Supervision of community health workers in Mozambique

Detalhes bibliográficos
Autor(a) principal: Ndima, Sozinho Daniel
Data de Publicação: 2015
Outros Autores: Sidat, Mohsin, Give, Celso, Ormel, Hermen, Kok, Maryse Catelijne, Taegtmeyer, Miriam
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.1186/s12960-015-0063-x
Resumo: PMID: 26323970 WOS:000360349700001
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spelling Supervision of community health workers in MozambiqueA qualitative study of factors influencing motivation and programme implementationCommunity health workersMotivationMozambiqueSupervisionSupportPublic AdministrationPublic Health, Environmental and Occupational HealthSDG 3 - Good Health and Well-beingPMID: 26323970 WOS:000360349700001Background: Community health workers (CHWs) in Mozambique (known as Agentes Polivalentes Elementares (APEs)) are key actors in providing health services in rural communities. Supervision of CHWs has been shown to improve their work, although details of how it is implemented are scarce. In Mozambique, APE supervision structures and scope of work are clearly outlined in policy and rely on supervisors at the health facility of reference. The aim of this study was to understand how and which aspects of supervision impact on APE motivation and programme implementation. Methods: Qualitative research methodologies were used. Twenty-nine in-depth interviews were conducted to capture experiences and perceptions of purposefully selected participants. These included APEs, health facility supervisors, district APE supervisors and community leaders. Interviews were recorded, translated and transcribed, prior to the development of a thematic framework. Results: Supervision was structured as dictated by policy but in practice was irregular and infrequent, which participants identified as affecting APE's motivation. When it did occur, supervision was felt to focus more on fault-finding than being supportive in nature and did not address all areas of APE's work - factors that APEs identified as demotivating. Supervisors, in turn, felt unsupported and felt this negatively impacted performance. They had a high workload in health facilities, where they had multiple roles, including provision of health services, taking care of administrative issues and supervising APEs in communities. A lack of resources for supervision activities was identified, and supervisors felt caught up in administrative issues around APE allowances that they were unable to solve. Many supervisors were not trained in providing supportive supervision. Community governance and accountability mechanisms were only partially able to fill the gaps left by the supervision provided by the health system. Conclusion: The findings indicate the need for an improved supervision system to enhance support and motivation and ultimately performance of APEs. Our study found disconnections between the APE programme policy and its implementation, with gaps in skills, training and support of supervisors leading to sub-optimal supervision. Improved methods of supervision could be implemented including those that maximize the opportunities during face-to-face meetings and through community-monitoring mechanisms.Instituto de Higiene e Medicina Tropical (IHMT)Global Health and Tropical Medicine (GHTM)RUNNdima, Sozinho DanielSidat, MohsinGive, CelsoOrmel, HermenKok, Maryse CatelijneTaegtmeyer, Miriam2018-05-11T22:02:58Z2015-09-012015-09-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.1186/s12960-015-0063-xengPURE: 1729370http://www.scopus.com/inward/record.url?scp=84940473815&partnerID=8YFLogxKhttps://doi.org/10.1186/s12960-015-0063-xinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:20:03Zoai:run.unl.pt:10362/36590Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:30:34.470909Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Supervision of community health workers in Mozambique
A qualitative study of factors influencing motivation and programme implementation
title Supervision of community health workers in Mozambique
spellingShingle Supervision of community health workers in Mozambique
Ndima, Sozinho Daniel
Community health workers
Motivation
Mozambique
Supervision
Support
Public Administration
Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
title_short Supervision of community health workers in Mozambique
title_full Supervision of community health workers in Mozambique
title_fullStr Supervision of community health workers in Mozambique
title_full_unstemmed Supervision of community health workers in Mozambique
title_sort Supervision of community health workers in Mozambique
author Ndima, Sozinho Daniel
author_facet Ndima, Sozinho Daniel
Sidat, Mohsin
Give, Celso
Ormel, Hermen
Kok, Maryse Catelijne
Taegtmeyer, Miriam
author_role author
author2 Sidat, Mohsin
Give, Celso
Ormel, Hermen
Kok, Maryse Catelijne
Taegtmeyer, Miriam
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Instituto de Higiene e Medicina Tropical (IHMT)
Global Health and Tropical Medicine (GHTM)
RUN
dc.contributor.author.fl_str_mv Ndima, Sozinho Daniel
Sidat, Mohsin
Give, Celso
Ormel, Hermen
Kok, Maryse Catelijne
Taegtmeyer, Miriam
dc.subject.por.fl_str_mv Community health workers
Motivation
Mozambique
Supervision
Support
Public Administration
Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
topic Community health workers
Motivation
Mozambique
Supervision
Support
Public Administration
Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
description PMID: 26323970 WOS:000360349700001
publishDate 2015
dc.date.none.fl_str_mv 2015-09-01
2015-09-01T00:00:00Z
2018-05-11T22:02:58Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://doi.org/10.1186/s12960-015-0063-x
url https://doi.org/10.1186/s12960-015-0063-x
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv PURE: 1729370
http://www.scopus.com/inward/record.url?scp=84940473815&partnerID=8YFLogxK
https://doi.org/10.1186/s12960-015-0063-x
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
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repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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