Does frequency of supportive supervisory visits influence health service delivery?-Dose and response study

Autor: Habtamu Zerihun Demeke, Bekele Belayhun Tefera, Mengistu Asnake Kibret, Mesele Damte Argaw, Binyam Fekadu Desta, Ismael Ali Beshir
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Service delivery framework
Health Care Providers
Science
Primary health care
Pathology and Laboratory Medicine
Pediatrics
Neonatal Care
03 medical and health sciences
Health services
0302 clinical medicine
Signs and Symptoms
Diagnostic Medicine
Sepsis
Health care
Supervisors
Medicine and Health Sciences
Medicine
Humans
Quality of Care
030212 general & internal medicine
Quality of care
Allied Health Care Professionals
Likelihood Functions
Multidisciplinary
Primary Health Care
business.industry
030503 health policy & services
Health Services Administration and Management
Repeated measures design
Health Care
Professions
Health Care Reform
Workforce
People and Places
Linear Models
Population Groupings
Health care reform
Neonatology
Neonatal Sepsis
0305 other medical science
business
Delivery of Health Care
Demography
Research Article
Zdroj: PLoS ONE, Vol 15, Iss 6, p e0234819 (2020)
PLoS ONE
ISSN: 1932-6203
Popis: High quality care-at a minimum-is a combination of the availability of tangible resources as well as a capable and motivated health workforce. Researchers have suggested that supportive supervision can increase both the performance and motivation of health workers and the quality of care. This study is aimed at assessing the required number of visits and time between visits to bring about improvements in health service delivery. The study employed a primary health care performance improvement conceptual framework which depicts building blocks for improved health service delivery using longitudinal program outcome monitoring data collected from July 2017 to December 2019. The analysis presented in this study is based on 3,080 visits made to 1,479 health centers in the USAID Transform: Primary Health Care project's intervention districts. To assess the effects of the visits on the repeated measure of the outcome variable (Service-Delivery), multilevel linear mixed model (LMM) with maximum likelihood (ML) estimation was employed. The results showed that there was a significant dose-response relationship that consistent and significant improvement on Service-Delivery indicator was observed from first (β = -26.07, t = -7.43, p < 0.001) to second (β = -21.17, t = -6.00, p < 0.01), third (β = -15.20, t = -4.49, p < 0.02), fourth (β = -12.35, t = -3.58, p < 0.04) and fifth (β = -11.18, t = -2.86, p < 0.03) visits. The incremental effect of the visits was not significant from fifth visit to the sixth suggesting five visits are the optimal number of visits to improve service delivery at the health center level. The time interval between visits also suggested visits made between 6 to 9 months (β = -2.86, t = -2.56, p < 0.01) showed more significant contributions. Therefore, we can conclude that five visits each separated by 6 to 9 months elicits a significant service delivery improvement at health centers.
Databáze: OpenAIRE