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Review
. 2019 Oct 11;4(Suppl 9):e001151.
doi: 10.1136/bmjgh-2018-001151. eCollection 2019.

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

Affiliations
Review

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

Gertrude Sika Avortri et al. BMJ Glob Health. .

Abstract

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.

Keywords: low-income countries; service delivery; supervision; supportive supervision.

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Conflict of interest statement

Competing interests: None declared.

References

    1. Bailey C, Blake C, Schriver M, et al. . A systematic review of supportive supervision as a strategy to improve primary healthcare services in Sub-Saharan Africa. Int J Gynaecol Obstet 2016;132:117–25. 10.1016/j.ijgo.2015.10.004 - DOI - PubMed
    1. Hill Z, Dumbaugh M, Benton L, et al. . Supervising community health workers in low-income countries--a review of impact and implementation issues. Glob Health Action 2014;7:24085 10.3402/gha.v7.24085 - DOI - PMC - PubMed
    1. Thakral S. The historical context of modern concept of supervision. Journal of Emerging Trends in Educational Research and Policy Studies 2015;6:79–88.
    1. Jones A. Clinical supervision: what do we know and what do we need to know? A review and commentary. J Nurs Manag 2006;14:577–85. 10.1111/j.1365-2934.2006.00716.x - DOI - PubMed
    1. Martin P, Copley J, Tyack Z. Twelve tips for effective clinical supervision based on a narrative literature review and expert opinion. Med Teach 2014;36:201–7. 10.3109/0142159X.2013.852166 - DOI - PubMed

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