Implementation of the caring for providers to improve patient experience (CPIPE) intervention in Migori County, Kenya: challenges, successes, and lessons

Key drivers of poor Person-Centered Maternal Care (PCMC)—respectful and responsive care—include provider stress and unconscious bias. The Caring for Providers to Improve Patient Experience (CPIPE) intervention, a 5-component intervention including provider training, peer support, mentorship, embedded champions, and leadership engagement, was successfully piloted over 6-months in two health facilities in Migori County. Didactic and interactive content to promote PCMC and address stress, burnout, difficult situations, and bias, was delivered during a 2-day training. Facility-based embedded champions then led monthly refreshers and facilitated peer support groups. Twenty-four mentors provided mentorship across various topics with paired mentees. We engaged facility and county leadership through a community advisory board (CAB). CPIPE increased provider awareness and commitment to avoid bias and provide PCMC to all women; increased awareness of techniques for managing stress and difficult situations; created a supportive workplace culture and facilitated advocacy with leadership to address sources of stress, provide mental health supports, and provide PCMC. Challenges included limited training time, hierarchical facility culture which hindered cross-cadre activities, varying levels of site engagement, competing demands, and leadership changes. CPIPE is an innovative and practical intervention which centers the experiences of the providers and the care of vulnerable women. The pilot success underscores the timeliness, relevance, and feasibility of similar interventions in resource-constrained settings. CPIPE advances the evidence base for interventions to improve patient and provider experiences of maternal care.