Table 4 Summary of CHW’s supervisor position
Supervisor Position | Profession | Outcome |
|---|---|---|
Health Workers | The identified health workers were mostly professional nurses [26, 33, 48, 50, 56, 61], environmental health officers [11, 47], medical doctors [27], nurse or midwife, and others were unspecified. | Results varied. Some studies mentioned that supervision in the form of feedback and monitoring from healthcare workers resulted in positive output, such as increased perceived satisfaction of the community [17], good coordination during work [27], and increased motivation amongst CHWs [63]. Negative results caused by untrained supervisors [11], no standardised skills [65], unintegrated supervision conducted by several programme supervisors [11]. |
CHW (peer supervisor) | Senior CHWs, peer/colleague, CHEW (not health workers nor undertaking formal health education). In Pakistan, Lady Health Supervisor (LHS) observed and gave verbal feedback to Lady Health Workers (LHW) – a Pakistani term for CHWs. To become an LHS, one should have a minimum of eight years of primary education and previous experience as an LHW, and must reside within the area. In Uganda and Kenya, CHEWs were employed in the public health sector, and responsible for supervising CHWs [22, 67]. | Generally, a positive outcome was related to CHW motivation. In Bangladesh, 68.4% of CHWs expressed satisfaction or motivation, while in Malawi it was 90.8% [31, 49]. Increase CHWs performance. Peer supervision was conducted in many countries like Malawi, India, and Uganda, with the increased CHWs performance was repeatedly mentioned to be the output of the programmes [29, 35, 65, 68]. |
Combination of supervisor | Community committees and CHEW [22, 32]; three-tiered structure [40]. | Results depend on the clarity of supervisors’ scope of work and coordination pathway. In Malawi, the seemingly complex structure of mentorship resulted in CHW perceived positive responses and good health outcomes from end-beneficiaries to their performance. CHWs did not have any negative feedback on the supervision process [40]. |