Human Resources for Health in Maternal, Neonatal and - HRH ...
Human Resources for Health in Maternal, Neonatal and - HRH ...
Human Resources for Health in Maternal, Neonatal and - HRH ...
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
eceived from outside the rout<strong>in</strong>e public health system, such as from NGOs or<br />
community groups,<br />
monitored through a system that holds supervisors <strong>and</strong> those above them responsible<br />
<strong>and</strong> accountable (Intra<strong>Health</strong> 2008).<br />
The connection to education <strong>and</strong> tra<strong>in</strong><strong>in</strong>g is also reported by other studies. The comb<strong>in</strong>ation<br />
of on the job tra<strong>in</strong><strong>in</strong>g <strong>and</strong> supervision has been found to improve the confidence <strong>and</strong> ma<strong>in</strong>ta<strong>in</strong><br />
the skills of auxiliary nurse midwives <strong>in</strong> a Prime II project <strong>in</strong> India (Intra<strong>Health</strong> 2001) <strong>and</strong><br />
CHWs engaged <strong>in</strong> a child health project <strong>in</strong> rural Boliva (Charleston 1994). In crisis contexts<br />
harness<strong>in</strong>g opportunities <strong>for</strong> supervisory activities <strong>in</strong>clude staff meet<strong>in</strong>gs, observations <strong>and</strong><br />
field visits, one-on-one meet<strong>in</strong>gs, <strong>and</strong> group supervision (Ehrlich 2004). In Samoa<br />
supervision is promoted by l<strong>in</strong>k<strong>in</strong>g it to accreditation required <strong>for</strong> all PHC health staff, so<br />
there is a strong imperative to be <strong>in</strong>volved <strong>in</strong> <strong>in</strong>-service tra<strong>in</strong><strong>in</strong>g (Burnet Institute 2007). Suh<br />
et al. found <strong>in</strong> Senegal that <strong>for</strong>mative supervision can improve the quality of reproductive<br />
health services, especially <strong>in</strong> areas where there is on-site skill build<strong>in</strong>g <strong>and</strong> refresher tra<strong>in</strong><strong>in</strong>g.<br />
This approach can also mobilize communities to participate <strong>in</strong> improv<strong>in</strong>g service quality.<br />
(2007). Supervisors themselves require tra<strong>in</strong><strong>in</strong>g <strong>in</strong> the provision of appropriate support <strong>and</strong><br />
guidance <strong>and</strong> the management of the per<strong>for</strong>mance system. Were states that CHW<br />
―supervisors should have tra<strong>in</strong><strong>in</strong>g on monitor<strong>in</strong>g processes, relationships, <strong>in</strong>puts (whether<br />
<strong>in</strong><strong>for</strong>mation or materials) as well as outputs <strong>in</strong>dicative of an improv<strong>in</strong>g situation‖ (2008).<br />
Clear criteria have been developed <strong>for</strong> the selection of supervisors of community level staff <strong>in</strong><br />
MNRH. The supervisors of lady health workers <strong>in</strong> Pakistan require at least an <strong>in</strong>termediate<br />
(Class 12) pass, however <strong>in</strong> practice most supervisors are considerably better qualified. More<br />
than half of the supervisors have graduated or completed higher degrees (Ox<strong>for</strong>d Policy<br />
Management 2002).<br />
The need <strong>for</strong> regular, on-go<strong>in</strong>g constructive feedback emerged from a Tanzanian study at<br />
PHC level. One auxiliary respondent stated:<br />
When the re-supervision is done <strong>for</strong> the second time, there should be feedback from the first<br />
supervision so that we can recognize where we went wrong <strong>and</strong> correct our mistakes. There<br />
should also be feedback of the problems identified from the previous supervision. It is not<br />
easy to th<strong>in</strong>k the supervisors are useful when reported problems rema<strong>in</strong> <strong>and</strong> no feedback is<br />
given (Manongi, Marchant et al. 2006)<br />
The recognition of good per<strong>for</strong>mance by supervisors dur<strong>in</strong>g feedback sessions contributes to<br />
health worker morale <strong>and</strong> motivation <strong>and</strong> is there<strong>for</strong>e critical (Willis-Shattuck, Bidwell et al.<br />
2008).<br />
P a g e | 72