The rise and fall of supervision in a project designed to strengthen supervision of Integrated Management of Childhood Illness in Benin

Health Policy and Planning
A K RoweM S Deming

Abstract

In developing countries, supervision is a widely recognized strategy for improving health worker performance; and anecdotally, maintaining regular, high-quality supervision is difficult. However, remarkably little research has explored in depth why supervision is so challenging. In the context of a trial to improve health worker adherence to Integrated Management of Childhood Illness (IMCI) guidelines and strengthen supervision in southeastern Benin, we used record reviews, focus group discussions, key informant interviews, and cross-sectional surveys to examine the supervision process. Initially, little IMCI supervision occurred. The frequency increased substantially after implementing a series of workshops, but then deteriorated. Quantitative and qualitative data revealed obstacles to supervision at multiple levels of the health system. Based on supervisors' opinions, the main problems were: poor coordination; inadequate management skills and ineffective management teams; a lack of motivation; problems related to decentralization; health workers sometimes resisting IMCI implementation; and less priority given to IMCI supervision because of incentives for non-supervision activities, a lack of leadership, and an expectation of ...Continue Reading

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Citations

Nov 7, 2012·BMC Medical Informatics and Decision Making·Natalie LeonEmmanuelle Daviaud
Mar 20, 2013·BMC Health Services Research·Rènée du ToitPaul Courtright
Sep 7, 2013·Human Resources for Health·Susan BradleyEilish McAuliffe
Feb 12, 2011·PLoS Medicine·UNKNOWN malERA Consultative Group on Health Systems and Operational Research
May 14, 2011·American Journal of Public Health·Alexander K RoweMichael S Deming
Jan 1, 2013·South African Journal of Information Management·Mark TomlinsonMickey Chopra
Nov 21, 2012·Nursing Outlook·Manzi AnatoleLisa R Hirschhorn
Jul 7, 2011·Tropical Medicine & International Health : TM & IH·Jemima A FrimpongJames F Phillips
Aug 20, 2014·Tropical Medicine & International Health : TM & IH·Sima BerendesJoseph J Valadez
Apr 30, 2015·Best Practice & Research. Clinical Obstetrics & Gynaecology·Anne-Marie BerghRobert C Pattinson
Jul 9, 2014·BMC Health Services Research·Anne-Marie BerghJeremie Zoungrana
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Jul 18, 2017·Frontiers in Public Health·Helen Nita Catton
Sep 19, 2020·Journal of Pharmaceutical Policy and Practice·Arthur BagonzaFreddy Eric Kitutu
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Mar 26, 2021·BMC Health Services Research·Mark Donald C ReñosaUNKNOWN National IMCI Evaluation Working Group
Dec 2, 2021·Health Policy and Planning·Bilal Iqbal AvanJoanna Schellenberg

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