Integrating community health workers into the formal health system to improve performance: a qualitative study on the role of on-site supervision in the South African programme

BMJ Open
Yu-Hwei TsengJane Goudge

Abstract

To explore the role of on-site supervision in community health worker (CHW) programmes and CHW integration into the health system. We compared the functioning of CHW teams reporting to a clinic-based nurse with teams supervised by a community-based nurse. We also consider whether a junior nurse can provide adequate supervision, given the shortage of senior nurses. A case study approach to study six CHW teams with different configurations of supervision and location. We used a range of qualitative methods: observation of CHW and their supervisors (126 days), focus group discussions (12) and interviews (117). South Africa where a national CHW programme is being implemented with on-site supervision. CHWs, their supervisors, clinic managers and staff, district managers, key informants from the community and CHW clients. Effective supervisors supported CHWs through household visits, on-the-job training, debriefing, reviewing CHWs' daily logs and assistance with compiling reports. CHWs led by senior nurses were motivated and performed a greater range of tasks; junior nurses in these teams could better fulfil their role. Clinic-based teams with senior supervisors were better integrated and more able to ensure continuity of care. In co...Continue Reading

References

Sep 9, 2011·The Cochrane Database of Systematic Reviews·Xavier Bosch-CapblanchPaul Garner
Apr 2, 2013·Lancet·Prabhjot Singh, Jeffrey D Sachs
May 18, 2013·American Journal of Public Health·Sarah Wood PallasElizabeth H Bradley
Apr 12, 2017·The Lancet Global Health· The Lancet Global Health
Jun 7, 2017·African Journal of Primary Health Care & Family Medicine·Tessa S MarcusChampak C Jinabhai
Jul 22, 2017·Administration and Policy in Mental Health·Miya L BarnettAnna S Lau
Nov 21, 2017·New Solutions : a Journal of Environmental and Occupational Health Policy : NS·Zara TraffordChristopher J Colvin
Apr 15, 2018·The Lancet Global Health·Niall WintersAnne Geniets

❮ Previous
Next ❯

Citations

Nov 21, 2020·Journal of Primary Care & Community Health·Cheryl Nelson, Sphiwe Madiba
Jan 22, 2021·The International Journal of Health Planning and Management·Peter Mgawe, Stephen O Maluka
Apr 8, 2021·Journal of General Internal Medicine·Rogério Meireles PintoW Galhego-Garcia
Oct 14, 2021·Health Research Policy and Systems·Carey WestgateHenry B Perry

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.