Bailey Claire, Blake Carolyn, Schriver Michael, Cubaka Vincent Kalumire, Thomas Tisa, Martin Hilber Adriane
Department of Social Statistics and Demography, University of Southampton, Southampton, UK.
Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
Int J Gynaecol Obstet. 2016 Jan;132(1):117-25. doi: 10.1016/j.ijgo.2015.10.004. Epub 2015 Nov 6.
It may be assumed that supportive supervision effectively builds capacity, improves the quality of care provided by frontline health workers, and positively impacts clinical outcomes. Evidence on the role of supervision in Sub-Saharan Africa has been inconclusive, despite the critical need to maximize the workforce in low-resource settings.
To review the published literature from Sub-Saharan Africa on the effects of supportive supervision on quality of care, and health worker motivation and performance.
A systematic review of seven databases of both qualitative and quantitative studies published in peer-reviewed journals.
Selected studies were based in primary healthcare settings in Sub-Saharan Africa and present primary data concerning supportive supervision.
Thematic synthesis where data from the identified studies were grouped and interpreted according to prominent themes.
Supportive supervision can increase job satisfaction and health worker motivation. Evidence is mixed on whether this translates to increased clinical competence and there is little evidence of the effect on clinical outcomes.
Results highlight the lack of sound evidence on the effects of supportive supervision owing to limitations in research design and the complexity of evaluating such interventions. The approaches required a high level of external inputs, which challenge the sustainability of such models.
可以假定支持性监督能有效建设能力，提高一线卫生工作者提供的护理质量，并对临床结果产生积极影响。尽管在资源匮乏地区迫切需要最大限度地发挥劳动力的作用，但关于撒哈拉以南非洲地区监督作用的证据尚无定论。
回顾撒哈拉以南非洲地区已发表的关于支持性监督对护理质量、卫生工作者积极性和绩效影响的文献。
对发表在同行评审期刊上的定性和定量研究的七个数据库进行系统综述。
所选研究基于撒哈拉以南非洲地区的初级卫生保健机构，并提供有关支持性监督的原始数据。
主题综合，即将已识别研究的数据按照突出主题进行分组和解读。
支持性监督可提高工作满意度和卫生工作者的积极性。关于这是否会转化为临床能力的提高，证据不一，而且几乎没有证据表明其对临床结果有影响。
结果凸显出由于研究设计的局限性以及评估此类干预措施的复杂性，关于支持性监督效果缺乏可靠证据。这些方法需要大量外部投入，这对这些模式的可持续性构成挑战。
