The role of supportive supervision on immunization program outcome - a randomized field trial from Georgia

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Publicado en:BMC International Health and Human Rights vol. 9, no. Suppl 1 (2009), p. S11
Autor principal: Djibuti, Mamuka
Otros Autores: Gotsadze, George, Zoidze, Akaki, Mataradze, George, Esmail, Laura C, Kohler, Jillian Clare
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BioMed Central
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Acceso en línea:Citation/Abstract
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100 1 |a Djibuti, Mamuka 
245 1 |a The role of supportive supervision on immunization program outcome - a randomized field trial from Georgia 
260 |b BioMed Central  |c 2009 
513 |a Journal Article 
520 3 |a Abstract Background: One of the most common barriers to improving immunization coverage rates is human resources and its management. In the Republic of Georgia, a country where widespread health care reforms have taken place over the last decade, an intervention was recently implemented to strengthen performance of immunization programs. A range of measures were taken to ensure that immunization managers carry out their activities effectively through direct, personal contact on a regular basis to guide, support and assist designated health care facility staff to become more competent in their immunization work. The aim of this study was to document the effects of "supportive" supervision on the performance of the immunization program at the district(s) level in Georgia. Methods: A pre-post experimental research design is used for the quantitative evaluation. Data come from baseline and follow-up surveys of health care providers and immunization managers in 15 intervention and 15 control districts. These data were supplemented by focus group discussions amongst Centre of Public Health and health facility staff. Results: The results of the study suggest that the intervention package resulted in a number of expected improvements. Among immunization managers, the intervention independently contributed to improved knowledge of supportive supervision, and helped remove self-perceived barriers to supportive supervision such as availability of resources to supervisors, lack of a clear format for providing supportive supervision, and lack of recognition among providers of the importance of supportive supervision. The intervention independently contributed to relative improvements in district-level service delivery outcomes such as vaccine wastage factors and the DPT-3 immunization coverage rate. The clear positive improvement in all service delivery outcomes across both the intervention and control districts can be attributed to an overall improvement in the Georgian population's access to health care. Conclusion: Provider-based interventions such as supportive supervision can have independent positive effects on immunization program indicators. Thus, it is recommended to implement supportive supervision within the framework of national immunization programs in Georgia and other countries in transition with similar institutional arrangements for health services organization. Abstract in Russian: See the full article online for a translation of this abstract in Russian.   One of the most common barriers to improving immunization coverage rates is human resources and its management. In the Republic of Georgia, a country where widespread health care reforms have taken place over the last decade, an intervention was recently implemented to strengthen performance of immunization programs. A range of measures were taken to ensure that immunization managers carry out their activities effectively through direct, personal contact on a regular basis to guide, support and assist designated health care facility staff to become more competent in their immunization work. The aim of this study was to document the effects of "supportive" supervision on the performance of the immunization program at the district(s) level in Georgia. A pre-post experimental research design is used for the quantitative evaluation. Data come from baseline and follow-up surveys of health care providers and immunization managers in 15 intervention and 15 control districts. These data were supplemented by focus group discussions amongst Centre of Public Health and health facility staff. The results of the study suggest that the intervention package resulted in a number of expected improvements. Among immunization managers, the intervention independently contributed to improved knowledge of supportive supervision, and helped remove self-perceived barriers to supportive supervision such as availability of resources to supervisors, lack of a clear format for providing supportive supervision, and lack of recognition among providers of the importance of supportive supervision. The intervention independently contributed to relative improvements in district-level service delivery outcomes such as vaccine wastage factors and the DPT-3 immunization coverage rate. The clear positive improvement in all service delivery outcomes across both the intervention and control districts can be attributed to an overall improvement in the Georgian population's access to health care. Provider-based interventions such as supportive supervision can have independent positive effects on immunization program indicators. Thus, it is recommended to implement supportive supervision within the framework of national immunization programs in Georgia and other countries in transition with similar institutional arrangements for health services organization. ABSTRACT IN RUSSIAN: See the full article online for a translation of this abstract in Russian. 
653 |a Health services 
653 |a Research design 
653 |a Intervention 
653 |a Experimental research 
653 |a Public health 
653 |a Immunization 
653 |a Health care 
653 |a Health care access 
653 |a Resource availability 
653 |a Social 
700 1 |a Gotsadze, George 
700 1 |a Zoidze, Akaki 
700 1 |a Mataradze, George 
700 1 |a Esmail, Laura C 
700 1 |a Kohler, Jillian Clare 
773 0 |t BMC International Health and Human Rights  |g vol. 9, no. Suppl 1 (2009), p. S11 
786 0 |d ProQuest  |t Health & Medical Collection 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/902234160/abstract/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/902234160/fulltextPDF/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch