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Community health extension workers’ training and supervision in Ethiopia: Exploring impact and implementation challenges for non-communicable disease service delivery
Training and supervision of health workers are critical components of any health system;thus, we assessed how they impact health extension workers’ (HEWs) role in non-communicable disease (NCD) service delivery in Ethiopia’s health extension program (HEP), using an in-depth qualitative study conduct...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021836/ https://www.ncbi.nlm.nih.gov/pubmed/36962619 http://dx.doi.org/10.1371/journal.pgph.0001160 |
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author | Tesema, Azeb Gebresilassie Peiris, David Abimbola, Seye Ajisegiri, Whenayon S. Narasimhan, Padmanesan Mulugeta, Afework Joshi, Rohina |
author_facet | Tesema, Azeb Gebresilassie Peiris, David Abimbola, Seye Ajisegiri, Whenayon S. Narasimhan, Padmanesan Mulugeta, Afework Joshi, Rohina |
author_sort | Tesema, Azeb Gebresilassie |
collection | PubMed |
description | Training and supervision of health workers are critical components of any health system;thus, we assessed how they impact health extension workers’ (HEWs) role in non-communicable disease (NCD) service delivery in Ethiopia’s health extension program (HEP), using an in-depth qualitative study conducted in 2019.The study covered two regions—the Tigray and the South Nations, Nationalities and Peoples Region (SNNPR)—and involved the Federal Ministry of Health. We conducted twenty-seven key informant interviews with federal and regional policymakers, district health officials, health centre representatives and HEWs.Participants highlighted substantial implementation challenges with training and supervision practices delivered via the HEP. Training for NCDs lacked breadth and depth. IT was described as inconsistently delivered with variable availability within and between regions;and when available, the quality was low with scant content specific to NCDs. HEP supervision was inconsistent and, rather than being supportive, mainly focused on finding faults in HEW work practices. Supervisors themselves had skill gaps in critical areas overall, and specifically concerning NCDs. HEWs’ performance appraisal encompassed too many indicators, leading to excessive complexity, which was burdensome to HEWs. This, negatively impacted HEW motivation and compromised service delivery. HEW involvement in non-HEP activities (such as promoting other government programs) often competed with their core mandates, thus affecting HEP service delivery.Efforts to address training and supervision constraints in Ethiopia’s HEP should focus on improving the quality of NCD training for HEWs and supervisors, shifting from authoritative to supportive supervision, simplifying performance appraisal and reducing competing attention from other programs. |
format | Online Article Text |
id | pubmed-10021836 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-100218362023-03-17 Community health extension workers’ training and supervision in Ethiopia: Exploring impact and implementation challenges for non-communicable disease service delivery Tesema, Azeb Gebresilassie Peiris, David Abimbola, Seye Ajisegiri, Whenayon S. Narasimhan, Padmanesan Mulugeta, Afework Joshi, Rohina PLOS Glob Public Health Research Article Training and supervision of health workers are critical components of any health system;thus, we assessed how they impact health extension workers’ (HEWs) role in non-communicable disease (NCD) service delivery in Ethiopia’s health extension program (HEP), using an in-depth qualitative study conducted in 2019.The study covered two regions—the Tigray and the South Nations, Nationalities and Peoples Region (SNNPR)—and involved the Federal Ministry of Health. We conducted twenty-seven key informant interviews with federal and regional policymakers, district health officials, health centre representatives and HEWs.Participants highlighted substantial implementation challenges with training and supervision practices delivered via the HEP. Training for NCDs lacked breadth and depth. IT was described as inconsistently delivered with variable availability within and between regions;and when available, the quality was low with scant content specific to NCDs. HEP supervision was inconsistent and, rather than being supportive, mainly focused on finding faults in HEW work practices. Supervisors themselves had skill gaps in critical areas overall, and specifically concerning NCDs. HEWs’ performance appraisal encompassed too many indicators, leading to excessive complexity, which was burdensome to HEWs. This, negatively impacted HEW motivation and compromised service delivery. HEW involvement in non-HEP activities (such as promoting other government programs) often competed with their core mandates, thus affecting HEP service delivery.Efforts to address training and supervision constraints in Ethiopia’s HEP should focus on improving the quality of NCD training for HEWs and supervisors, shifting from authoritative to supportive supervision, simplifying performance appraisal and reducing competing attention from other programs. Public Library of Science 2022-11-09 /pmc/articles/PMC10021836/ /pubmed/36962619 http://dx.doi.org/10.1371/journal.pgph.0001160 Text en © 2022 Tesema et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Tesema, Azeb Gebresilassie Peiris, David Abimbola, Seye Ajisegiri, Whenayon S. Narasimhan, Padmanesan Mulugeta, Afework Joshi, Rohina Community health extension workers’ training and supervision in Ethiopia: Exploring impact and implementation challenges for non-communicable disease service delivery |
title | Community health extension workers’ training and supervision in Ethiopia: Exploring impact and implementation challenges for non-communicable disease service delivery |
title_full | Community health extension workers’ training and supervision in Ethiopia: Exploring impact and implementation challenges for non-communicable disease service delivery |
title_fullStr | Community health extension workers’ training and supervision in Ethiopia: Exploring impact and implementation challenges for non-communicable disease service delivery |
title_full_unstemmed | Community health extension workers’ training and supervision in Ethiopia: Exploring impact and implementation challenges for non-communicable disease service delivery |
title_short | Community health extension workers’ training and supervision in Ethiopia: Exploring impact and implementation challenges for non-communicable disease service delivery |
title_sort | community health extension workers’ training and supervision in ethiopia: exploring impact and implementation challenges for non-communicable disease service delivery |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021836/ https://www.ncbi.nlm.nih.gov/pubmed/36962619 http://dx.doi.org/10.1371/journal.pgph.0001160 |
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