This was presented as part of a panel at the ICT4D Conference in Lusaka, Zambia in May 2018. Supportive supervision is important, but is often irregular and disconnected from service provision data and citizen feedback. Digital tools have an opportunity to improve supervisor and health worker performance through improved supervisor skills, logistics and planning, increased communications between all levels of the system and a shared record of action items.

1. Supportive Supervision: Past, Present
and Future
Steve Ollis, John Snow Inc., steve_ollis@jsi.com
Sharon Langevin, Medic Mobile, Sharon@medicmobile.org
Erica Layer, D-tree International, elayer@d-tree.org
Guillaume DeFlaux, Dimagi, gdeflaux@dimagi.com

2. Supervision and needs
• Supervision
• Supervisory Checklists
• Facility Assessments
• Data Quality assessments
• Mentoring
• Managers need
• Information on areas needing emphasis
• Data on Supervisor performance
• Citizen Feedback
• Supervisors need
• Information and action items on prior visits
• Data on service provision (DHIS2-type)
• Data on HW activity / performance
• Access to learning resources for improvement
• Citizen Feedback
• Healthworkers need
• Information and action items on prior visits
• Data on service provision (DHIS2-type)
• Peer data on HW activity / performance
• Access to learning resources for improvement
• Citizen Feedback
• Peer support

3. It’s simple,
right?
supervisor
Citizen
feedback
CHWCHW CHW
CHW
National / District Management
Peer support

4. Supervisor Application for L10K project (HEW Focal Person)
Update Health
Post Settings
Supervision Checklists
Includes the Health Post Checklist, the
Visit Observation Checklist and
CommCare Checklist. You should
complete these forms when you visit
the HEW at their Health Post.
Update Health Post Settings
Allows Focal Person to update any
information pertaining to the Health
Posts they support
Troubleshooting
A form that guides you to solve problems that
HEWs, Midwives or other Focal Persons may
be having with their mobile device or
application.
Late ANC and PNC Visits
Lists of all visits that HEW is
overdue to conduct and allows for
Focal Person to take appropriate
follow up actions.
HMIS Reports
Allows Focal Person to see monthly
reports for each of the Health Posts
that they support.

5. TRADITIONAL SUPPORTIVE SUPERVISION DIGITAL SUPPORTIVE SUPERVISION
• Interactive
• Personalized
• High standard protocols
• Decision support
• Real-time refreshers
VS.
• Variable feedback quality
• Subjective
• Limited follow-up
• Ad-hoc planning
• Lengthy checklists

6. Software for Community Health Systems

7. What We Do
Medic Mobile designs, delivers, and supports world-class software for health workers
who provide care in the hardest-to-reach communities.
Today, 20,000 health workers rely on the software to care for 11 million people.
Between 2017 and 2021, we aim to help provide care to 100 million people.

8. Meet Ann, CHW Supervisor

9. CHW Performance Management

10. CHW Coaching Dashboard

11. Targeting Tools and Supervision App

12. Manager Comparison

13. Facility Comparison

14. ● Effectively manage
health workers
● Oversee high-quality
care that reaches
everyone
● Use the app as a
“command center”
Looking Ahead
Now Soon This year

15. Supervision Approaches

16. Sharon Langevin sharon@medicmobile.org

18. Supervision
• Monthly reporting
• Managing stock/commodities
• Confirming referrals
• Holding monthly meetings
• Monitoring supervisor activities
• Providing feedback & support
• Using data for decision-making
• Monitoring activity/performance targets
• Mentoring & capacity building
• Troubleshooting technical issues
• Communicating information
Accountability &
support from
superiors
Routine work
Accountability &
support to
health workers

19. Safer Deliveries: Zanzibar
• CHV performance
• On-device reports
• Composite risk score
• Drill-down to individual visits
• Individual feedback
• Supervisor pay for performance
• Referral tracking & coordination
• Bi-directional feedback

20. Digital Village Clinic: Malawi
• Peer support/mentoring post-
training
• In-person observations & support
• Routine supervision
• MOH checklists for ANC, PNC, FP,
CCM
• Digital tool checklist
• Technical troubleshooting
• Government reporting

22. Supportive Supervision
Example from Burkina Faso

23. Integrated eDiagnostic
Approach
• Burkina Faso
• IMCI Diagnostic Support
Tool
• Health Workers
• Rural PHC Facilities

24. Quality Improvement
• Problems + Solutions + Indicators
• Quality Improvement Plan (QIP)
• Definition of targets for specific QIP indicators
• Revise targets periodically
• Iterative process

25. Create Value For Supervisors
• Level 1 - Improved data quality across supervised facilities
• Level 2 - Easier reporting
• Level 3 - Ability to track QIP implementation progress
• Facility Level
• Individual Level
• Level 4 - Ability to expose performance of the district