In November 2024, Liam Barford, Operations Manager for Women’s and Children’s Services, and Dr Ivilina Pandeva, Consultant Gynaecologist and Subspecialist Urogynaecologist at Cambridge University Hospitals NHS Foundation Trust (CUH), visited Kakamega, Kenya, to co-deliver continuous quality improvement (QI) training as part of the Global Health Workforce Programme.
The quality improvement aspect of the programme is focused on the delivery of maternity and newborn care at Kakamega Country Referral and Teaching Hospital and Malava Sub- County Hospital, as well as on the management of emergencies within maternity and neonatal care. The programme is part of the broader work of the Kakamega – Cambridge Health Partnership that is addressing high rates of antimicrobial resistance in Kenya with a particular focus on maternal and neonatal care.
The project involves QI fundamentals training with staff, as well as ‘train the trainer’ courses. This is to enable coaches in Kakamega to share the learning and methodology across the local healthcare system, train more people to deliver the QI training, and establish a sustainable QI environment within the local healthcare system. This approach benefits multiple sites and achieves long-lasting knowledge transfer in a relatively short period of time.
During their week-long visit, Liam and Ivilina co-delivered in-person and virtual QI fundamentals training to staff at Malava Sub-County Hospital, drawing on their experience of quality improvement and QI coaching at CUH. Training was delivered to three groups of 20 to 30 healthcare staff across two hospitals, and to 32 QI coaches.
“We came in acknowledging that the Kenyan staff already have a lot of experience, and we were there to guide them, not to tell them what to do,” explains Ivilina. “They already have a wealth of knowledge and expertise in quality improvement and have completed many projects. Our role was simply to provide them with the tools, help them practice those tools, and show them how to pass that knowledge on to become coaches and how to streamline those efforts moving forward.”
Working with the Kakamega partners they established a core group of three individuals who will be able to deliver future face-to-face QI fundamentals training. This ‘train the trainer’ aspect of the programme will have the most significant impact as it means the training can continue to be delivered within the local healthcare system, contributing to the ongoing improvement of maternity and neonatal care for people in Kakamega County.
We came in acknowledging that they already have a lot of experience, and we were there to guide them, not to tell them what to do. Our role was simply to provide them with the tools, help them practice those tools, and show them how to pass that knowledge on to become coaches and how to streamline those efforts moving forward.
Liam and Ivilina’s visit to Kakamega was a rewarding experience, though it came with its fair share of challenges. One of the key difficulties they encountered was the reality of delivering healthcare in a setting with significantly limited resources. Additionally, periodic power outages disrupted some of the face-to-face training sessions. However, these challenges were managed through flexible training approaches, adjusting activities within and between sessions, and incorporating more practical elements to ensure effective learning.
“The experience significantly improved my quality improvement coaching skills and gave me greater practical knowledge of delivering coaching and training in different healthcare environments,” explains Liam. “My confidence in delivering coaching across a broad range of professional groups has improved, as well as my ability to adapt coaching concepts to different scenarios,” he adds.
For both Liam and Ivilina, their involvement in the programme has given them a different perspective on global health, the drivers of health and why outcomes vary around the world. For both, they have a renewed appreciation for what they can offer in a global health setting. Ivilina is now fundraising to deliver another project in Kenya with CGHP focused on fistula prevention and the long-term health consequences women can develop as a result.
Interested in participating in global health but not sure where to begin? Find out about the support, advice and funding CGHP offers you or email us at info@cghp.org.uk.
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