By: Michele Goergen
Recently in Northern Nigeria, the Tech RRT was deployed to help improve the quality of care in stabilization centers across Borno and Yobe states. Northern Nigeria has been in a state of violent conflict for the last few years, causing unprecedented movement of populations. The conflict has left a significant number of people with limited access to food. The onset of the lean season in June 2017 has impacted the situation negatively leading to increased rates of Severe Acute Malnutrition (SAM). This created a need to improve reach and quality of CMAM services, particularly services offering inpatient management of SAM with medical complications.
Stabilization Centers are inpatient treatment centers that treat malnourished children with complications. The children admitted into SC’s are the most sick and vulnerable. It’s often tricky for doctors working in stabilization centers as the treatment of common illnesses (anemia, dehydration, diarrhea, fever, malaria, etc.) is different for malnourished children than it is for well-nourished children. Because of this, doctors untrained in nutrition, often prescribe contraindicated treatments for malnourished children, putting their lives at increased risk.
In emergencies, it’s important to provide lifesaving treatment in the fastest most effective way possible. On-the-job coaching is an effective, low cost way of doing this as trained coaches can be sent to hard to reach areas and work with medical teams to ensure proper treatment of the most severely malnourished children.
There is a simple 4-step coaching model the Tech RRT used to train coaches in Northern Nigeria.
Following this model, coaches spend 2-3 days at each stabilization center. They work with the team daily, noting strengths and areas for improvements. They discuss these with the stabilization center teams, hospital administration and other key stakeholders to come up with workable solutions. Any gaps in capacity are addressed right then with the coach.
Some techniques used to build capacity with on the job coaching are:
- Group discussions: Finding workable solutions to problems
- Use of National Protocols and guidelines: Assign reading then discuss
- Creation of a tool: Have team create a poster with agreed upon policies and procedures
- Assisted changes: Help team complete a step of the plan
- Demonstrations: Show the team how to complete an action
- Field trips: To neighboring SC’s that are doing well
- Trainings: Send one person to a training and hold them responsible for training others upon their return
There are now two teams of trained coaches in Borno and Yobe States who are qualified to conduct on-the-job-coaching in existing and future SC’s to ensure quality of treatment and care.