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Improving primary health care through systematic supervision: a controlled field trial
B P Loevinsohn1, E T Guerrero, S P Gregorio
1Asian Development Bank, Manila, Philippines.
Health Policy and Planning
|May 8, 1995
Summary
Systematic supervision using a checklist significantly improved health worker performance in primary care facilities. This cost-effective approach enhanced service delivery in developing countries.
Area of Science:
- Public Health
- Health Services Research
- Developing Country Health Systems
Background:
- Primary health care in developing nations often relies on peripheral facilities with inadequate supervision.
- This context presents challenges for consistent and quality healthcare delivery.
Purpose of the Study:
- To evaluate the impact of systematic supervision, using objective indicators, on health worker performance.
- To determine the cost-effectiveness of implementing a supervision checklist.
Main Methods:
- A 20-indicator checklist developed by the Philippine Department of Health was implemented in 4 remote provinces.
- A control group of 6 provinces from similar regions did not use the checklist.
- Health facilities in all 10 provinces were surveyed before and after the 6-month intervention.
Main Results:
- Performance scores improved by 42% in the experimental group versus 18% in the control group.
- A correlation between supervision frequency and performance improvement was observed in experimental facilities.
- Implementation costs were low: US $19.92 initial and $1.85 annual recurrent cost per facility.
Conclusions:
- Systematic supervision with quantifiable indicators effectively enhances health worker performance.
- This intervention offers a cost-effective strategy to improve primary healthcare services in resource-limited settings.
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