Supervising community health workers in low-income countries: a review of impact and implementation issues

Authors: Zelee Hill, Mari Dumbaugh, Lorna Benton, Karin Ka ̈llander, Daniel Strachan, Augustinus ten Asbroek, James Tibenderana, Betty Kirkwood3 and Sylvia Meek

Community health workers (CHWs) are an increasingly important component of health systems and programs. This study was conducted to determine the impact of supervision strategies used in low- and middle- income countries and discuss implementation and feasibility issues with a focus on CHWs.

Few supervision strategies have been rigorously tested and data on CHW supervision is particularly sparse. This review highlights the diversity of supervision approaches that policy makers have to choose from and, while choices would be context specific, this study suggests that high-quality supervision that focuses on supportive approaches, community monitoring, and/or quality assurance/ problem solving may be most effective.