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Key findings from REACHOUT work in Kenya
- 1. What Makes Supervision Work: Reflections from Kenya Experiences in QI Cycle 1 REACHOUT Consortium Meeting Dhaka, Bangladesh 12th June 2016
- 2. Presentation Overview 1. Background 2. REACHOUT in Kenya 3. Reflections: What makes supervision work in Kenya
- 4. 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 AFTERDEVOLUTION BEFOREDEVOLUTION
- 5. 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
- 6. 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…”
- 7. 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
- 8. 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
- 9. 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 Were Community Health Service Goodwill Ambassador, Kenya
- 10. Next steps (QI cycle 2) • Embed Quality Improvement (QI) approaches in Health system • Activities: 1. Building QI capacity of community level supervisors 2. Formation of QI teams at community and sub-County level 3. Measure embedment, supervision, data quality
- 11. 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 baad Asante sana
Editor's Notes
- Kenya is a country in East Africa Diverse Country
- How this affects health service delivery
- Add Graphs and quotes
- Community Health Systems are complex and in flux Example – Kitui county minister leadership for success of community strategy
- Evidence shows supervision improves health outcomes e.g. referral, uptake of services, retention REACHOUT provision of tools in units improved approach and frequency of supervision and action planning
- Its not enough to build the capacity of CTC supervisors at community level E.g. prof Miriam Were, MoH level champions are engaged in the process of scaling up QI work