A methodology for design, evaluation, and improvement of village health worker supervision schemes in rural Tanzania

• Published in: Socio-economic planning sciences Vol. 20; no. 4; pp. 219 - 232
• Main Authors: Parker, Barnett R., Mtango, F.D., Koda, G.R., Killewo, J.J., Muhondwa, E.P., Newman, Jeanne S.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Ltd 1986; Pergamon Press; Elsevier
• Series: Socio-Economic Planning Sciences
• Subjects: Africa; Bgi / Prodig; Developing Countries; East Africa; Evaluation; Health Care; Health Professions; Methodology; Paramedical Personnel; Supervision; Tanzania; Villages
• ISSN: 0038-0121; 1873-6041
• DOI: 10.1016/0038-0121(86)90013-3

The utilization of village health workers (VHWs) and other front-line health personnel represents an increasingly important form of primary health care delivery in developing regions. In attempting to build and maintain cohorts of effective VHWs, it must be recognized that appropriate worker supervision is an element crucial to success. However, identification of “best” supervision scheme designs remains a difficult and time-consuming task. So too do the tasks of scheme evaluation and correction/improvement. For these reasons, such efforts have been noticeably absent in the development of most VHW programs. The current paper attempts to reduce these difficulties in proposing a methodology that formalizes the process of designing VHW supervision schemes. In so doing, the methodology performs 3 critical and intimately related functions: (1) identification of a “best” or reference VHW supervision scheme; (2) assessment/evaluation of the existing VHW supervision scheme (whatever its form); and (3) appropriate corrections/improvements to the current or revised scheme, moving it closer in design and performance to the reference scheme. The methodology is developed and applied within the context of an on-going project to design effective VHW supervision schemes in rural Tanzania.