360° Supervision in Practice

Marlyatou Sidibé, Communications and Special Projects Fellow at Muso, shares her experience shadowing a Muso CHW Supervisor as she supports front-line Community Health Workers through 360° Supervision.

The day began early: at 8am, I met Muso CHW Supervisor Alimata* and we started out to visit one of the zones in peri-urban Mali where the Community Health Workers she supervises work. Alimata began Muso’s 360° Supervision process by visiting households chosen at random, to assess their recent experiences receiving care from their CHW, Kadiatou*. Today, the feedback was positive. Family members shared that Kadiatou had visited them consistently in the past months. Muso recently hired new CHWs in response to the growing population of Yirimadio, and Kadiatou was newly assigned to this family through this process. Yet this family reported that their routine home visits never stopped and they noticed no gap in care during the switch to a new CHW.

Supervisor visits with patients, without the CHW present, act as a patient satisfaction audit, allowing the CHW Supervisor and families served by the CHW to speak honestly about the CHW’s performance and quickly address any performance issues. By proactively soliciting this patient feedback, Muso is able to verify data, oversee CHW performance, and make sure patients are heard by the health system.

During Alimata’s patient visits this day, a husband offered a testimonial in favor of Kadiatou: while he had been fortunate not to need care himself, he shared that both his son and his wife, now deceased, had received care at home as well as at the health center, for illnesses proactively identified by their assigned CHW.

After Alimata completed patient quality care assessments for the zone, she rendezvoused with Kadiatou, working nearby, to perform a check of her kit. CHW kits are regularly assessed to ensure that they are stocked with essential medications and supplies. As is often the case in the middle of a day in the Sahara, this meeting took place in the bit of shade the two were able to find nearby. Seated together in this refuge, Alimata provided targeted feedback to Kadiatou based on common themes from the patient feedback audit.

For me, this day was eye-opening. In an area where even water can be challenging to access, Muso CHWs, supported by their dedicated Supervisors in Muso’s 360° Supervision model, are committed to providing care at the doorstep for any malady they encounter. During proactive case detection with CHW Kadiatou, we encountered a very young woman, in her third pregnancy after two stillbirths, who had never received a prenatal visit. Kadiatou spoke with her about the benefits of prenatal care and urged her to go to the clinic as soon as possible. She offered to accompany the pregnant patient to the health center for her first prenatal check-up. Following protocol, Kadiatou will follow up with this patient to close the loop and ensure she receives the WHO-recommended number of prenatal visits at the clinic level.

Learn more about the 360° Supervision system supporting Community Health Workers for improved performance, including efficiency and quality of care.

*Names and pictures have been disaggregated to protect patient-provider privacy. 

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