Improving community health worker performance through supportive supervision: a randomised controlled implementation trial in Pakistan.
Acta Paediatr
; 107 Suppl 471: 63-71, 2018 12.
Article
en En
| MEDLINE
| ID: mdl-30570797
ABSTRACT
AIM:
To assess the effect of enhanced supportive supervision of lady health workers (LHWs) by lady health supervisors on integrated community case management of childhood pneumonia and diarrhoea.METHODS:
A total of thirty-four supervisors were randomly assigned to intervention and comparison arms. The intervention included enhanced training of supervisors on supervisory skills and written feedback to LHWs by supervisors. The performance of both cadres was assessed three times. Household surveys judged caregiver practices.RESULTS:
Intervention arm LHWs performed better than those in the comparison arm in assessing dehydration (92% [n = 25] vs 64% [n = 25]) and in classifying diarrhoea correctly (68% [n = 25] vs 40% [n = 25]). The two arms differed little in correct disease classification for pneumonia (44% [n = 25] vs 40% [n = 25]). Supervisory performance of intervention arm supervisors was better than that in the comparison arm in correcting the workers' clinical examination skills (64% [n = 25] vs 40% [n = 25]) and more frequent feedback. In the household survey, only 18% (n = 2182) intervention and 23% (n = 2197) comparison arm caregivers considered LHWs capable of providing diarrhoea and pneumonia care. Commodities for integrated community case management were not regularly available to workers.CONCLUSION:
Supportive supervision can improve community case management performance. Support through refresher training, logistics and commodities is essential.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Neumonía
/
Agentes Comunitarios de Salud
/
Diarrea
/
Rendimiento Laboral
Tipo de estudio:
Clinical_trials
/
Qualitative_research
/
Sysrev_observational_studies
Límite:
Adult
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Child, preschool
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Female
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Humans
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Infant
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Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
Acta Paediatr
Año:
2018
Tipo del documento:
Article
País de afiliación:
Pakistán