Supervising Illiterate Community Health Workers in South Sudan to Deliver Integrated Community Case Management Services for Newborns and Children

Improving and maintaining the clinical skills of frontline health workers over time is critical for strengthening health systems and providing adequate care to mothers, newborns, and children – supervision is widely recognized as a key to improving health worker performance.  In Warrap State, South Sudan, a 13-month study was undertaken to describe and assess a supervision model for illiterate CHWs.  CHWs were training, supervised and studied to asses correct use of newborn and child health record forms; identification, classification, treatment and referral of disease.  After the supervision period 87% of CHWs were accredited as competent to deliver Integrated Community Case Management plus essential newborn care services (ICCM Plus), with 95% of registration form completed.  

Program results showed CHWs to be effective in improving coverage of key MNCH practices, assessing mothers and children, and initiating treatment for malaria and diarrhea.  Results indicate that a supervision process to monitor, improve and maintain clinical skill performance by CHWs within a community case management strategy, is an important element of program design and implementation to obtain health outcomes, especially among community-based approaches where treatment with drugs is included and in fragile state context.