Abstract of Master’s Dissertation
No.1

International Health
CourseDevelopment

Name

Fuka Uchiumi(Master of Public Health)Thesis

Impacts of supportive supervision on community health workers’ performance:

Title

A mixed-methods study in four districts of the Northern region, Ghana

Background:
Community health workers (CHWs) carry out community-based health care activities asmembers of their communities and have a shorter education and training than otherprofessionals. Supportive supervision is considered to improve CHWs’ performance, but theresults of earlier studies on the effectiveness of supportive supervision in CHWs' performanceare mixed. Moreover, few studies on supportive supervision for Community Health Officers(CHOs) were conducted in Ghana. An earlier study aimed at evaluation of supportive
supervision in Upper West region did not compare the effectiveness neither between pre-andpost-interventions or not between the intervention and control groups. This resulted in less clear
conclusion on whether supportive supervision was effective in performance of healthprofessionals including CHOs. Thus, there is a critical need for study on the effectiveness ofsupportive supervision in CHWs’ performance in Ghana. In Northern Ghana, basic supportive
supervision was rolled out. However, it has been limited and additional supportive supervision
has been introduced in parts of the Northern Region.
Objectives:
This study aimed to estimate the CHWs’ performance in the intervention group (basic plus
additional supportive supervision) by comparing the control group (basic supportive supervisiononly).
Methods:
A mixed-methods sequential explanatory study, composed of structured and Key Informant
interviews, and Focus Group Discussions was employed. The study participants were CHOs,
their supervisors, and women receiving health care services from their CHOs in four districts ofthe Northern Region. For quantitative data analysis, mixed-effects logistic regression wasperformed to identify any possible association between CHOs’ performance and its 121
independent variables. Thematic analysis was conducted for qualitative data analysis.

＊ The abstract, containing background, objectives, methods, results and conclusion should not exceed
300-500words and printed double sided on A4 paper)

Abstract of Master’s Dissertation
No.2

International Health
CourseDevelopment

Name

Fuka Uchiumi(Master of Public Health)Results:
A total of 58 CHOs and 28 supervisors participated in structured interviews. Nineteen CHOs
in the intervention group (67.9%) and 10 in the control group (33.3%) timely submitted
complete reports for 12 months. Nine (32.1%) and 11 (36.7%) in the intervention and control
groups made sufficient referrals, respectively. No and only one CHO achieved the home visits
and attendance performance targets, respectively. CHOs assigned to the best well-equipped
CHPS facilities tended to perform better in report submission than those not (Adjust Odds
Ratio (AOR)=8.41; p=0.033). CHOs in the intervention group tended to perform 3.93 times
better in report submission, though its AOR was not significant (p=0.119). CHOs living at
CHPS compound were 4.80 times more likely to give referrals than those who commute totheir workplace (p=0.021). CHOs working under supervisors who spent four years on nursing
education were more likely to give referrals than those not (AOR=3.77; p=0.052). CHOs in theintervention group performed 1.38 times better on the number of referrals than the control
group (p=0.634) though these differences were not statistically significant. In contrast, theresults of qualitative data analysis showed several positive elements of supportive supervisionon CHOs’ performance, such as supportive supervision as a motivating factor.
Conclusion:
Supportive supervision has potential effectiveness in improving the CHOs’ performance. The
study also found that several other factors such as availability of equipment and CHPS
compound as accommodation for CHOs were associated with the CHOs’ performance.
(499 words)