A methodology for design, evaluation, and improvement of village health worker supervision schemes in rural Tanzania
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 supervi...
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| Published in | Socio-economic planning sciences Vol. 20; no. 4; pp. 219 - 232 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
New York, NY
Elsevier Ltd
1986
Pergamon Press Elsevier |
| Series | Socio-Economic Planning Sciences |
| Subjects | |
| Online Access | Get full text |
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| Abstract | 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. |
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| AbstractList | 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. The utilization of village health workers (VHWs) & other front-line health personnel represents an increasingly important form of primary health care delivery in developing regions. In attempting to build & maintain cohorts of effective VHWs, appropriate worker supervision is crucial to success. A methodology is put forth that formalizes the process of designing VHW supervision schemes, involving three critical & intimately related functions: (1) identification of a "best" or reference supervision scheme; (2) assessment/evaluation of the existing VHW supervision scheme; & (3) appropriate corrections/improvements to the current or revised scheme, moving it closer in design & performance to the reference scheme. The methodology is applied within the context of an on-going project to design effective VHW supervision schemes in Ru Tanzania. 3 Tables, 2 Figures, 1 Appendix, 31 References. Modified HA |
| Author | Newman, Jeanne S. Mtango, F.D. Koda, G.R. Killewo, J.J. Muhondwa, E.P. Parker, Barnett R. |
| Author_xml | – sequence: 1 givenname: Barnett R. surname: Parker fullname: Parker, Barnett R. organization: Department of Health Policy and Administration, University of North Carolina, Chapel Hill, NC 27514-6201, U.S.A – sequence: 2 givenname: F.D. surname: Mtango fullname: Mtango, F.D. organization: Department of Epidemiology and Biostatistics, Muhimbili Medical Center, Dar es Salaam, Tanzania – sequence: 3 givenname: G.R. surname: Koda fullname: Koda, G.R. organization: Scientific Computing Centre, University of Dar es Salaam, Dar es Salaam, Tanzania – sequence: 4 givenname: J.J. surname: Killewo fullname: Killewo, J.J. organization: Department of Epidemiology and Biostatistics, Muhimbili Medical Center, Dar es Salaam, Tanzania – sequence: 5 givenname: E.P. surname: Muhondwa fullname: Muhondwa, E.P. organization: Department of Behavioral Sciences, Muhimbili Medical Center, Dar es Salaam, Tanzania – sequence: 6 givenname: Jeanne S. surname: Newman fullname: Newman, Jeanne S. organization: Center for Human Services, Chevy Chase, Maryland, U.S.A |
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| References | Ignizio (BIB27) 1982 Gish (BIB13) 1973 Callan (BIB6) 1970; 85 Ofosu-Amaah (BIB8) 1983 Delp, Thesen, Motiwalla, Seshadri (BIB16) 1977 Parker (BIB20) 1985; 13 World Health Organization (BIB5) 1978 Silver, Vidal, deWerra (BIB31) 1980; 5 Mtango, Neuvians (BIB14) 1983 Srinivasan, Shocker, Weinstein (BIB22) 1973; 9 Scriven (BIB29) 1967 Kleczkowski, Elling, Smith (BIB9) 1984 O'Conner (BIB12) 1980 Parker (BIB4) 1983; 10 Likert (BIB30) 1967 Bazaraa, Bouzaher (BIB26) 1981; 27 Dawes, Corrigan (BIB21) 1974; 81 Schaefer, Reynolds (BIB11) 1985 Parker, Srinivasan (BIB18) 1976; 24 Bainbridge, Sapirie (BIB17) 1974 (BIB10) 1967 Wagner (BIB24) 1975 World Health Organization (BIB3) 1979 Pan American Health Organization (BIB19) 1978 Lamptey, Nicholas, Quartey-Papafio (BIB1) 1980; 1 Pan American Health Organization (BIB7) 1975 Mwabulambo (BIB15) 1977 Zeleny (BIB28) 1981; 8 Parker, Skinner (BIB23) 1982; 3 Molina, Turizo, Arango, deMurillo (BIB2) 1980; 1 Green, Srinivasan (BIB25) 1978; 5 Green (10.1016/0038-0121(86)90013-3_BIB25) 1978; 5 Srinivasan (10.1016/0038-0121(86)90013-3_BIB22) 1973; 9 Silver (10.1016/0038-0121(86)90013-3_BIB31) 1980; 5 Mtango (10.1016/0038-0121(86)90013-3_BIB14) 1983 Wagner (10.1016/0038-0121(86)90013-3_BIB24) 1975 Delp (10.1016/0038-0121(86)90013-3_BIB16) 1977 (10.1016/0038-0121(86)90013-3_BIB10) 1967 Zeleny (10.1016/0038-0121(86)90013-3_BIB28) 1981; 8 World Health Organization (10.1016/0038-0121(86)90013-3_BIB5) 1978 Molina (10.1016/0038-0121(86)90013-3_BIB2) 1980; 1 Lamptey (10.1016/0038-0121(86)90013-3_BIB1) 1980; 1 Scriven (10.1016/0038-0121(86)90013-3_BIB29) 1967 Parker (10.1016/0038-0121(86)90013-3_BIB4) 1983; 10 World Health Organization (10.1016/0038-0121(86)90013-3_BIB3) 1979 Pan American Health Organization (10.1016/0038-0121(86)90013-3_BIB7) 1975 Mwabulambo (10.1016/0038-0121(86)90013-3_BIB15) 1977 O'Conner (10.1016/0038-0121(86)90013-3_BIB12) 1980 Dawes (10.1016/0038-0121(86)90013-3_BIB21) 1974; 81 Parker (10.1016/0038-0121(86)90013-3_BIB23) 1982; 3 Bazaraa (10.1016/0038-0121(86)90013-3_BIB26) 1981; 27 Pan American Health Organization (10.1016/0038-0121(86)90013-3_BIB19) 1978 Likert (10.1016/0038-0121(86)90013-3_BIB30) 1967 Gish (10.1016/0038-0121(86)90013-3_BIB13) 1973 Ignizio (10.1016/0038-0121(86)90013-3_BIB27) 1982 Bainbridge (10.1016/0038-0121(86)90013-3_BIB17) 1974 Schaefer (10.1016/0038-0121(86)90013-3_BIB11) 1985 Parker (10.1016/0038-0121(86)90013-3_BIB20) 1985; 13 Callan (10.1016/0038-0121(86)90013-3_BIB6) 1970; 85 Kleczkowski (10.1016/0038-0121(86)90013-3_BIB9) 1984 Parker (10.1016/0038-0121(86)90013-3_BIB18) 1976; 24 Ofosu-Amaah (10.1016/0038-0121(86)90013-3_BIB8) 1983 |
| References_xml | – volume: 85 start-page: 780 year: 1970 end-page: 787 ident: BIB6 article-title: Supervision, the key to success with aides publication-title: Publ. Hlth Rep. contributor: fullname: Callan – year: 1978 ident: BIB5 publication-title: Primary Health Care: Report of the International Conference on Primary Health Care, Alma-Ata USSR, Geneva contributor: fullname: World Health Organization – volume: 10 start-page: 375 year: 1983 end-page: 389 ident: BIB4 article-title: A program selection/resource allocation model for control of malaria and related parasitic diseases publication-title: Comput. Ops. Res. contributor: fullname: Parker – volume: 1 start-page: 52 year: 1980 end-page: 56 ident: BIB1 article-title: Training village health workers in rural Ghana publication-title: Wld Hlth Forum contributor: fullname: Quartey-Papafio – year: 1977 ident: BIB16 article-title: Systems Tools for Project Planning contributor: fullname: Seshadri – year: 1977 ident: BIB15 article-title: Village health workers scheme in Tanzania publication-title: Paper presented at the International Medical and Research Foundation Symposium on the Community Health Worker, Warrenton, Virginia contributor: fullname: Mwabulambo – volume: 13 start-page: 313 year: 1985 end-page: 330 ident: BIB20 article-title: A multiple goal methodology for evaluating management information systems publication-title: Omega contributor: fullname: Parker – year: 1967 ident: