Gupta Suruchi, Chatterjee Anirban, Singhal Kritika, Pakhare Abhijit P, Joshi Ankur
International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA.
Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, IND.
Cureus. 2025 Jun 24;17(6):e86648. doi: 10.7759/cureus.86648. eCollection 2025 Jun.
Supportive supervision of community health workers (CHWs) is considered a promising intervention for optimizing efficiency and health systems outcomes. However, little is known about how supportive supervision is conceptualized and implemented across maternal and child health (MCH) programs in India. We examined the scope of supportive supervision in selected MCH programs. We analyzed 29 programmatic documents and implementation guidelines from seven programs, and identified and extracted data on several themes, such as conceptualization, operationalization, monitoring and evaluation, and quality assurance of supportive supervision according to a pre-determined domain-based template. We found notable differences in the scope and quality of supportive supervision offered under different programs. Many programs did not include supportive supervision as a supervisory modality. Programs which included supportive supervision did not define all the parameters of operationalization - responsible workforce, frequency of visits, procedure, training, logistic support, supervision formats/checklists, scope for and frequency of monitoring and evaluation, and quality assurance of supervisory visits. Even when some parameters were defined, there was considerable heterogeneity in implementation across programs. Such inconsistencies may adversely affect the quality and efficiency of supportive supervision, thereby minimizing its potential. Policymakers should prioritize the redesign of supportive supervision strategies to ensure greater clarity and consistency across key domains, thereby optimizing community health worker performance and strengthening public health program outcomes.
对社区卫生工作者（CHW）的支持性监督被认为是一种很有前景的干预措施，有助于优化效率和改善卫生系统成果。然而，对于印度母婴健康（MCH）项目中支持性监督是如何被概念化和实施的，我们却知之甚少。我们研究了选定的母婴健康项目中支持性监督的范围。我们分析了来自七个项目的29份项目文件和实施指南，并根据预先确定的基于领域的模板，识别并提取了有关几个主题的数据，如支持性监督的概念化、实施、监测与评估以及质量保证。我们发现不同项目所提供的支持性监督在范围和质量上存在显著差异。许多项目并未将支持性监督作为一种监督方式。纳入支持性监督的项目并未明确所有实施参数——责任人员、访视频率、程序、培训、后勤支持、监督形式/清单、监测与评估的范围和频率，以及监督访问的质量保证。即使定义了一些参数，各项目在实施过程中仍存在相当大的异质性。这种不一致可能会对支持性监督的质量和效率产生不利影响，从而降低其潜力。政策制定者应优先重新设计支持性监督策略，以确保关键领域有更高的清晰度和一致性，从而优化社区卫生工作者的绩效并加强公共卫生项目成果。
