CHW Central: Supervision of Community Health Workers

Below are extracts from an excellent blog (book chapter) by Kate Tulenko, IntraHealth International’s Vice President of Health Systems Innovation. The full text is available here:

This is the tenth chapter of the CHW Reference Guide produced under the Maternal and Child Health Integrated Program, the United States Agency for International Development Bureau for Global Health’s flagship maternal, neonatal and child health project.

Chapter 10 of the CHW Reference Guide explores the critical and complex issue of the supervision of community health workers (CHWs). Supervision of CHWs is a core health systems function that is often poorly understood and undervalued. Supervision is often incorrectly viewed as policing or as an unnecessary expense, but as this chapter shows, when supervision is properly designed and implemented, it can yield significant rewards in terms of quality of care, productivity, and retention of health workers…

There is still much to be done in the field of supervision, many innovations to be tested and challenges to be explored… The role of supervision of CHWs as a form of governance also needs greater recognition and exploration. CHWs are often the only formal representative of the central government in many communities.

Supervision is strongly linked to citizen voice and to women’s empowerment. When community members have a role in supervising their CHWs, they can — sometimes for the first time — have a say in the delivery of government service…

Ultimately, CHWs have special supervision needs. Their general level of education, literacy, and numeracy is usually much lower than other health workers and their period of formal CHW training is often less than a year…

Best wishes, Neil

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