Supervision, along with training, has traditionally been seen as crucial for ensuring quality of care among community health workers. However, anecdotal evidence shows that supervision does not occur as often as is necessary for ensuring quality of care.
The fellow will develop a synthesis document on Delivering Quality of Care in Remote Communities, based on a systematic review of the literature.
Delivery of health care services in communities includes:
- Treating principal killers of children under five – diarrhea, pneumonia, malaria.
- Providing family planning services
- Treating children for severe acute malnutrition
The providers of community health care services have many names, including:
- Community volunteers
- Community health workers (CHW)
- Community nutritionists
- Community-based distributors
- Activists
- Female health volunteers
For this activity, “remote communities” are defined as those communities where people cannot access formal health system easily, and where clinical supervision is structurally impossible in frequency or intensity to ensure quality of care. In rural areas, this is often due to transportation and logistics challenges, but also time availability from potential clinical supervisors (nurses, etc.). Distance is rarely an issue in urban areas, but other elements (e.g., language barriers, insecurity) could create “remote urban communities.”
“Traditional supervision” approach here means that a clinical provider of higher skill, not working in the same setting as the CHW, carries out visits to the CHW in the community, to monitor, teach, mentor, and problem solve on service delivery issues.
Working with supervisors, the fellow will develop and implement a plan for a systematic review to address critical questions about delivering quality of care in remote communities.
Based on this review, the intern will develop a 5,000 word synthesis of what is known and unknown about strategies to ensure Quality of Care (QOC) through CHWs delivering services.
Essential Duties, Responsibilities and Impact
- Define the literature search strategy with supervisors [primarily peer literature]
- Develop data extraction tool
- Search the literature and gather abstracts
- Cull the list of abstracts
- Finalize data extraction
- Gather and review final list of papers
- Extract data and analyze
- Synthesize the findings
The questions to be addressed will be refined in the first steps listed above but should include:
- Evidence for the existence of “remote communities” as defined above, aka where supervision is structurally impossible in frequency or intensity to ensure quality of care.
- Evidence and documentation of internal and external motivators (aka ‘disposition to act’[1]) for CHW performance.
- Evidence for the potential of non-traditional approaches to supervision (peer supervision, team supervision, community supervision, use of digital health applications, combination of approaches with and without traditional supervision, etc.), to impact motivators, and performance of CHWs.
The final synthesis paper (5,000 words) will be finalized with the supervisors, and should include testable theories of change, based on the evidence gathered, for improving quality of care delivered in remote communities by CHWs.
- Possess strong written skills, solid interpersonal skills and ability to work within a team.
- Proficient in Microsoft Office
- Proficient in research searches
- Currently eligible to work in the U.S.
- Structured learning and development program
- Meaningful work under the direct supervision of an experienced Save the Children staff member
- Highly collaborative and innovative teams
- Networking program with managers across the organization
- Flexible schedule
- A family friendly work environment
- The knowledge that the work you are supporting is changing the lives of children all around the world