring program were undertaken.
Capacity Building of the Staff Nurses and ANMs at the delivery points, along with continuous advocacy and follow-up, resulted in strengthening of the nurse mentoring program across the Aligarh District. The DPM and ACMO RCH visited some of the facilities along with the District Senior Specialist to review the ground level work done by the nurse mentors. Now, the ACMO and DPM are themselves are taking active interest in the program and following up with the nurse mentors for timely submission of honorarium formats for timely release of honorarium. The honorarium system also became functional and regularized, which added momentum to the work of labour room staff.
“The Nurse Mentoring Program has given me an opportunity to build my capacity as a Nurse Mentor. My knowledge and skills, especially in managing PPH, Eclampsia, sick newborn children have improved. Now I can observe considerable improvement in their knowledge, skills and practices. At the beginning of each rapid improvement cycle of two months, I check the competencies of the staff using OSCE tool and then mentor them accordingly. The gap identified along with plan for gap closure, quality of care, documentation, etc. is discussed during the quality circle meetings where all key members of the facility participate. The mannequins and equipment in the Mini Skill Labs aid us in experiential learning. Now, the CHC staff looks upto me for guidance and I feel respected.”
Meenu, Nurse Mentor
Block Jawan, District Aligarh, Uttar Pradesh
Building upon the learnings over the years, GoUP with the support of UP TSU, plans to establish a sustainable mechanism for nomination and attrition management of the Nurse Mentors. UP TSU will support the government in taking up the entire ownership of the program. A unified mentoring application will be rolled out which will provide a holistic information/updates on doctor as well nurse mentoring programs. This application will give information on the skills, practices and performance of doctors as well as nurses, thus providing an overall facility score to plan better.
1 It is NHM’s mandate that all nurse mentors receive three kinds of training – DAKSH and DAKSHATA Training based on clinical and technical competencies, and Mentoring methodology, based on principles of mentoring and quality improvement.
A Monitoring and Evaluation Unit was established within UP TSU, to support the Government of Uttar Pradesh to enhance the use of data for decision-making in terms of data availability, accessibility, quality and use for improved health outcomes. This brief captures the innovative approaches and interventions adopted by UP TSU in strengthening government data eco-system in Uttar Pradesh.
This issue provides an update on UP-TSU’s efforts in integrating the Gender e-module in SBA training, a feedback workshop with Government of Uttar Pradesh health officials by medical college RRTC faculty members and support Monitoring and Evaluation division of National Health Mission on capacity building workshop for State/Division/District officials to improve data-driven decision-making.