Friday, 8 July 2016

Collaborating to change behaviour in Mozambique

In this blog, Eleanor Bull, Health Psychologist, and Corina Mason, Trainee Health Psychologist, reflect on their recent experience working in partnership to change health worker practice at Beira Central Hospital, Mozambique. 

In 2016, as part of a new THET funded programme called the Change Exchange, health psychologists joined existing partnerships to help understand and change healthcare staff practice, helping to strengthen THET partnerships. As health psychology practitioners employed in NHS Grampian, we are fortunate to have broad roles in offering expertise in the complex task of changing health behaviour. Our practice includes patient interventions and research and training of professionals across prevention and self-management initiatives in public health and the acute sector.

Both of us had previously volunteered in Uganda, and were inspired by this fascinating programme. The cultural and personal learning opportunities from previous experience in Uganda had influenced our professional development. Following an article in ‘The Psychologist’ (the British Psychological Society monthly publication), we rushed to register our interest in working with a network of multi-disciplined professionals to improve the local health needs in a low income country.  The partnership approach particularly appealed to us as we observe in our daily practice the benefits of working in collaboration with our multi-disciplined colleagues.

From the outset, we were warmly welcomed into the partnership with great enthusiasm and interest from the fantastic team of health professionals at Ipswich Hospital and Beira Central hospital.  The partnership’s current aim is to improve patient safety through projects related to two key strands of work: medical equipment maintenance and medication safety. The Medical Director at Beira Central Hospital states, ‘this is important for us because hospital changes start in the mind of staff.’

Our role predominantly focuses on the complex strand of medication safety because the ideas being implemented by Beira Hospital professionals depend on changes in staff practice. Some initiatives include:

· adaptations to in-patient medication charts
· development and delivery of drug dosage calculation training
· availability of emergency drug boxes on each ward
During our visit to Beira Central hospital in June this year, we collected information from health professionals by conducting interviews, discussion groups and questionnaires with staff involved in implementing the new medication safety procedures. We observed drug dosage calculation training to understand its active ingredients, presented to Beira healthcare staff on the role of Health Psychology and the importance of behaviour in healthcare, and worked with our Ipswich partners to deliver training on antibiotic resistance.

Following data collection, we presented findings and recommendations based on health psychology to help the partners implement their excellent work. We were really pleased that health professionals in the partnership suggested our input to date has been valuable, as the Head of Nursing states,  ‘this is very good for all situations here (at the hospital) and is good that you made these observations as we are too busy to do this.’

This was an amazing and inspiring opportunity to develop our health psychology skills within a brilliant UK-African partnership. We are both incredibly grateful for this opportunity and particularly the invaluable help of our UK and Mozambican translators, as unfortunately our Portuguese still doesn’t stretch far beyond ‘Obrigado!’ We are now engaged in meetings on Skype and producing a report outlining our recommendations before a second planned visit in November to offer further help in changing staff practice.