Measuring the quality of supervisor-provider interactions in health care facilities in Zimbabwe

Abstract

The study concludes with recommendations to the Ministry of Health and Child Welfare on how the quality of supervision in Zimbabwe could be improved.

Mobile instant messaging for rural community health workers: a case from Malawi

“…The second aspect helped facilitators with continuous visualisation and problem solving beyond the geographical and temporal constraints of on-site visits, which are also common beyond the setting of this study [28]. The findings of this research indicate that through the use of MIM, supervisors and facilitators could trace developments in their groups more continuously and develop a more persistent problem-based support.…”

Supervising community health workers in low-income countries – a review of impact and implementation issues

“…In developing countries, the need for supervision was highlighted during the primary health care movement where remote workers were perceived as needing supervision to link them to the health system and to supplement their training. By the start of the decade, it was recognized that traditional supervision, emphasizing inspection and control of health workers, was not working and there was a move toward supportive or facilitative supervision focusing on providers’ needs and collaborative problem solving (15, 16). This move was influenced by the emergence of models of clinical supervision from high-income countries (17–25), which take varied theoretical and practical stances to supervision but have been criticized for failing to demonstrate how they can be practically applied (25, 26).…”

“…Despite the recognized role that supportive supervision can play in performance and motivation, numerous studies from a range of countries and programs have found that supervision often has low coverage; low administrative focus; is irregular, unsupportive, and demotivating; and lacks adequate training for supervisors and problem solving or feedback mechanisms for providers (11, 16, 27–32). For example, in a time-use study in Ghana, only 15% of workers reported feeling supported by their supervisor (33).…”

“…For example, in a time-use study in Ghana, only 15% of workers reported feeling supported by their supervisor (33). These shortcomings are caused by a range of issues including geographical, financial, human resource, and transport problems; lack of tools, coordination, skills, and training; competing responsibilities; poor motivation; and hierarchical systems based on a culture of top-down management and control rather than collaboration (16, 28, 30, 34–56). …”

Development and validation of the ExPRESS instrument for primary health care providers’ evaluation of external supervision

“…It was difficult to find appropriate items to evaluate the key concept of joint problem solving. At an advanced stage (step 16), a publication [31] provided an idea for how to add ‘solving problems jointly’ as a latent variable (a variable that may not be directly observed but may be indirectly measured through a set of observable items) in section A, using phrases such as ‘engaged me in’ and ‘involved me in’.…”