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What Makes Supervision Work: Reflections from Kenya Experiences in QI Cycle 1
REACHOUT Consortium MeetingDhaka, Bangladesh
12th June 2016
Presentation Overview
1. Background2. REACHOUT in Kenya3. Reflections: What makes supervision work in Kenya
Kenya…who we are..
Government Structure
National Government
8 Provinces
Districts
Divisions
National Government
47 County Governments
Sub-County Level
Community Level
• Policy Formulation
• Standards and Guidelines
• Capacity Building
• Technical Support
• Human Resource
Management
• Procurement and Supplies
• Planning and financing
AFTE
R DE
VOLU
TIO
N
BEFO
RE D
EVO
LUTI
ON
REACHOUT in Kenya
Context analysis
Quality improvement
Quality embedded
•Inadequate supervision – frequency and approach
•Worked with four community sites in two counties
•Trained community level supervisors in supportive
supervision
•Provided supervision tools
•Mentored supervisors on supervision
Key Findings
SUPERVISORS CHANGED APPROACH
“…when you are supervising you are like a mentor. You also mentor those you are supervising...”
TRAINING WAS HELPFUL “That training was good because it
taught us supervision. This is something we didn’t understand
before…”
SUPERVISORS WERE MORE SUPPORTIVE
“…..so she encouraged me to continue doing the things that I had done the right way and also corrected me..”
SUPERVISION TOOLS WERE USEFUL “The supervision tool is systematic it has a way of reminding me what to take when am in the process of…”
Lesson 1: Leadership
• Leadership is required to drive supervision – Supervision is not just a job– Supervision has to be part of QI agenda
• Leadership needed in Human Resource Management– Staff motivation– Staff development Community leaders engaging with
community about their health priorities
Lesson 2: Investment
• Evidence shows supervision improves health outcomes
• Supervision works when there is investment in: – Supervision tools– Logistical support– Building capacity of supervisors
Supervisors’ require logistical support
Lesson 3: Engage all Health System Actors
• Engage senior managers in the health systems for:– Accountability– Work planning– Resource allocation
• Identify champions at all levels– National – County – Community
Prof. Miriam WereCommunity Health Service Goodwill Ambassador, Kenya
Next steps (QI cycle 2)
• Embed Quality Improvement (QI) approaches in Health system• Activities:
1. Building QI capacity of community level supervisors2. Formation of QI teams at community and sub-County level3. Measure embedment, supervision, data quality
In summary…
• Community Health systems are complex and in flux
• For supportive supervision to work, its important to:– Provide leadership in the health system– Invest in Capacity and operations support– Engage stakeholders at all levels
Dhonno baadAsante sana
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