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infrastructure, ensuring adequate supply of equipment; continued support for quality service delivery; undertook data collection and analysis; and provided technical support to state NRHM. The process entailed developing a structured schedule for visits in consultation with SNCUs; capacity building; on-site visit/support and off site support; standardised monthly reporting; feedback services; and interactive discussion with all SNCUs by video conferencing. It provided support through personal visits; monthly statistics analysis & feedback; visits by administrative heads; review meetings every 2 month / video conferencing; annual refresher training; and team visits. The team comprised of Monitoring: Professor / Asst. professor/ DM (neo) post graduates – ICH &HC; RCC coordinator / RCC Clinical Nurse; Staff Nurse from ICH. Components of mentoring included checking for availability (space, manpower, equipment, drugs); capacity building (Nodal officer – SNCU; SNCU MOs; obstetricians; staff nurses of SNCUs, LR, PN ward and OT; Cleaning staff/Security); delivery of obstetric and neonatal care (Protocols in place, Skill & Technical guidance, Perusal of 46 Consultation on Supportive Supervision to Strengthen Capacity of Frontline Workers and Service Providers
ecords and data collection); assessment report (To SNCU; administrators; district & state). Implementing Partners: UNICEF; EKAM (NGO); SRHM, TNHSP; GVK-EMRI; SECT (NGO), NCC. Assessment was carried out of clinical practice (admission and discharge policy, resuscitation, early initiation of breast feeding, KMC, early introduction of feeding, use of antibiotics, infection control and post natal rounds); critical review of performance (infrastructure, power back-up, oxygen source, lab facility); capacity building. Results • y Admission policy and Antibiotic policy: Admission & Referral Policy were standardised; antibiotic usage streamlined; microbial culture facility not available in all SNCUs. • y Where infrastructure was concerned, it was found that space for neonatal care was adequate but space for mothers, storage and soil area was inadequate. • y Oxygen source was central but not 24 hours though other sources were adequate. • y Electricity situation saw frequent power cuts and generator back-up was not uniform. • y There were maintenance issues with regard to equipment and drugs with problems related to pulse oximeter probe, temperature probe of warmer and infusion pump; a tie-up with NGO- EKAM for equipment maintenance addressed some of these issues. • y IV fluids and drugs were found in adequate supply. Enabling factors: These included timely flow and proper utiisation of sanctioned funds, cooperative hospital heads, creating academic environment, supportive feedback, listening and finding solutions. Challenges: Included poor follow-up of SNCU graduates, neonatal transport, attrition of trained staff nurses/doctors, inadequate salary, round-the-clock oxygen and uninterrupted power supply, inadequate lab services, database standardisation and getting time/permission for visits. Lessons learnt: Better understanding of problems at ground level; documentation not given importance; reciprocal relationships working better; administrative support being of critical value; sustained effort needed for quality improvement; systematic reinforcement needed. There was also need for commitment, time and contribution to community, with funding options. Next steps: Include follow-up clinic services, tracking of SNCU graduates, capacity building of mentors and expanding the teams and integration with NRHM activities including funding. Consultation on Supportive Supervision to Strengthen Capacity of Frontline Workers and Service Providers 47
Page 1: Consultation on Supportive Supervis
Page 5 and 6: Acknowledgments UNICEF is grateful
Page 7: RI : Routine Immunization SHRC : Sy
Page 11 and 12: Introduction & Background Defining
Page 13 and 14: In the corporate world, this approa
Page 15 and 16: Proceedings of the Consultation The
Page 17 and 18: Key Features of ICDS ICDS was a wel
Page 19 and 20: AWC. This included representation f
Page 21 and 22: “I have been to the field and fou
Page 23 and 24: These supervisory checklists should
Page 25 and 26: Title of Project: Mitanin Programme
Page 27 and 28: District Coordinators: They are app
Page 29 and 30: Medical Officers. They aimed to inc
Page 31 and 32: Results “If ASHAs could not fill
Page 33 and 34: Learnings • y Functional overlap
Page 35 and 36: Key Incentives to Support Supervisi
Page 37 and 38: Leveraging Support through Communit
Page 39 and 40: contributed to slowing down of the
Page 41 and 42: • y Absence of performance benchm
Page 43 and 44: Discussion • y When the process w
Page 45 and 46: UNICEF operates in Karnataka, West
Page 47: SESSION 6: Supportive Supervision f
Page 51 and 52: There were things that did not impr
Page 53 and 54: • y Joint supervision of Block He
Page 55 and 56: Key challenges in providing support
Page 57 and 58: Annexure 1: Programme Agenda Consul
Page 59 and 60: DAY 2 - 23 nd Nov 2012 Time Topic F
Page 61 and 62: 31. Anagha Khot, Project Management
Page 63 and 64: Importantly, supportive supervision
Page 65: Participants The workshop participa

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