On the Horizon for the Hope Initiative
The Hope Initiative was developed in Rwanda by TIP Global Health to understand the influence of hopefulness among nurses and mothers in rural health centers of Rwanda on quality of care, behavior change, and sustained improvements in health outcomes. We began our research, “Inspiring Hope to Improve Maternal and Child Health Outcomes” by identifying the appropriate instrument to measure hopefulness and ensure validity, reliability and psychometric factor consistency in the Rwandan context. This Herth Hope Index-Kinyarwanda was published in the Health and Quality of Life Outcomes Journal. The three psychometric factors of hope – interconnectedness, readiness for change, and future orientation – were used to develop a framework for our mixed methods research that involved the analysis of the drivers of hope among frontline health workers, pregnant and breastfeeding women in Rwanda. A manuscript of our findings is currently under development.
This research affirmed that maternal hope is a critical driver of maternal engagement in care. There is strong agreement among both frontline health workers and mothers that it is the responsibility of frontline health workers to inspire hope among mothers to promote maternal engagement in care and adoption of care recommendations. Additionally, there is strong agreement that the ability of frontline health workers to inspire hope among mothers is dependent upon their own level of hope; and that it is the responsibility of the health system to provide an enabling environment that promotes hopefulness among health workers.
With guidance from the TWCF Global Innovations for Character Development (GICD) platform, we are validating a Quality-of-Care evaluation toolkit that incorporates the factors that influence hope among mothers. This toolkit defines quality across five pillars – clinical skills, patient-centeredness, health education, data management, and logistics. Our team is validating a patient report instrument in Rwanda to evaluate components of care needed to inspire hope that cannot be captured through observational checklists or data extraction from electronic medical record systems.
To better articulate the factors that influence hope among frontline health workers, we are also working on a System of Hope toolkit that evaluates a health system’s performance in terms of inspiring hope among frontline health workers. TIP Global Health has created an intervention catalog that outlines evidence-based interventions that can influence various themes and subthemes of hope among healthcare workers. Health systems will be able to evaluate their performance and choose interventions to address gaps that are identified.
TIP Global Health hopes that our research will elevate the importance of hopefulness in promoting responsive and resilient health care systems that achieve lasting good health for all.
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