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Focus of Supportive Supervision
• y Helping workers follow-up all referred cases.
• y Checking availability of all supplies with workers.
• y Supervising Women’s Group Meeting conducted by workers.
• y Providing feedback to study Field Managers, health and ICDS and to workers.
• y Ensuring all incentives are paid in time.
• y Improving motivation and performance of workers; undertaking quality
assurance.
• y Setting up SNCUs and stabilisation units at district hospitals and peripheral
government institutions to facilitate referrals.
• y Mobilising existing system of ambulance services for referral transportation and
awareness creation.
• y Involving men in the community and Panchayat.
Triggers for the Initiative
At the outset, a range of problems were identified in supervision which included vacant
positions, high workload of frontline workers, irregular supervisory visits, poor quality
of supervision, absence of hands-on training, poor motivation of workers, high attrition
and a scenario where most supervisors came from other cities and towns.
Implementation
Extensive planning: Alternative approaches were worked out in consultation with
Government, covering aspects related to hiring of supervisors, providing transport,
incentives, skill training and feedback.
Recruitment: Supervisors were recruited but they reported directly to health and
ICDS system.
Training: 8 days IMNCI training was provided as a Health Worker Module followed by
2 days of the supervisor module by National Level trainers at Government Hospitals
in Delhi.
Duty schedules developed: Monthly rosters were prepared and specified number of
ASHA/ANM assigned for supervision; each supervisor supervised 30-40 AWW/ASHA,
3-4 ANM and 15-20 TBAs.
Women-friendly initiatives: Women group meetings were held by ASHAs and special
medicine depots were opened in their homes.
Reporting and Monitoring: Apart from checklists and supervisory tasks, there was an
independent cross check-in with families with new births; and feedback was taken on
supervisors.
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Consultation on Supportive Supervision to Strengthen
Capacity of Frontline Workers and Service Providers