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Table 1 SWOT analysis from needs assessment of Shinyanga Regional Referral Hospital

From: A case study on building capacity to improve clinical mentoring and maternal child health in rural Tanzania: the path to implementation

Strengths

Weakness

Organized, management team at both the hospital and district level

• Planned establishment of a birthing home to accommodate women living very far who want to deliver in the hospital

• Daily interprofessional ward rounds currently take place

• Hospital orientation in place for new nurse hires; 6-month process that functions like a new graduate internship program

• 3-year contract required by all new staff

• High demand for resources-human, structural and supplies

• Nationally, has some of the worst statistics related to maternal and infant mortality but trending improvements

• Partograph competency low

• Reinforcement of practical skills in neo-natal resuscitation; managing a patient with complex care issues

• Quality of care challenges due to HR staffing, recruitment, and retention issues

Change in nursing education (reduced time) found to affect quality of care provided by graduates; poor coordination with local facility to address needs

Opportunities

Threats

Patient Education to Improve Outcomes

• Provide educational sessions in key problem areas (e.g. nutrition, paternal care of the pregnant woman) for patients who are awaiting care in the wards or clinics

Long term operational improvement opportunities

Creating a conducive environment for students to learn since they are vital to assisting with delivery of care on units

Implement a clinical ladder program to improve internal career development opportunities and improve retention

• Establish a 3 month, short term volunteer program for internationally educated nurses & other healthcare providers

• Ability to measure long term impact of this training; whether this training will be able to make a difference given the severity of the nursing shortage and the volume of deliveries per month in the hospital

• Lack of digitized data for analysis to examine the impact of various organizational interventions or staffing changes on patient outcomes in the facility

• High staff turnover