BIB30 article-title: The Human Organization: Its Management and Value contributor: fullname: Likert – year: 1980 ident: BIB12 article-title: Managing Health Systems in Developing Areas: Experiences from Afghanistan contributor: fullname: O'Conner – year: 1975 ident: BIB7 article-title: Guide for the Organization of Health Services in Rural Areas and the Utilization of Auxiliary Personnel publication-title: Scientific Publication No. 290 contributor: fullname: Pan American Health Organization – start-page: 39 year: 1967 end-page: 83 ident: BIB29 article-title: The methodology of evaluation publication-title: American educational research association monograph series in curriculum evaluation: perspectives of curriculum evaluation contributor: fullname: Scriven – start-page: 1251 year: 1973 end-page: 1254 ident: BIB13 article-title: Doctor auxiliaries in Tanzania publication-title: Lancet contributor: fullname: Gish – volume: 27 start-page: 396 year: 1981 end-page: 413 ident: BIB26 article-title: linear goal programming model for developing economies with an illustration from the agricultural sector in Egypt publication-title: Mgmt Sci. contributor: fullname: Bouzaher – volume: 81 start-page: 95 year: 1974 end-page: 106 ident: BIB21 article-title: Linear models in decision making publication-title: Psychol. 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Ops Res. doi: 10.1016/0305-0548(81)90022-8 contributor: fullname: Zeleny – year: 1975 ident: 10.1016/0038-0121(86)90013-3_BIB24 contributor: fullname: Wagner – volume: 5 start-page: 103 issue: 2 year: 1978 ident: 10.1016/0038-0121(86)90013-3_BIB25 article-title: Conjoint analysis in consumer research: issues and outlook publication-title: J. Consumer Res. doi: 10.1086/208721 contributor: fullname: Green – year: 1985 ident: 10.1016/0038-0121(86)90013-3_BIB11 contributor: fullname: Schaefer – year: 1977 ident: 10.1016/0038-0121(86)90013-3_BIB15 article-title: Village health workers scheme in Tanzania publication-title: Paper presented at the International Medical and Research Foundation Symposium on the Community Health Worker, Warrenton, Virginia contributor: fullname: Mwabulambo – year: 1978 ident: 10.1016/0038-0121(86)90013-3_BIB19 article-title: Utilization of Auxiliaries and Community Leaders in Health Programs in Rural Areas publication-title: Scientific Publication No. 296 contributor: fullname: Pan American Health Organization – start-page: 39 year: 1967 ident: 10.1016/0038-0121(86)90013-3_BIB29 article-title: The methodology of evaluation contributor: fullname: Scriven – year: 1984 ident: 10.1016/0038-0121(86)90013-3_BIB9 contributor: fullname: Kleczkowski – year: 1977 ident: 10.1016/0038-0121(86)90013-3_BIB16 contributor: fullname: Delp – volume: 24 start-page: 991 issue: 5 year: 1976 ident: 10.1016/0038-0121(86)90013-3_BIB18 article-title: A consumer preference approach to the planning of rural primary health-care facilities publication-title: Ops. Res. doi: 10.1287/opre.24.5.991 contributor: fullname: Parker – start-page: 1251 year: 1973 ident: 10.1016/0038-0121(86)90013-3_BIB13 article-title: Doctor auxiliaries in Tanzania publication-title: Lancet doi: 10.1016/S0140-6736(73)90986-0 contributor: fullname: Gish – volume: 81 start-page: 95 issue: 2 year: 1974 ident: 10.1016/0038-0121(86)90013-3_BIB21 article-title: Linear models in decision making publication-title: Psychol. Bull. doi: 10.1037/h0037613 contributor: fullname: Dawes – year: 1967 ident: 10.1016/0038-0121(86)90013-3_BIB10 – volume: 3 start-page: 229 issue: 2 year: 1982 ident: 10.1016/0038-0121(86)90013-3_BIB23 article-title: Improving the selection of family medicine residents through development of multi-dimensional policy models publication-title: Hlth Policy and Education doi: 10.1016/0165-2281(82)90004-2 contributor: fullname: Parker – year: 1982 ident: 10.1016/0038-0121(86)90013-3_BIB27 contributor: fullname: Ignizio – volume: 5 start-page: 153 issue: 3 year: 1980 ident: 10.1016/0038-0121(86)90013-3_BIB31 article-title: A tutorial on heuristic methods publication-title: Eur. J. Opl Res. doi: 10.1016/0377-2217(80)90084-3 contributor: fullname: Silver – year: 1983 ident: 10.1016/0038-0121(86)90013-3_BIB8 contributor: fullname: Ofosu-Amaah – volume: 85 start-page: 780 issue: 9 year: 1970 ident: 10.1016/0038-0121(86)90013-3_BIB6 article-title: Supervision, the key to success with aides publication-title: Publ. Hlth Rep. doi: 10.2307/4593965 contributor: fullname: Callan – year: 1975 ident: 10.1016/0038-0121(86)90013-3_BIB7 article-title: Guide for the Organization of Health Services in Rural Areas and the Utilization of Auxiliary Personnel publication-title: Scientific Publication No. 290 contributor: fullname: Pan American Health Organization – issue: 633 year: 1979 ident: 10.1016/0038-0121(86)90013-3_BIB3 article-title: Training and Utilization of Auxiliary Personnel for Rural Health Teams in Developing Countries publication-title: Technical Report Series contributor: fullname: World Health Organization – volume: 9 start-page: 147 year: 1973 ident: 10.1016/0038-0121(86)90013-3_BIB22 article-title: Measurement of a composite criterion of management success publication-title: Organizational Behavior and Human Performance doi: 10.1016/0030-5073(73)90043-3 contributor: fullname: Srinivasan – year: 1980 ident: 10.1016/0038-0121(86)90013-3_BIB12 contributor: fullname: O'Conner – volume: 1 start-page: 57 issue: 1–2 year: 1980 ident: 10.1016/0038-0121(86)90013-3_BIB2 article-title: Colombia: how to select community health leaders publication-title: Wld Hlth Forum contributor: fullname: Molina – year: 1983 ident: 10.1016/0038-0121(86)90013-3_BIB14 contributor: fullname: Mtango – year: 1974 ident: 10.1016/0038-0121(86)90013-3_BIB17 contributor: fullname: Bainbridge – volume: 10 start-page: 375 issue: 4 year: 1983 ident: 10.1016/0038-0121(86)90013-3_BIB4 article-title: A program selection/resource allocation model for control of malaria and related parasitic diseases publication-title: Comput. Ops. Res. doi: 10.1016/0305-0548(83)90012-6 contributor: fullname: Parker – volume: 1 start-page: 52 issue: 1–2 year: 1980 ident: 10.1016/0038-0121(86)90013-3_BIB1 article-title: Training village health workers in rural Ghana publication-title: Wld Hlth Forum contributor: fullname: Lamptey |
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| SubjectTerms | Africa Bgi / Prodig Developing Countries East Africa Evaluation Health Care Health Professions Methodology Paramedical Personnel Supervision Tanzania Villages |
| Title | A methodology for design, evaluation, and improvement of village health worker supervision schemes in rural Tanzania |
| URI | https://dx.doi.org/10.1016/0038-0121(86)90013-3 http://econpapers.repec.org/article/eeesoceps/v_3a20_3ay_3a1986_3ai_3a4_3ap_3a219-232.htm https://search.proquest.com/docview/1761723042 https://search.proquest.com/docview/60689162 https://search.proquest.com/docview/61610830 |
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