A mixed method study on supportive supervision of Community Health Workers from Central India

Abstract Introduction Supportive supervision of the Community health workers (CHWs) are critical for their efficient functioning in various health programs. CHWs in India are supervised by facilitators known as ASHA Sahyogini. Our study aimed at investigating the linkage between 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 nature of supportive supervision of their facilitators. Methods A mixed method explanatory study using purposive sampling was conducted in a rural block of Madhya Pradesh (Central India). The CHWs were categorised into relatively high performing (RHP) and relatively low performing (RLP) groups based on their performance-based incentives received during (2017-2018). Quantitative component comprised of self-administered questionnaire and skill assessment while the qualitative component comprised of three focussed group discussion with RHP, RLP CHWs and their facilitators. Results The mean (SD) supportive supervision score given by CHW facilitators were found to be significantly associated with CHWs 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 dependant on their facilitators and executed duties by self. Conclusion CHWs performance cannot be ascribed completely to the CHW facilitators performance. The challenges perceived by CHW facilitators were unmodifiable and requires them to strongly motivate and support their CHWs in order to improve their functionality.