Effective supervision model for improved primary healthcare services: case of Egypt.

ABSTRACT

BACKGROUND: In Egypt, primary healthcare workers (PHCWs) often work in challenging situations and in relative isolation from the health system and specialists' experiences. Supervision is currently applied by PHCWs to present practice, control and upgrade knowledge and skills. OBJECTIVES: To assess the current supervision system in the Ministry of Health and Population (MOHP) at the central, governorate, district, and primary healthcare (PHC) facility levels. METHODS: The research setting is the MOHP-PHC head quarter (HQ) and five governorates. DESIGN: Cross-sectional analytical observational health system research qualitative and quantitative study of Egyptian health service and operations. SAMPLING The multistage sampling technique was used to select districts (n = 25) units (n = 250), physicians (n = 250), and nurses (n = 250) from five randomly selected governorates that represent four Egypt regions. DATA COLLECTION Focus group discussions (FGDs) and self-administered questionnaires. RESULTS: Response rate to questionnaires were in total 73% (67% for physicians and 80% for nurses). FGDs demonstrated that PHC has an effective supervision system at central, governorate, and district levels. The effective supervision allowed overcoming barriers related to the shortage in PHCWs needed to cover 5364 PHC units in addition to mobile clinics. Supervisors use a standardized consistent checklist covering all items of service delivery. More than 95% of physicians and nurses appreciated receiving on-the-job training from the district supervisory teams. CONCLUSION: Egypt MOHP-PHC has an effective supervision model in place at the central, governorate and district levels that supports continuous communication between PHC facilities' staff and the health system enabling continuous personal and professional upgrade and development and improved problem-solving skills at the facility level.