Quality of patient care and provider experiences are intrinsically linked. Provider stress and burnout intensify biases that impact patients and lead to poor patient experiences

Patience Afulani and team tested an intervention to address provider stress and bias in Migori County, Kenya. The CPIPE intervention offers a unique approach integrating multiple strategies to improve healthcare provider experiences and reduce the effects of implicit and explicit bias in health care provision.

CPIPE leverages five strategies:

1. Training. Presentations and interactive sessions with refreshers on person-centered maternity care, coping with stress and burnout, mindfulness, bias awareness, dealing with difficult situations, teamwork and communication.
2. Peer support groups. Group peer support to discuss challenges, brainstorm solutions and support each other.
3. Mentorship. Mentor-mentee relationships to coach junior providers on professional development, work-life balance, clinical skills, career advancement and other relevant topics.
4. Champions. Champions to lead peer support groups and refresher trainings and serve as role models.
5. Leadership engagement. Engagement of county leadership to advise on intervention areas including training format, content, length and composition, with regular updates and discussion of systemic gaps that impact provider stress and bias.

The pilot of the CPIPE intervention in Health facilities in Migori County, Kenya, resulted in:

• Increased provider knowledge and competency in managing stress and mitigating bias.
• Decreased stress, burnout, and explicit bias levels.
• Increased accountability to address bias and advocacy to address sources of stress.
• Increased provision of person-centered maternity care.
• Improved relationships among providers and between providers and patients, leading to a supportive work environment.