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Supportive supervision to improve service delivery in low-income countries: is there a conceptual problem or a strategy problem?

Supportive supervision is perceived as an intervention that strengthens the health system, enables health workers to offer quality services and improve performance. Unfortunately, numerous studies show that supervisory mechanisms in many low-income countries (LICs) are suboptimal. Further, the under...

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Detalles Bibliográficos
Autores principales: Avortri, Gertrude Sika, Nabukalu, Joy Belinda, Nabyonga-Orem, Juliet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6797347/
https://www.ncbi.nlm.nih.gov/pubmed/31673434
http://dx.doi.org/10.1136/bmjgh-2018-001151
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author Avortri, Gertrude Sika
Nabukalu, Joy Belinda
Nabyonga-Orem, Juliet
author_facet Avortri, Gertrude Sika
Nabukalu, Joy Belinda
Nabyonga-Orem, Juliet
author_sort Avortri, Gertrude Sika
collection PubMed
description Supportive supervision is perceived as an intervention that strengthens the health system, enables health workers to offer quality services and improve performance. Unfortunately, numerous studies show that supervisory mechanisms in many low-income countries (LICs) are suboptimal. Further, the understanding of the concept and its implementation is still shrouded in misinterpretations and inconsistencies. This analysis contributes to a deeper understanding of the concept of supportive supervision and how reorganisation of the approach can contribute to improved performance. The effectiveness of supportive supervision is mixed, with some studies noting that evidence on its role, especially in LICs is inconclusive. Quality of care is a core component of universal health coverage which, accentuates the need for supportive supervision. In the context of LICs, it is imperative for supportive supervision to be implemented as an on-going approach. Factors that affect supportive supervision encompass cultural, social, organizational and context dimensions but the capacity of majority of LIC to address these is limited. To this end, we underscore the need to review the supportive supervision approach to improve its effectiveness, and ensure that facility-based supervision embodies as many of the envisioned qualities as possible. We thus make a case for a stronger focus on internal supportive supervision where internal refers to health facility/unit/ward level. Inherent in the approach is what we refer to as ‘supervisee initiated supportive supervision’. The success of this approach must be anchored on a strong system for monitoring, data and information management at the health facility level.
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spelling pubmed-67973472019-10-31 Supportive supervision to improve service delivery in low-income countries: is there a conceptual problem or a strategy problem? Avortri, Gertrude Sika Nabukalu, Joy Belinda Nabyonga-Orem, Juliet BMJ Glob Health Analysis Supportive supervision is perceived as an intervention that strengthens the health system, enables health workers to offer quality services and improve performance. Unfortunately, numerous studies show that supervisory mechanisms in many low-income countries (LICs) are suboptimal. Further, the understanding of the concept and its implementation is still shrouded in misinterpretations and inconsistencies. This analysis contributes to a deeper understanding of the concept of supportive supervision and how reorganisation of the approach can contribute to improved performance. The effectiveness of supportive supervision is mixed, with some studies noting that evidence on its role, especially in LICs is inconclusive. Quality of care is a core component of universal health coverage which, accentuates the need for supportive supervision. In the context of LICs, it is imperative for supportive supervision to be implemented as an on-going approach. Factors that affect supportive supervision encompass cultural, social, organizational and context dimensions but the capacity of majority of LIC to address these is limited. To this end, we underscore the need to review the supportive supervision approach to improve its effectiveness, and ensure that facility-based supervision embodies as many of the envisioned qualities as possible. We thus make a case for a stronger focus on internal supportive supervision where internal refers to health facility/unit/ward level. Inherent in the approach is what we refer to as ‘supervisee initiated supportive supervision’. The success of this approach must be anchored on a strong system for monitoring, data and information management at the health facility level. BMJ Publishing Group 2019-10-11 /pmc/articles/PMC6797347/ /pubmed/31673434 http://dx.doi.org/10.1136/bmjgh-2018-001151 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0
spellingShingle Analysis
Avortri, Gertrude Sika
Nabukalu, Joy Belinda
Nabyonga-Orem, Juliet
Supportive supervision to improve service delivery in low-income countries: is there a conceptual problem or a strategy problem?
title Supportive supervision to improve service delivery in low-income countries: is there a conceptual problem or a strategy problem?
title_full Supportive supervision to improve service delivery in low-income countries: is there a conceptual problem or a strategy problem?
title_fullStr Supportive supervision to improve service delivery in low-income countries: is there a conceptual problem or a strategy problem?
title_full_unstemmed Supportive supervision to improve service delivery in low-income countries: is there a conceptual problem or a strategy problem?
title_short Supportive supervision to improve service delivery in low-income countries: is there a conceptual problem or a strategy problem?
title_sort supportive supervision to improve service delivery in low-income countries: is there a conceptual problem or a strategy problem?
topic Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6797347/
https://www.ncbi.nlm.nih.gov/pubmed/31673434
http://dx.doi.org/10.1136/bmjgh-2018-001151
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