Laboratory worker examining samples through a microsope. Credit: Riccardo Gangale.

A key component of PMI’s case management support to Ghana’s National Malaria Control Program is the provision of outreach training and supportive supervision (OTSS) at health facilities.

To help collect standardized information and better assess health facility performance over time, PMI supported the introduction of a checklist that is completed by supervisors during their OTSS visits. At first, OTSS visits were conducted using paper-based checklists; however, the time required for manual data entry and compilation of aggregate facility data through a centralized database led to delays in analysis and action. To help provide supervisors and other decision-makers with timely access to quality data, PMI supported the development and introduction of an electronic data system (EDS).

Some key features of the EDS include:

  • Automatically generated scores: After completing an observation, supervisors can easily review scores on each module and overall help assess the healthcare worker’s performance and give immediate feedback.
  • Real-time data review: Once entered and sent automatically via any available network, data are immediately available in the on-line DHIS-2 platform for review by Ministry of Health staff located around the country, from the district up to the national level.
  • Data storage for tracking facilities over time: Once an assessment has been submitted, the data are stored, and this enables supervisors to track the progress of individual health workers and facilities over time at subsequent visits.

In Ghana, a total of 685 supervisors from the 5 regions have been trained with PMI’s support on the use of EDS to conduct 2 rounds of OTSS, which reached 1,937 facilities in 107 districts. Performance of facilities and staff can now be easily and quickly tracked over time as compared to the previous paper-based approach.

Adoption of the EDS has enabled hundreds of supervisors to analyze their own data at the provincial, district, and even facility level. Low-performing facilities can be targeted for additional rounds of OTSS, and supervisors can identify which critical steps need additional mentoring to improve a given facility’s performance.

Based on the success of the EDS so far, ministries of health in other PMI focus countries, including Malawi and Tanzania, are planning to adopt the electronic platform for health worker supervision and expand its use to additional regions.