What is the “state of the art?”11Q3 11Q4 12Q1 12Q2 12Q3 12Q4 13Q1 13Q2 13Q3 13Q4 14Q1 14Q2 14Q3...
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What is the “state of the art?” About effectiveness of supervision in stable contexts… • Tools need to be simple • Competence, accuracy, supervision of SUPERVISORS is key • Direct observation is a promising practice • Planned but poorly executed supervision is worse than none at all November 23, 2015 1
Transcript of What is the “state of the art?”11Q3 11Q4 12Q1 12Q2 12Q3 12Q4 13Q1 13Q2 13Q3 13Q4 14Q1 14Q2 14Q3...
What is the “state of the art?”
About effectiveness of supervision in stable contexts… • Tools need to be simple • Competence, accuracy, supervision of SUPERVISORS
is key • Direct observation is a promising practice
• Planned but poorly executed supervision is worse than
none at all
November 23, 2015
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What “difficult contexts/”
• Program goal – Increase women’s access to family planning and post-abortion care in difficult contexts
• Program content– training and supervision to front-line primary care providers in family planning and post-abortion care initiative (also demands-side, supply chain, etc)
• Program context: Chad, eastern DRC, Mali, Pakistan, Djibouti; affected by natural disaster, active conflict, fragile state
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What does success look like?
• # family planning users • # post-abortion care cases
• % FP clients choosing long-acting family planning • %PAC clients accepting PAC • Infection prevention score from supervision
checklist
• NOTE – respectful care and clinical skills should be included – in a perfect world November 23, 2015
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What were the key elements of effective supervision?
• Community involvement in quality improvement
• Data-driven front-line management
• Regular supervisory visits
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Regular visits
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2011 2014 Going forward
Mon
ths
= Facilities
Data-Driven front line management
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Community engagement, as essential supervision step
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Quality Improvement – Method Mix
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-40%
-20%
0%
20%
40%
60%
80%
100%
11Q3 11Q4 12Q1 12Q2 12Q3 12Q4 13Q1 13Q2 13Q3 13Q4 14Q1 14Q2 14Q3 14Q4 15Q1 15Q2
% Long Acting and Permanent Methods of All New Users
CHD
DJI
DRC.
MAL
PAK
Quality Improvement – FP among PAC
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
11Q3 11Q4 12Q1 12Q2 12Q3 12Q4 13Q1 13Q2 13Q3 13Q4 14Q1 14Q2 14Q3 14Q4 15Q1 15Q2
% Post-Abortion Care Clients who Accepted Family Planning
CHD.
DJI.
DRC..
MAL.
PAK.
Quality Improvement – Infection Prevention scores
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5.00
5.50
6.00
6.50
7.00
7.50
8.00
8.50
9.00
9.50
10.00
2014_02
2014_03
2014_04
2014_05
2014_06
2014_07
2014_08
2014_09
2014_10
2014_11
2014_12
Chad
DRC
The numbers to prove it
• 128,518 new FP users PAC services to 7,341 women, between July 2011 and December 2014
• 68% FP users chose LAPM (Up from virtually 0%)
• 59% PAC clients accepted FP
• Infection prevention scores (on a 1 – 10 scale) improved from below 8 to above 9.5
• Plus, data quality errors were virtually eliminated, and stock-outs reduced significantly in all countries.
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In summary • Regularly (not necessarily frequency) matters
• Include communities for mutual accountability
• Data motivates - Positive competition among stakeholders fuels emulation of effective techniques
• Supervision is a building block across health areas
• Supervision is “high investment” but front-line health workers without it wastes potential
• KISS
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Thank you
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