Improving Community Health Worker performance by using a personalised feedback dashboard for supervision: a randomised controlled trial

Whidden, Caroline; Kayentao, Kassoum; Liu, Jenny X.; Lee, Scott; Keita, Youssouf; Diakité, Djoumé; Kéita, Adama Diaman; Diarra, Seydou; Edwards, Jackie; Yembrick, Amanda; Holeman, Isaac; Samaké, Salif; Plea, Boureima; Coumaré, Mama; Johnson, Ari

doi:10.7189/jogh.08.020418

Cited by 56 publications

(55 citation statements)

References 24 publications

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“…Research has played a fundamental role; Medic Mobile staff and our partners have produced more than thirty peer-reviewed publications. Study methods have ranged from ethnography (Holeman & Barrett, 2017 ) to randomized controlled trials (Whidden et al, 2018 ), and design research methods including research through design (Zimmerman, Forlizzi, & Evenson, 2007 ) and action design research (Sein et al, 2011 ). While each of these studies answered questions about specific design projects, over time we came to see that this collection of articles did not amount to an accessible, substantive reflection on our design practice as a whole – a gap we hoped to address through this paper.…”

Section: Methodsmentioning

confidence: 99%

Human-centered design for global health equity

Holeman

Kane

2019

Information Technology for Development

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194

131

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As digital technologies play a growing role in healthcare, human-centered design is gaining traction in global health. Amid concern that this trend offers little more than buzzwords, our paper clarifies how humancentered design matters for global health equity. First, we contextualize how the design discipline differs from conventional approaches to research and innovation in global health, by emphasizing craft skills and iterative methods that reframe the relationship between design and implementation. Second, while there is no definitive agreement about what the 'human' part means, it often implies stakeholder participation, augmenting human skills, and attention to human values. Finally, we consider the practical relevance of human-centered design by reflecting on our experiences accompanying health workers through over seventy digital health initiatives. In light of this material, we describe humancentered design as a flexible yet disciplined approach to innovation that prioritizes people's needs and concrete experiences in the design of complex systems.

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Section: Methodsmentioning

confidence: 99%

Human-centered design for global health equity

Holeman

Kane

2019

Information Technology for Development

Self Cite

194

131

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“…Different approaches to supervision and support to community health workers have been tried. There is no consensus regarding who should provide the supervision, where it should be done, at what frequency, with what content, and with what tools [ 13 ]. Supervision approaches should be context-specific [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Association between a complex community intervention and quality of health extension workers’ performance to correctly classify common childhood illnesses in four regions of Ethiopia

et al. 2021

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Background Due to low care utilization, a complex intervention was done for two years to optimize the Ethiopian Health Extension Program. Improved quality of the integrated community case management services was an intermediate outcome of this intervention through community education and mobilization, capacity building of health workers, and strengthening of district ownership and accountability of sick child services. We evaluated the association between the intervention and the health extension workers’ ability to correctly classify common childhood illnesses in four regions of Ethiopia. Methods Baseline and endline assessments were done in 2016 and 2018 in intervention and comparison areas in four regions of Ethiopia. Ill children aged 2 to 59 months were mobilized to visit health posts for an assessment that was followed by re-examination. We analyzed sensitivity, specificity, and difference-in-difference of correct classification with multilevel mixed logistic regression in intervention and comparison areas at baseline and endline. Results Health extensions workers’ consultations with ill children were observed in intervention (n = 710) and comparison areas (n = 615). At baseline, re-examination of the children showed that in intervention areas, health extension workers’ sensitivity for fever or malaria was 54%, 68% for respiratory infections, 90% for diarrheal diseases, and 34% for malnutrition. At endline, it was 40% for fever or malaria, 49% for respiratory infections, 85% for diarrheal diseases, and 48% for malnutrition. Specificity was higher (89–100%) for all childhood illnesses. Difference-in-differences was 6% for correct classification of fever or malaria [aOR = 1.45 95% CI: 0.81–2.60], 4% for respiratory tract infection [aOR = 1.49 95% CI: 0.81–2.74], and 5% for diarrheal diseases [aOR = 1.74 95% CI: 0.77–3.92]. Conclusion This study revealed that the Optimization of Health Extension Program intervention, which included training, supportive supervision, and performance reviews of health extension workers, was not associated with an improved classification of childhood illnesses by these Ethiopian primary health care workers. Trial registration ISRCTN12040912, http://www.isrctn.com/ISRCTN12040912.

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“…For example, results from a study in Ghana show that the effects of supervision on CHW productivity depend on how supportive the supervisors were [ 17 ]. Another study from Mali found that dedicated monthly supervision with feedback tailored to each CHW was associated with gains in CHW productivity [ 34 ].…”

Section: Introductionmentioning

confidence: 99%

Anganwadi worker time use in Madhya Pradesh, India: a cross-sectional study

Jain

Walker

Avula

et al. 2020

BMC Health Serv Res

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Background Anganwadi Workers (AWWs) are a group of 1.4 million community health workers that operate throughout rural India as a part of the Integrated Child Development Services program. AWWs are responsible for disseminating key health information regarding nutrition, family planning, and immunizations to the women and children in their catchment area, while maintaining detailed registers that track key beneficiary data, updates on health status, and supply inventory beneficiaries. There is a need to understand how AWWs spend their time on all of these activities given all of their responsibilities, and the factors that are associated with their time use. Methods This cross-sectional study conducted in Madhya Pradesh, collected time use data from AWWs using a standard approach in which we asked participants how much time they spent on various activities. Additionally, we estimated a logistic regression model to elucidate what AWW characteristics are associated with time use. Results We found that AWWs spend substantial amounts of time on administrative tasks, such as filling out their paper registers. Additionally, we explored the associations between various AWW characteristics and their likelihood of spending the expected amount of time on preschool work, filling out their registers, feeding children, and conducting home visits. We found a positive significant association between AWW education and their likelihood of filling out their registers. Conclusions AWWs spend substantial amounts of time on administrative tasks, which could take away from their ability to spend time on providing direct care. Additionally, future research should explore why AWW characteristics matter and how such factors can be addressed to improve AWWs’ performance and should explore the associations between Anganwadi Center characteristics and AWW time use.

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Improving Community Health Worker performance by using a personalised feedback dashboard for supervision: a randomised controlled trial

Cited by 56 publications

References 24 publications

Human-centered design for global health equity

Human-centered design for global health equity

Association between a complex community intervention and quality of health extension workers’ performance to correctly classify common childhood illnesses in four regions of Ethiopia

Anganwadi worker time use in Madhya Pradesh, India: a cross-sectional study

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