LEVELS OF SUPERVISION IN PRIMARY HEALTH CARE

The level of supervision in PHC exists at:

1.      The Village Level

2.      The Local Government level

3.      The State Level.

4.      The Federal Level.

For lecture purposes, emphasis shall be laid on the conduct of supervision within the Local Government Area. At this level the supervision has been divided into four levels namely:

i.                    The Village Level

ii.                  The Health Facility level

iii.                The District referral facility.

iv.                The LGA Headquarter

Supervision takes place at each of the above levels.

Also a supervision checklist is usually designed to monitor various activities at each level. The Federal Ministry of Health has provided a supervision checklist which spells out at each level of supervision, who does supervision, how often, and what to use. For instance, the use of checklist and the feedback. The focus of this lecture shall be on supervision at the District Referral facility level e.g. Pakoto Health Centre.

CHARACTERISTICS OF A GOOD SUPERVISOR:

§     The supervisor has to be regular and timely.

§     Supervision has to be based on targets

§     Supervisor has to be knowledgeable, and sound in whatever he/she is supervising.

§     Supervision has to be done n a culturally accepted manner e.g. gender identity/ roles. Female supervisor vs male subordinate, or in cases of age discrimination i.e. the method of supervision should not bring about humiliation.

§     A good supervisor should command respect, subordinates will; have genuine respect for him /her.

Factors that could affect supervisory style are:

The nature of the job to be supervised; the job nature deals with the complexity of the job itself. For instance, while supervising the provision of sanitary well for a community, the best style to adopt is the democratic style. If other styles like autocratic style is used. Community members can accept the project but not utilize facility, therefore the democratic style would be more acceptable. But if there is an outbreak of epidemic, in an area, the health team members need to use autocratic style for community members to act promptly and to check death rate, as there will be a need for quick decisions and consistent results.

·         Job Maturity of Worker: This is an aspect of personal factor of the subordinate. lob maturity deals with the workers’ or subordinates ability or job competence, skills, reliability and wok experience.

·         Psychological Maturity: This psychological maturity deals with the willingness of workers to accept responsibility.

·         Personality of the Manager: A good manager/leader should not allow his or her personality to affect his leadership style.

Finally one will say that the style of leadership or supervision should be determined by die situation. In other words, the situational leadership is the best approach.

The reasons for planning supervision is:

To focus attention during supervision on those activities arid considered most important for the efficient and effective implementation of PHC Programme.

To remind the supervisor of all the activities and tasks that should be supervised.
Therefore clinic managers should plan supervision to ensure that clinic activities are done properly and at the right time.

Steps involved in planning Supervision

The steps involved in planning Supervision are:

·         Identity major activities that will be supervised at the level.

·   Sequence the activate in order of priority.

·   Determine me indicators for supervising each activity.

Note: Indicators are measures of progress expected to be achieved by a programme and are usually expressed in percentages.

·         Align indicators to the activities on the list that is arrange the indicators for die activities.

·         Develop a supervision checklist.

METHODS OF SUPERVISION

The methods of supervising appropriate for the level of Supervision are as follows:

·         Physical supervision

·         Correspondence

·         Regular submission of monthly report.