| Training and Supervision Did Not Meaningfully Improve Quality of Care for Pregnant Women or Sick Children in Sub-Saharan Africa |
| Authors: |
Hannah H. Leslie, Anna Gage, Humphreys Nsona, Lisa R. Hirschhorn, and Margaret E. Kruk |
| Source: |
Health Affairs, 35(9):1716-1724; doi: 10.1377/hlthaff.2016.0261 |
| Topic(s): |
Antenatal care
Child health
Health care utilization
|
| Country: |
Africa
Multiple African Countries
|
| Published: |
SEP 2016 |
| Abstract: |
In-service training courses and supportive supervision of health
workers are among the most common interventions to improve the
quality of health care in low- and middle-income countries. Despite
extensive investment from donors, evaluations of the long-term effect of
these two interventions are scarce. We used nationally representative
surveys of health systems in seven countries in sub-Saharan Africa to
examine the association of in-service training and supervision with
provider quality in antenatal and sick child care. The results of our
analysis showed that observed quality of care was poor, with fewer than
half of evidence-based actions completed by health workers, on average.
In-service training and supervision were associated with quality of sick
child care; they were associated with quality of antenatal care only when
provided jointly. All associations were modest—at most, improvements
related to interventions were equivalent to 2 additional provider actions
out of the 18–40 actions expected per visit. In-service training and
supportive supervision as delivered were not sufficient to meaningfully
improve the quality of care in these countries. Greater attention to the
quality of health professional education and national health system
performance will be required to provide the standard of health care that
patients deserve. |
| Web: |
http://content.healthaffairs.org/content/35/9/1716.abstract |