Development and implementation of clinical mentorship in Rwanda: successes and challenges
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Rwanda has prioritized the decentralization and integration of HIV services over the past decade to ensure universal access to HIV services throughout the nation. Improving the capacity of healthcare providers to provide high-quality HIV prevention and treatment services was a crucial component of this process. In partnership with the authors, Rwanda’s national health implementation agency developed a national clinical mentorship program from 2011 to 2017 to facilitate this transition. The Rwanda Clinical Mentorship Model aims to effectively manage HIV-infected patients across all levels of healthcare delivery, implement task shifting, and adhere to national guidelines. The clinical care of HIV-positive individuals was transferred from HIV specialists to family physicians and nurses. The facility team was trained, supervised, and mentored by a multidisciplinary team. Mentorship consisted of routine site visits during which clinical case reviews, clinical supervision teaching, and data reviews were conducted to assess the facility’s performance and identify obstacles. Between 2012 and 2020, 5,774 healthcare professionals across the country received HIV testing and treatment training. This clinical mentoring has demonstrated a pragmatic, data-driven, and enduring strategy for enhancing clinical practice at all levels of care. A dedicated cadre of mentors is required to ensure the coordination and sustainability of this approach, according to one finding. The authors participated in accelerating the geographic and scope expansion of clinical mentoring in Rwanda. Developing a sustainable HIV clinical mentorship program in Rwanda requires longterm partnerships and evolving technical assistance.
Gupta A, Juneja S, Vitoria M, Habiyambere V, Nguimfack BD, Doherty M, et al. Projected Uptake of New Antiretroviral (ARV) Medicines in Adults in Low- and Middle-Income Countries: A Forecast Analysis 2015-2025. PLoS One. 2016;11:1–18.
Kharsany ABM, Karim QA. HIV Infection and AIDS in Sub-Saharan Africa: Current Status, Challenges and Opportunities. Open AIDS J. 2016;10:34–48.
World Health Organization, UNAIDS. Treating 3 Million by 2005: Making it happen. Geneva, Switzerland; 2003.
World Health Organization. Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: Recommendations for a Public Health Approach. Geneva, Switzerland; 2016.
Ministry of Health Rwanda, Centers for Disease Control and Prevention (CDC), ICAP at Columbia University. Rwanda Population-based HIV Impact Assessment (RPHIA) 2018-2019: Summary Report. Kigali, Rwanda, Atlanta, Georgia and New York, New York, USA; 2020 Feb.
Prouty AM, Helmeke KB, Fischer J. Development of the “Mentorship in Clinical Training Scale” (MiCTS). Contemp Fam Ther. 2016;38:140–58.
Stockton MA, Giger K, Nyblade L. A scoping review of the role of HIV-related stigma and discrimination in noncommunicable disease care. PLoS One. 2018;13.
Ikeda D, Srithanaviboonchai K, Nyblade L, Agins B. Applying Structured Quality Improvement Methods to Reduce HIV-related Stigma and Discrimination in Healthcare Facilities: Implementation of the Southeast Asia Stigma Reduction Learning Network. Int J Qual Heal Care. 2018;30:19–20.
Copyright (c) 2023 the Authors
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.