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Supportive supervision of close-to-community providers of health care: Findings from action research conducted in two counties in Kenya

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Karuga, Robinson Njoroge, Mireku, Maryline, Muturi, Nelly, McCollum, Rosalind, Vallieres, Frederique, Bruce Kumar, Meghan, Taegtmeyer, Miriam ORCID: https://orcid.org/0000-0002-5377-2536 and Otiso, Lilian (2019) 'Supportive supervision of close-to-community providers of health care: Findings from action research conducted in two counties in Kenya'. PLoS ONE, Vol 14, Issue 5, e0216444.

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Abstract

Background: Close-to-community (CTC) providers of health care are a crucial workforce for delivery of high-quality and universal health coverage. There is limited evidence on the effect of training supervisors of this cadre in supportive supervision. Our study aimed to demonstrate the effects of a training intervention on the approach to and frequency of supervision of CTC providers of health care.
Methods: We conducted a context analysis in 2013 in two Kenyan counties to assess factors that influenced delivery of community health services. Supervision was identified a priority factor that needed to be addressed to improve community health services. Supervision was inadequate due to lack of supervisor capacity in supportive approaches and lack of supervision guidelines. We designed a six-day training intervention and trained 48 purposively selected CTC supervisors on the educative, administrative and supportive components of supportive supervision, problem solving and advocacy and provided them with checklists to guide supervision sessions. We administered quantitative questionnaires to supervisors to assess changes in supervision frequency before and after the training and then explored perspectives on the intervention with community health volunteers (CHVs) and their supervisors using qualitative in-depth interviews.
Results: Six months after the intervention, we observed that supervisors had shifted the supervision approach from being controlling and administrative to coaching, mentorship and problem solving. Changes in the frequency of supervision were found in Kitui only, whereby significant decreases in group supervision were met with increases in accompanied home visit supervision. Supervisors and CHVs reported the intervention was helpful and it responded to capacity gaps in supervision of CHVs. Conclusion: Our intervention responded to capacity gaps in supervision and contributed to enhanced supervision capacity among supervisors. Supervisors found the curriculum acceptable and useful in improving supervision skills.

Item Type: Article
Subjects: W General Medicine. Health Professions > W 21 Medicine as a profession.
WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > Health Administration and Organization > WA 546 Local Health Administration. Community Health Services
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1371/journal.pone.0216444
SWORD Depositor: JISC Pubrouter
Depositing User: Stacy Murtagh
Date Deposited: 30 May 2019 11:24
Last Modified: 17 Oct 2019 10:52
URI: https://archive.lstmed.ac.uk/id/eprint/10913

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