Revadi G, Joshi Ankur, Pakhare Abhijit P
Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.
Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
Indian J Community Med. 2025 Jan-Feb;50(1):119-125. doi: 10.4103/ijcm.ijcm_48_23. Epub 2024 Oct 3.
Supportive supervision of the Community health workers (CHWs) is critical for their efficient functioning in various health programmes. CHWs in India are supervised by facilitators known as ASHA Sahyogini. Our study aimed to investigate the linkage between the knowledge and skills of CHW facilitators and their CHWs. To understand the problems encountered by the CHW facilitators while assisting their CHWs. Also, to determine the perceptions of CHWs on the nature of supportive supervision of their facilitators.
A mixed-method explanatory study using purposive sampling was conducted in a rural block of Madhya Pradesh (Central India). The CHWs were categorized into relatively high performing (RHP) and relatively low performing (RLP) groups based on their performance-based incentives received during (2017-2018). The quantitative component comprised of self-administered questionnaire and skill assessment while the qualitative component comprised of three focused group discussions with RHP, RLP CHWs and their facilitators.
The mean (SD) supportive supervision score given by CHW facilitators were found to be significantly associated with CHW's performance. Problems faced by CHW facilitators while assisting their CHWs resulted from inadequate education of CHWs, insufficient incentives, transport problems and repetitive surveys. While some CHWs perceived to have received good assistance from their facilitators, there were a few who were not dependent on their facilitators and executed duties by themselves.
CHW's performance cannot be ascribed completely to the CHW facilitator's performance. The challenges perceived by CHW facilitators were unmodifiable and required them to strongly motivate and support their CHWs to improve their functionality.
对社区卫生工作者（CHW）的支持性监督对于他们在各种卫生项目中的高效运作至关重要。印度的社区卫生工作者由称为ASHA Sahyogini的促进者进行监督。我们的研究旨在调查社区卫生工作者促进者的知识和技能与其所负责的社区卫生工作者之间的联系。了解社区卫生工作者促进者在协助其社区卫生工作者时遇到的问题。此外，确定社区卫生工作者对其促进者支持性监督性质的看法。
在印度中部中央邦的一个农村街区进行了一项采用目的抽样的混合方法解释性研究。根据社区卫生工作者在2017 - 2018年期间获得的基于绩效的激励措施，将他们分为表现相对较高（RHP）和表现相对较低（RLP）两组。定量部分包括自填式问卷和技能评估，而定性部分包括与表现相对较高、表现相对较低的社区卫生工作者及其促进者进行的三次焦点小组讨论。
发现社区卫生工作者促进者给出的平均（标准差）支持性监督得分与社区卫生工作者的表现显著相关。社区卫生工作者促进者在协助其社区卫生工作者时面临的问题源于社区卫生工作者教育不足、激励措施不足、交通问题和重复性调查。虽然一些社区卫生工作者认为从他们的促进者那里得到了良好的帮助，但也有一些人不依赖他们的促进者，而是自行履行职责。
社区卫生工作者的表现不能完全归因于社区卫生工作者促进者的表现。社区卫生工作者促进者所面临的挑战是无法改变的，这要求他们大力激励和支持其社区卫生工作者以提高其功能。
