ABSTRACT
Background: Nutritional status of under?5 children in India is not promising and lags far behind the WHO Global Nutrition Targets. Although the Integrated Child Development Services has been continuously delivered through Anganwadi centers since 1975, the burden of malnutrition still persists. Objectives: This study was conducted to estimate the knowledge and practice pattern of Anganwadi supervisors and the effect of capacity building through remote supportive supervision during the COVID-19 pandemic in Assam, India. Methods: A cross-sectional before-after study using a mixed methods approach was used to evaluate the knowledge pattern and service delivery of supervisors from each district of Assam. For qualitative assessment, telephone depth interviews were conducted. Results: Knowledge of supervisors in the beginning was 83.43% which improved by 7.97% at the end of the study. The highest burden of SAM children was in Tinsukia and Barpeta districts. On mapping, most districts with lower burden of SAM had supervisors with higher knowledge levels on Infant and Young Child Feeding practices. Qualitative assessment revealed house?to?house visit for ensuring service delivery and use of online platforms and phone calls for counseling. However, community resistance and lack of transport stood as a main challenge. Conclusion: Supportive supervision done remotely during the pandemic to enhance the performance of health workforce was found effective.
ABSTRACT
Supportive supervision is one of the most important tasks in health systems management. A baseline assessment conducted by the primary health care transformation initiative had shown that the Gurage Zone health department had been conducting regular supportive supervision every quarter for the last five years in Gurage Zone. The study proposed establishing a feedback auditing system as an intervention to routinely assess the progress of previous visit actions included in the written feedback. The finding showed the culture of working on previous supportive supervision action items by woreda (district) health offices were significantly improved
ABSTRACT
Background: Supportive supervision (SS) as a public health strategy has gathered much consideration in cold chain anagement and effective service delivery of routine immunization (RI). Objectives: In this study, an attempt was made to assess the effect of mobile-based SS strategy on cold chain point’s (CCPs) management and RI service delivery. Materials and Methods: UNICEF supported mobile-based software was used to carry out the SS in Golaghat district of Assam. A total of 15 CCPs and 18 session sites were visited 2 times each in the year 2017. Data collected in the first visit were compared with the second visit to find out whether there was any improvement in cold chain management in CCPs and at routine immunization session sites following SS. Results: We observed a significant improvement in vaccine management and infrastructure handling at CCPs from initial to the second visit. Knowledge and skills of cold chain handlers regarding cold chain management at session site were improved adequately. This substantiates successful transfer of knowledge and skills during SS. Conclusion: The observed improvements in the CCP management practices and service delivery indicate positive influence of mobile-based SS. The improvement in the skills and knowledge of health workers on different components related to CCP management could be due to successful real-time hand holding of cold chain handlers and workers through SS.