Innovation in supervision and support of community health workers for better newborn survival in southern Tanzania.
BACKGROUND
Home visits by community health workers may help to improve newborn survival, but sustained high-quality supervision of community volunteers is challenging.


OBJECTIVE
To compare facility-led and community-linked supervision approaches of 824 community health volunteers working to improve newborn care in Southern Tanzania.


METHODS
Using a before-after design, we compared 6 months of supervision reports from each approach.


RESULTS
During the community-linked approach over 50 times more supervision contacts were recorded than during the facility-only supervision approach (1.04 contacts per volunteer per month vs 0.02), and the volunteer-supervisor ratio reduced from 7.8 to 1.6.


CONCLUSIONS
Involving community leaders has the potential to improve supervision of community health volunteers. ClinicalTrials.gov Identifier: NCT01022788; http://clinicaltrials.gov/ct2/show/NCT01022788?term=INSIST&rank=1.
Ifakara Health Institute, Plot 463 Kiko Avenue, Mikocheni Dar es Salaam, Tanzania emkumbo@ihi.or.tz.
Elibariki
E
Mkumbo
Ifakara Health Institute, Plot 463 Kiko Avenue, Mikocheni Dar es Salaam, Tanzania Department of Public Health Sciences, Karolinska Institutet, Widerströmska Huset, 17177 Stockholm, Sweden Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Claudia
C
Hanson
Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Suzanne
S
Penfold
Ifakara Health Institute, Plot 463 Kiko Avenue, Mikocheni Dar es Salaam, Tanzania.
Fatuma
F
Manzi
Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Joanna
J
Schellenberg
D002983:Clinical Competence; D003150:Community Health Workers / Q000592:standards / Q000706:statistics & numerical data*; D065187:Controlled Before-After Studies; D005260:Female; D006699:Home Care Services / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D010559:Personnel Management / Q000706:statistics & numerical data*; D011181:Postnatal Care / Q000458:organization & administration / Q000592:standards*; D013636:Tanzania; D014838:Volunteers
Community health workers; Newborn health; Supervision; Tanzania