Digital-based supportive supervision for newborn care providers

The intervention will be applied at cluster (district hospital) level. The intervention includes repeated self-practice by providers augmented with mobile phone-based supportive supervision by facilitators. Self-practice will be repeated once per month for both management of breathing and non-breathing babies. Both intervention and control arms will receive an initial refresher Early Essential Newborn Care (EENC) coaching session at each of the district hospitals. The refresher coaching session will be provided by provincial facilitators. It is a one-day session that includes inductive lectures, hands-on practice and knowledge and skill assessments on management of breathing and non-breathing babies. Standardised assessments of provider knowledge and skills will be conducted before and after the coaching sessions. Intervention arm: The intervention group will receive: ·After the initial one-day coaching, we will conduct a one-day workshop involving providers and representatives of the Board of Directors from that district hospital. Providers will practice taking and sending videos via a new WhatsApp group using their mobile phones. A data management system that is now under development may be attached to WhatsApp to manage the data exchanged between providers and facilitators. A protocol for the data management system development is separately developed and submitted to ethics committees. We will also discuss and agree on strategies for continuing the intervention by reviewing facilitators and barriers using the pCAT (pragmatic context assessment tool) checklist. We will then assign at least one person to monitor the implementation status at each district hospital. ·Providers in the intervention arm will conduct bi-weekly simulation-based self-practising on essential newborn care (once in a month each for management of breathing and non-breathing baby) alongside their clinical duties. They will also be encouraged to send videos of their performance during practice sessions to provincial facilitators bi-weekly, using the Social Network Service (SNS). ·We expect at least two videos per provider per month period will be sent to provincial facilitators. ·Provincial facilitators will review the videos and send feedback on how to handle newborns based on the EENC guidelines via the group SNS. ·As central facilitators are also members of this group, they can also provide individual feedback to the provincial facilitators regarding the comments they provided to district staff. We anticipate this will help provincial facilitators to improve their supervisory and feedback skills. ·The self-practise supported by the mobile phone-based supervision will continue for 12 months.