Nepal

4.6 BASIC MANAGEMENT AND ADMINISTRATIVE SYSTEMS
4.6.1 Supervision
Personal supervision can be an important source of support and direction for health facility staff
members. Supervision of child health care providers is fairly common throughout Nepal care facilities.
Overall, nearly 7 of every 10 interviewed child health care providers reported receiving personal supervision
in the six months before the NHFS visit (Table 4.14). The level of supervision was higher in peripheral
public facilities than in public hospitals. By managing authority, providers at private facilities received less
supervisory support than those at public facilities.
Table 4.14 Supportive management for providers of child health services
Among interviewed child health service providers, the percentage who report receiving training related to
their work and personal supervision during the specified time periods, by background characteristics, Nepal
Health Facility Survey 2015
Background
characteristic
Percentage of interviewed providers who received:
Training related to
child health during
the 24 months
preceding the
survey 1
Personal
supervision during
the 6 months
preceding the
survey 2
Training related to
child health during
the 24 months and
personal
supervision during
the 6 months
preceding the
survey
Number of
interviewed
providers
Facility type
Zonal and above
hospitals 10.3 62.2 8.5 55
District-level hospitals 28.7 67.6 20.6 156
Private hospitals 7.5 58.7 4.1 395
PHCCs 33.6 75.7 27.5 257
HPs 34.0 73.6 26.3 2,369
UHCs 27.5 74.6 25.3 65
Managing authority
Public 33.1 73.3 25.8 2,901
Private 7.5 58.7 4.1 395
Ecological region
Mountain 28.9 67.3 17.8 335
Hill 29.2 71.2 22.7 1,656
Terai 31.4 73.0 25.2 1,306
Earthquake-affected
districts (14) 30.3 69.1 22.3 707
National average 30.0 71.5 23.2 3,296
1
Training refers only to in-service training. The training must be structured sessions; it does not include
individual instruction that a provider might have received during routine supervision.
2
Personal supervision refers to any form of technical support or supervision from a facility-based supervisor
or from a visiting supervisor. It may include, but is not limited to, review of records and observation of work,
with or without any feedback to the health worker.
4.6.2 Training
Training, too, is an important management function to support health care providers. Periodic inservice
training in particular can keep providers up to date and help them refresh their knowledge and skills.
In Nepal health facilities, 3 of every 10 interviewed child health service providers said they had
received in-service training related to child health in the 24 months before the assessment (Table 4.15).
Providers in government facilities were more likely to have received recent training (33 percent) than
providers in private hospitals (8 percent).
Overall, 23 percent of interviewed child health service providers had recently received both personal
supervision and in-service training. Providers from PHCCs (28 percent), health posts (26 percent), and UHCs
(25 percent) were most likely to have recently received both training and supervision. Fewer than 1 in 10
providers at zonal and above hospitals and 1 in 20 providers at private hospitals had been supervised recently
and had received in-service training in the 24 months before the survey.
Child Health Services • 91