Co-Designing A National Model for CHW Supervision in Zambia

Strengthening community health systems at scale requires investment not only in frontline health workers, but also in the supervision systems that help them succeed. 

Dr. Christian Rusangwa with the trainer and Community Health Workers during the training session in Zambia.

This quarter, Muso deepened its partnership with Zambia's Ministry of Health to co-design an enhanced CHW supervision approach that will strengthen coaching, performance support, and accountability for approximately 12,800 CHWs. This supervision system will then be ready to support a growing national CHW workforce. In the years to come, the government aims to sign contracts with more than 40,000 CHWs, to provide rapid access to community healthcare nationwide.

Building on Zambia’s existing community health strategy, Muso is helping integrate key elements from its 360° supervision approach, including stronger coaching practices, clearer supervisory roles, and practical tools to help supervisors support CHWs effectively. The process reflects Muso's commitment to strengthening  government systems and building on what already exists, rather than creating parallel structures. 

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To ensure the approach is practical and scalable, Muso will launch it in two districts in partnership with On Call Africa. Through this collaboration, we will have the opportunity to test, adapt, and refine the approach in a real-world setting ahead of rollout across five Ministry-led districts in the first phase of supervision rollout. Over the past several months, Muso has completed significant foundational work to prepare for implementation, including co-developing and validating the supervision training materials with relevant stakeholders within the Zambian Ministry of Health and On Call Africa.

Insights from implementation will also inform the development of a digital supervision platform designed to support supervisors in their daily work. The platform will combine practical job aids with dashboards and data visualization tools, providing actionable information to strengthen decision-making and performance management across multiple levels of the health system. 

Through this partnership, Muso is supporting Zambia's vision for a stronger community health system - one where frontline workers have the tools, guidance, and support needed to deliver quality care to every community.