Beyond the Clinical: Integrating Soft Skills at the Jacaranda Clinic

When we think of clinical skill building, the first things that come to mind are probably medical training, hands-on simulation, or research. Rarely does it occur to us that some of the most important skills for a provider go far beyond the clinical. At Jacaranda, we believe that safe and respectful maternity care is about more than direct medical service — it’s about taking the psychosocial background of each client into account, from partner support to financial means and family makeup. It’s about communicating to each client with patience, humility, and respect while attending to her medical needs.

With this in mind, this month we initiated a new type of training program for the Jacaranda clinic staff. We’re calling it “Soft Skills,” and it will center on the other stuff of clinical care, especially interpersonal capabilities and good customer service. It will also focus on productive communication, because we know that in order for Jacaranda to become a sustainable enterprise, clinic staff must be well trained on communicating the value of our services. Soft Skills will be a monthly session for all the clinic staff – from nurses and patient care assistants to janitors and cooks – and will incorporate active role playing and real-time feedback.

This past week, we held our first Soft Skills training session on customer service and how to talk about MamaKiba, our mobile phone-based pre-payment tool to help expectant mothers save for delivery. We’ll be sure to keep you updated on future trainings as we roll them out.

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Celebrating Mothers

Today is Mother’s Day. In honor of this special day, this week Save the Children released their 14th annual State of the World’s Mother report, which rates the best and worst places to give birth. Kenya came in 156th out of the 176 countries. If you’re reading this, chances are you know what this report means for women worldwide, and you know why it is important – particularly on Mother’s Day – to remember that mothers in most of the world struggle in vain to access quality, respectful maternity care.

This week, in the spirit of thanking our own mothers and paying tribute to the mothers who support and serve with us, we asked some of our colleagues at Jacaranda to share why mothers are important to them. Here are their words:

Kate, Midwife. One child, one on the way. One year at Jacaranda. 

As a mother, when I’m tired and I get home late, it’s like a new day when I see my children. It makes me respect my mother even more because I know she’s done this before me…

I’m proud to help mothers because they are the core of each family. The hardest thing we have to do as women is face is labor and delivery, and making that transition easier for women is something I’m proud of.

 

 

 

Evelyne, Clinical Manager. Four children. Three months at Jacaranda.

I love mothers because I know what I’ve gone through as a mother and I appreciate others who are doing the same. When you think of a mother carrying a baby in the womb and growing it until the time of delivery, you realize that in fact it’s a miracle. Mothers are a gift.

I’m happy to serve mothers at Jacaranda. Our clinic is very clean – you can’t even compare it other hospitals. Before, I was serving women with a lot of money at a large hospital, but there is a big difference in serving the women at Jacaranda. They really appreciate our care. They value the respect they get more than words can say.

 

 

Rachel, Patient Care Assistant. One child. One year at Jacaranda.

I’m proud to support mothers at Jacaranda first because I love babies – but also because I know that when you go to another maternity clinic, no one speaks kindly to you and no one recognizes you as important. I like working at a place where mothers are appreciated. When women come to Jacaranda, they feel good and they feel loved. They get respect, and they feel like they want to go back again. I am proud to offer counseling and education and take the time to know my clients.

When you give birth, you’re supposed to feel that you’ve done a great thing, like you’ve really accomplished something. I’m serving mothers to make that a reality.

 

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Where Respectful Maternity Care Begins

As featured on Maternal Health Task Force blog on April 8, 2013.

At Jacaranda Health, we are working to build a model of maternity care that is more respectful and mother-centered. In a health system where respect is not the norm, its contribution to quality of care cannot be understated. Respectful care for us has two components: patient-centered processes and a culture of empathy.

Many of our team members have first-hand experience with childbirth in Kenya, and these experiences are the foundation of a culture of empathy.  For example, Nyambura* chose to deliver her second child outdoors with a traditional birth attendant because the nearby public facility was unhygienic. Rahab*, on bed rest for the week before her delivery in a public hospital, watched mothers around her separated from their newborns and detained in the hospital until they could afford to pay for the delivery services.  Wanjiku* had a supportive nurse respect her decision to refuse an operation and helped her to turn and deliver the breech baby safely.

After listening to these personal experiences with maternity services, we asked our colleagues: so, what does respectful maternity care mean to you? A few of their responses:

‘It means your decision, as a woman, is respected.  You need to be given the right information; you need to be granted your privacy; and you need to be getting equal rights in terms of service delivery – it doesn’t matter who you are or where you come from.’ – Kathy, Nurse-in-Charge, Mobile Clinic

‘When there is a nurse there to fully support her, to walk her around, to rub her back, to give her food, to take the food back if she complains, then the client really feels respected and loved’ – Fridah, Maternity Hospital Janitor

‘You have to respect the client’s decisions, and respect the information they have come in with. You have to put yourself in their shoes and imagine who they are and where they are coming from. I explain the procedures again and again and again so they can understand if they didn’t understand the first time, to create a space where they can feel free to ask questions, to let them know that I, too, am learning from them.’ – Maria, Patient Care Assistant

‘A pregnant woman is not a sick woman. To me, it’s about customer service, not just about delivering the baby and moving on to the next, it’s about supporting the Mum, speaking kindly, reassuring them, holding her hand, just being there with her.’ – Dennis, Human Resources Manager

We see these sentiments reflected in interactions with clients, from the waiting room to the labor ward to postpartum visits. To us, this is where respectful maternity care begins.

*names have been changed to respect privacy

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Jacaranda Health and partner Population Council featured on BBC

We were excited to see Jacaranda’s maternity in Ruiru on the BBC.

In a story entitled “Can a phone replace the doctor in Kenya?”, BBC Click featured Baby Monitor, a project run by Population Council and carried out in partnership with Jacaranda’s nurses and maternity.

Baby Monitor is a mHealth innovation seeking to connect pregnant women in underserved areas to care via mobile phone, as many women in Kenya are more likely to have access to a mobile signal than to a health provider. Baby Monitor uses interactive voice response (IVR) technology to call expectant and postpartum mothers screening them for dangerous complications which lead to maternal and neonatal morbidity and mortality. As Baby Monitor is currently in the formative stages, researchers from the Population Council are conducting a study to refine systems and clinical screening protocols. The Population Council is collaborating with Jacaranda Health nurses to conduct in-person clinical assessments after participants complete mobile screening at crucial antenatal and postnatal time points. The nurses provide a gold standard of care that the phone system results can be measured against.

Keep an eye out for Jacaranda nurse Dorothy Njeru!

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First Baby Delivered!

On its first official day of being open for deliveries our maternity clinic delivered its first baby!  A beautiful baby girl was born on Sunday afternoon to a woman who started ANC with us in our Mwiki mobile clinic.  Two of our nurses, our clinical director, and several clinical and support staff were present and did a great job ensuring that everything went smoothly.

A lot of hard work and sacrifice went into making this day possible from everyone at Jacaranda Health.  Congratulations to all.

Now we are looking forward to our first baby boy…and many, many other happy and healthy babies who come into the world with help from our amazing team of professionals.

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