Coaching Health Workers to Maximize Performance
Health workers strive to achieve high performance in the same way professionals do in many fields – gain knowledge through study and refine skills through practice. Ongoing coaching is also often needed to achieve peak performance. Most health systems, however, deploy health workers to the field with little further mentorship to help them hone their skills and execute at their best.
Since December 2013, our team from the Earth Institute and Columbia Global Center South Asia has worked with SVS Medical College and Mahbubnagar district in Telangana state in India to pilot a program for coaching health workers. Mahbubnagar is one of the poorest districts in southern India with about 4 million people including a high concentration of marginalized groups. In May 2014, the district leadership announced plans to scale up the coaching program based on the success of the pilot. At the same time, this model has caught the attention of health officials in Rajasthan, a state in northern India of about 70 million people, where discussions are underway to implement a similar coaching approach in 6 high-burden districts in partnership with UNFPA, Earth Institute/Columbia Global Center South Asia, and others.
In the Mahbubnagar pilot, nurse-trainers from SVS Medical College served as health worker ‘coaches’ and regularly rotated through health facilities, spending up to three days during each visit. They gauged the performance of health workers and provided customized training through lectures, hands-on demonstrations, and mentored practice. The coaches provided routine follow-up and conducted periodic unannounced spot-checks.
In the six-month evaluation, health workers demonstrated a nearly 100% improvement in knowledge and practical skills in core areas including newborn resuscitation, care of high-risk infants, and the management of complications during childbirth. Health workers also reported increased confidence in performing these interventions and expressed a preference for the on-site coaching approach.
Coaching health workers can generate the same gains that coaching does in other fields. Determining how this type of model can be applied effectively in health systems at scale can be an important way to help health workers perform at their best.