Page 101 - SAHCS HIVMed Journal Vol 20 No 1 2019

Page 5 of 6 Original Research

systems improved the overall impact of the mentoring research conducted on the role of psychosocial support for
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programme. Our findings suggest that health facility staff mentees in health system-related interventions in LMICs.
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value these broader approaches to mentoring that include More broadly, however, Eller et al. found that a ‘caring
non-clinical staff as they may facilitate an overall improvement personal relationship’ was an important aspect of effective
in services available to patients while simultaneously limiting mentoring relationships among nurses in the US, and the
constraints to the impact of clinical mentoring resulting from emotional support provided by mentors in other contexts has
administrative or pharmacy-related problems. However, been found to improve mentees’ self-efficacy and emotional
this approach does not address broader health system well-being. 18,19 Our findings support the value of the mentor-
management issues, which Edwards et al. suggest may further mentee relationship as a source of psychosocial support.
improve patient outcomes. 6 This suggests that the effectiveness of ART scale-up using
mentoring programmes could potentially be improved by
A second important attribute of the mentoring programme paying particular attention to the development of supportive
was the fact that the programme adopted a sequential relationships within these interventions.
proactive and reactive approach, which allowed mentors to
leverage real-world problems faced by health workers to There are some limitations to our study that may have
support their implementation of new knowledge and skills. affected our interpretation of the data. Firstly, our data only
The sequence of implementing the proactive and reactive included interviews with the DoH staff; as such it is possible
aspects of the programme directly affected the effectiveness that we would have reached different conclusions if interview
of mentoring. It was important that initial proactive data were available from mentors and other implementing
mentoring occurred to build trust and relationships between agency staff. Secondly, the authors are employed by the
mentors and mentees. Based on these relationships, health implementing agency, and while we made a conscious effort
workers were comfortable enough to ask for help (i.e. to to remain objective, it is possible that our interpretations of
initiate reactive mentoring) when they needed it. Where the data were skewed by our personal investment in the
mentors did not build relationships with mentees sufficiently, mentoring programme.
there appeared to be less willingness to ask for support.
The development of trusting relationships between mentors
and mentees as a prerequisite for successful mentoring In spite of these limitations, this study is among the first to
examine the role of mentoring in strengthening HIV and TB
relationships is a common finding in the mentoring programmes in South Africa. By identifying key factors
literature. 3,16,17,18 In the context of HSS in SSA, Edwards et al.
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found that mutual trust between implementing agency and supporting and limiting the success of the mentoring
Mozambique DoH staff based on an open and collaborative programme, this study may provide important lessons for
relationship was a critical enabling factor supporting the the implementation of similar programmes elsewhere.
success of health management mentoring. The importance of
developing trusting mentoring relationships during proactive Conclusion
mentoring phases of programme implementation should Mentoring is a well-recognised and frequently used means of
therefore be emphasised to mentors during the preparatory providing technical assistance in health-related interventions
stages of these programmes. around the world. However, the likelihood of success
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of mentoring programmes depends on the dual role of
Finally, mentors played an important role in providing mentors as supporting the proactive and reactive transfer of
psychosocial support to nurse mentees in particular. knowledge and skills to mentees, while simultaneously
Psychosocial support was important because it helped nurses providing the psychosocial support necessary for mentees to
to develop the self-confidence to apply their NIMART training develop the confidence to apply these in practice. Where this
and to take responsibility for managing the ongoing care of balance in mentors’ dual role is successfully achieved,
patients on ART without direct supervision. There were mentoring is likely to be a powerful tool to improve healthcare
several ways in which the mentoring programme was able to globally.
provide this type of support. Simply having the knowledge
that mentors were available if they needed them enabled Acknowledgements
nurses to initiate patients onto ART without excessive anxiety
about managing side effects or complications. Mentors also The authors wish to thank Carmel Marock and Candice
played an important role in providing psychosocial support Harrison-Train for managing the data collection process.
by providing a means for nurses to deal with the stress of
managing patients on ART. Here, the personal relationships This study is made possible by the generous support of the
between mentors and mentees were critical, and several American people through the US President’s Emergency Plan
participants noted how important their mentors’ caring and for AIDS Relief (PEPFAR) through the United States Agency
supportive attitudes were in helping them to gain confidence for International Development (USAID) under Cooperative
in implementing their new skills and knowledge. Although Agreement number 674-A-12-00015 to the Anova Health
psychosocial support has long been recognised as a critical Institute. The contents are the responsibility of Anova Health
aspect of mentoring relationships, there is relatively little Institute and do not necessarily reflect the views of USAID

http://www.sajhivmed.org.za 94 Open Access