Cargando…
The relationship between primary healthcare providers and their external supervisors in Rwanda
BACKGROUND: External supervision of Rwandan primary healthcare facilities unfolds as an interaction between supervisors and healthcare providers. Their relationship has not been thoroughly studied in Rwanda, and rarely in Africa. AIM: To explore perceived characteristics and effects of the relations...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AOSIS
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675927/ https://www.ncbi.nlm.nih.gov/pubmed/29113446 http://dx.doi.org/10.4102/phcfm.v9i1.1508 |
_version_ | 1783276986442973184 |
---|---|
author | Schriver, Michael Cubaka, Vincent K. Nyirazinyoye, Laetitia Itangishaka, Sylvere Kallestrup, Per |
author_facet | Schriver, Michael Cubaka, Vincent K. Nyirazinyoye, Laetitia Itangishaka, Sylvere Kallestrup, Per |
author_sort | Schriver, Michael |
collection | PubMed |
description | BACKGROUND: External supervision of Rwandan primary healthcare facilities unfolds as an interaction between supervisors and healthcare providers. Their relationship has not been thoroughly studied in Rwanda, and rarely in Africa. AIM: To explore perceived characteristics and effects of the relationship between providers in public primary healthcare facilities and their external supervisors in Rwanda. SETTING: We conducted three focus group discussions with primary healthcare providers (n = 16), three with external supervisors (n = 15) and one mixed (n = 5). METHODS: Focus groups were facilitated under low-moderator involvement. Findings were extracted thematically and discussed with participating and non-participating providers and supervisors. RESULTS: While external supervision is intended as a source of motivation and professional development in addition to its managerial purpose, it appeared linked to excessive evaluation anxiety among Rwandan primary healthcare providers. Supervisors related this mainly to inescapable evaluations within performance-based financing, whereas providers additionally related it to communication problems. CONCLUSION: External supervision appeared driven by systematic performance evaluations, which may prompt a strongly asymmetric supervisory power relation and challenge intentions to explore providers’ experienced work problems. There is a risk that this may harm provider motivation, calling for careful attention to factors that influence the supervisory relationship. It is a dilemma that providers most in need of supervision to improve performance may be most unlikely to benefit from it. This study reveals a need for provider-oriented supportive supervision including constructive attention on providers who have performance difficulties, effective relationship building and communication, objective and diligent evaluation and two-way feedback channels. |
format | Online Article Text |
id | pubmed-5675927 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | AOSIS |
record_format | MEDLINE/PubMed |
spelling | pubmed-56759272017-11-13 The relationship between primary healthcare providers and their external supervisors in Rwanda Schriver, Michael Cubaka, Vincent K. Nyirazinyoye, Laetitia Itangishaka, Sylvere Kallestrup, Per Afr J Prim Health Care Fam Med Original Research BACKGROUND: External supervision of Rwandan primary healthcare facilities unfolds as an interaction between supervisors and healthcare providers. Their relationship has not been thoroughly studied in Rwanda, and rarely in Africa. AIM: To explore perceived characteristics and effects of the relationship between providers in public primary healthcare facilities and their external supervisors in Rwanda. SETTING: We conducted three focus group discussions with primary healthcare providers (n = 16), three with external supervisors (n = 15) and one mixed (n = 5). METHODS: Focus groups were facilitated under low-moderator involvement. Findings were extracted thematically and discussed with participating and non-participating providers and supervisors. RESULTS: While external supervision is intended as a source of motivation and professional development in addition to its managerial purpose, it appeared linked to excessive evaluation anxiety among Rwandan primary healthcare providers. Supervisors related this mainly to inescapable evaluations within performance-based financing, whereas providers additionally related it to communication problems. CONCLUSION: External supervision appeared driven by systematic performance evaluations, which may prompt a strongly asymmetric supervisory power relation and challenge intentions to explore providers’ experienced work problems. There is a risk that this may harm provider motivation, calling for careful attention to factors that influence the supervisory relationship. It is a dilemma that providers most in need of supervision to improve performance may be most unlikely to benefit from it. This study reveals a need for provider-oriented supportive supervision including constructive attention on providers who have performance difficulties, effective relationship building and communication, objective and diligent evaluation and two-way feedback channels. AOSIS 2017-11-01 /pmc/articles/PMC5675927/ /pubmed/29113446 http://dx.doi.org/10.4102/phcfm.v9i1.1508 Text en © 2017. The Authors https://creativecommons.org/licenses/by/4.0/ Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License. |
spellingShingle | Original Research Schriver, Michael Cubaka, Vincent K. Nyirazinyoye, Laetitia Itangishaka, Sylvere Kallestrup, Per The relationship between primary healthcare providers and their external supervisors in Rwanda |
title | The relationship between primary healthcare providers and their external supervisors in Rwanda |
title_full | The relationship between primary healthcare providers and their external supervisors in Rwanda |
title_fullStr | The relationship between primary healthcare providers and their external supervisors in Rwanda |
title_full_unstemmed | The relationship between primary healthcare providers and their external supervisors in Rwanda |
title_short | The relationship between primary healthcare providers and their external supervisors in Rwanda |
title_sort | relationship between primary healthcare providers and their external supervisors in rwanda |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675927/ https://www.ncbi.nlm.nih.gov/pubmed/29113446 http://dx.doi.org/10.4102/phcfm.v9i1.1508 |
work_keys_str_mv | AT schrivermichael therelationshipbetweenprimaryhealthcareprovidersandtheirexternalsupervisorsinrwanda AT cubakavincentk therelationshipbetweenprimaryhealthcareprovidersandtheirexternalsupervisorsinrwanda AT nyirazinyoyelaetitia therelationshipbetweenprimaryhealthcareprovidersandtheirexternalsupervisorsinrwanda AT itangishakasylvere therelationshipbetweenprimaryhealthcareprovidersandtheirexternalsupervisorsinrwanda AT kallestrupper therelationshipbetweenprimaryhealthcareprovidersandtheirexternalsupervisorsinrwanda AT schrivermichael relationshipbetweenprimaryhealthcareprovidersandtheirexternalsupervisorsinrwanda AT cubakavincentk relationshipbetweenprimaryhealthcareprovidersandtheirexternalsupervisorsinrwanda AT nyirazinyoyelaetitia relationshipbetweenprimaryhealthcareprovidersandtheirexternalsupervisorsinrwanda AT itangishakasylvere relationshipbetweenprimaryhealthcareprovidersandtheirexternalsupervisorsinrwanda AT kallestrupper relationshipbetweenprimaryhealthcareprovidersandtheirexternalsupervisorsinrwanda |