Effect of support supervision on maternal and newborn health services and practices in Rural Eastern Uganda
Loading...
Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
Global Health Action
Abstract
Support supervision is one of the strategies used to check the quality of
services provided at health facilities. From 2013 to 2015, Makerere University School of
Public Health strengthened support supervision in the district of Kibuku, Kamuli and Pallisa
in Eastern Uganda to improve the quality of maternal and newborn services.
Objective: This article assesses quality improvements in maternal and newborn care services
and practices during this period.
Methods: District management teams were trained for two days on how to conduct the
supportive supervision. Teams were then allocated particular facilities, which they consistently
visited every quarter. During each visit, teams scored the performance of each facility
based on checklists; feedback and corrective actions were implemented. Support supervision
focused on maternal health services, newborn care services, human resources, laboratory
services, availability of Information, education and communication materials and infrastructure.
Support supervision reports and checklists from a total of 28 health facilities, each with
at least three support supervision visits, were analyzed for this study and 20 key-informant
interviews conducted.
Results: There was noticeable improvement in maternal and newborn services. For instance,
across the first, second and third quarters, availability of parenteral oxytocin increased from
57% to 75% and then to 82%. Removal of retained products increased from 14% to 50% to
54%, respectively. There was perceived improvement in the use of standards and guidelines
for emergency obstetric care and quality of care provided. Qualitatively, three themes were
identified that promote the success of supportive supervision: changes in the support supervision
style, changes in the adherence to clinical standards and guidelines, and multi-stakeholder
engagement.
Conclusion: Support supervision helped district health managers to identify and address
maternal and newborn service-delivery gaps. However, issues beyond the jurisdiction of
district health managers and facility managers may require additional interventions beyond
supportive supervision.
Description
Keywords
Support supervision, Implementation science, Human resource, Health workers, Maternal and newborn services
Citation
Angela N. Kisakye, Rornald Muhumuza Kananura, Elizabeth Ekirapa-Kiracho, John Bua, Martha Akulume, Gertrude Namazzi & Suzanne Namusoke Kiwanuka (2017) Effect of support supervision on maternal and newborn health services and practices in Rural Eastern Uganda, Global Health Action, 10:sup4, 1345496, DOI: 10.1080/16549716.2017.1345496