Page 99 - SAHCS HIVMed Journal Vol 20 No 1 2019

Page 3 of 6 Original Research

Results was an important means of jointly identifying areas in which

Mentoring as knowledge and skills transfer staff needed more support:
‘… mostly [mentors] come to check how we pack treatment and
The targeted mentoring programme focussed on supporting make sure that if over-stocking arrange the drugs so we use the
three main aspects of the South African Department of old ones first, and they come and check the data capturer …’
Health’s (DoH) antiretroviral therapy (ART) scale up. (Deputy facility manager 2, Johannesburg)
These were: NIMART, pharmacy management and data ‘They do the stock checks of ARVs and the other stock. They also
management. The mentoring programme adopted a two- available on the phone to help with stock control. [Name] helps to
stage approach, which we classified as proactive and reactive ensure the stock in the pharmacy is arranged logically.’
mentoring. 14 (Pharmacist 1, Winelands)
‘We get support from [the implementing agency]. When they come
Proactive mentoring and check the computers and check the data and check the data
is clear.’ (Data capturer 1, Johannesburg)
Proactive mentoring involved scheduled visits to health
facilities by mentors. During these visits, several activities While proactive mentoring was generally appreciated by
took place, which were noted as important by the DoH the DoH staff, for the mentoring programme to operate
staff. For professional nurses being trained to initiate ART, successfully in this role, clear interpersonal communication
an important feature of the mentoring visits was having and relationship management on the part of the mentors
nurse-mentors accompany them during consultations with were critical. Where these factors were perceived to be absent,
patients. In this role, mentors were able to provide bridging the DoH staff found the programme less useful:
support between off-site training courses and the actual ‘You just see them here and they say they here for support visit
implementation of the skills learnt on these courses. This was but there is no programme around their visits as we don’t know
particularly important because initiating and managing ART when they are coming and cannot plan around it. They just
was a significant increase in nurses’ responsibilities in the come and you might not be ready for them and therefore the
context of HIV treatment and care: visit does not become fruitful. If we knew when they were
coming then we could plan the problems we are having.’
‘I think the mentoring system is good and it is needed … ART (Facility manager 1, Limpopo)
initiation is difficult so the mentoring has helped.’ (Nurse 1,
Johannesburg) ‘They don’t consult with me and that is one of the challenges.’
(Facility manager 1, Johannesburg)
Supporting nurses in learning to initiate ART, and to ‘They have not told us that they are not capturing the data
manage the care of patients on ART, was a critical feature of anymore.’ (Data capturer 2, Johannesburg)
participants’ discussions about the role of the mentoring
programme, and several participants discussed the A further challenge in terms of proactive mentoring occurred
knowledge they had gained through the training and when implementing agency staff took on a direct service
mentoring process as empowering them to take on a more delivery role, and in doing so prevented the DoH staff from
active role in treating HIV-positive patients required by the applying their training. A participant in the Winelands, for
NIMART programme: example, reported that the nurse mentor tended to do the
clinical work herself, rather than allowing her mentees to
‘… before I was scared of patients who had HIV/AIDS, I was practice and gain experience:
scared and immediately after I was trained I had power and now
I can do it and even critically ill patients are living healthy lives.’ ‘[Name] does the work but does not explain what she is doing …
(Deputy facility manager 1, Limpopo) she does more clinical work than a mentor should do.’ (Facility
manager 3, Winelands)
Several participants also discussed support from the
implementing agency in terms of their mentors’ roles in Reactive mentoring
assessing and evaluating their practice. In this context, the A second theme highlighted from study participants’
mentors’ presence facilitated the application of the skills discussion around the mentoring programme related to
learnt through NIMART training: mentors’ roles as problem solvers and sources of on-demand
14
‘And [mentors] come for mentoring us for treatment and support. We termed this reactive mentoring. To facilitate
checking if we have difficulties. If I have a patient and want to this, mentors provided mentees with their contact information
initiate and I am taking the baseline to find the patient is in bad to enable them to ask for assistance as and when they needed
condition they check if we are coping.’ (Nurse 3, Limpopo) it. This aspect of the mentoring programme was important as
an enabling mechanism for participants, particularly for
The mentors’ roles in assessing participants’ progress was nurses who were beginning to initiate and manage patients
also discussed by pharmacists, pharmacy assistants and data on ART:
staff as an important aspect of the mentoring programme. ‘… we phone if we have problems and when they come there are
In assessing the application of knowledge and skills, the issues we ask them and they come frequently and help us with
mentors created a platform from which to provide ongoing problems and how do we deal with it.’ (Facility manager 4,
training and support to these staff. This process of ‘checking’ Johannesburg)

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