وضعیت نظارت حمایتی در مراکز بهداشتی و خانه های بهداشت دانشگاه علوم پزشکی شهید بهشتی
فصلنامه علمی پژوهشی بهداشت در عرصه,
دوره 7 شماره 2,
21 June 2019
,
صفحه 32-44
https://doi.org/10.22037/jhf.v7i2.25220
چکیده
زمینه و اهداف: نظارت بعنوان یکی از مهمترین کارکردهای مدیریت منابع انسانی، نقش مهمی در انگیزش و عملکرد کارکنان سلامت ایفا می کند. هدف از این مطالعه بررسی وضعیت نظارت حمایتی از دیدگاه کارکنان و ناظران مراقبت های بهداشتی اولیه بود.
مواد و روشها: این مطالعه توصیفی- مقطعی با مشارکت 325 نفر از کارکنان و 92 نفر از ناظران آنها انجام شد. داده ها با استفاده از دو پرسشنامه تهیه شده بر اساس مرور گسترده متون که روایی و پایایی آنها تایید شد، جمع آوری گردید. تحلیل داده ها با استفاده از آمار توصیفی و تحلیلی در نرم افزار SPSS16 انجام شد. تمامی مراحل مطالعه حاضر طبق موازین اخلاقی اجرا گردید.
یافته ها: میانگین نمره وضعیت نظارت حمایتی از دیدگاه کارکنان 1/24±0/38و از دیدگاه ناظران 1/6±0/2از دو نمره و این تفاوت معنی دار بود (P<0/001) بود. از دیدگاه کارکنان حیطه ایجاد محیط خوشایند (1/64±0/4) و حیطه ایفای نقش مربی برای بهبود مهارت های ارائه دهندگان خدمات بهداشتی (0/99±0/53) به ترتیب بیشترین و کمترین میانگین را داشته اند. از دیدگاه ناظران حیطه ارائه بازخورد دقیق (1/71±0/23)، بالاترین و حیطه منابع اختصاص داده شده به بازدید نظارتی (1/35±0/42)، کمترین میانگین را داشته است.
نتیجه گیری: یافته ها نشان داد که برخی از حیطه های مهم نظارت در عرصه مورد بررسی کمتر حمایتی است. تدوین سیاست های جدید نظارتی در راستای تحقق نظارت حمایتی ضروری است. آموزش ناظرین در زمینه مهارت های مربیگری و ارائه بازخورد سازنده و اجرای نظام عادلانه مشوق ها نقش مهمی در این زمینه ایفا خواهد کرد.
- نظارت حمایتی؛ کارکنان بهداشتی؛ مراقبت های بهداشتی اولیه
ارجاع به مقاله
مراجع
- Reich MR, Harris J, Ikegami N, Maeda A, Cashin C, Araujo EC, et al. Moving towards universal health coverage: lessons from 11 country studies. The Lancet 2016; 387(10020):811-16.
- WHO. Human resources for health: developing policy options for change. Discussion paper. Geneva:
World Health Organization; 2002. Available from: http://www.who.int/hrh/documents/en/Developing_
policy_options.pdf.
- WHO. Can human resource for health in the context of noncommunicable disease control be a level for
health system changes. Bulletin of the World Health Organization. 2013; 91:895-96.
- WHO. Every woman, every child; global strategy for women’s and children’s health. access
for all to skilled, motivated and supported health workers. Geneva: World Health Organization; 2010.
Availablefrom:http://www.who.int/pmnch/activities/ jointactionplan/20101007_4_skilledworkers.pdf.
- Bangdiwala S, Fonn S, Okoye O, Tollman S. Workforce resources for health in developing countries.
Public Health Reviews 2010; 32(1):296-318.
- WHO. Global strategy on human resources for health: workforce 2030. Global strategy on human resources for health: workforce 2030; Geneva: World Health Organization; 2016. Geneva. Available from:http:// www.who.int/hrh/resources/pub_globstrathrh2030/ en/7
- Kok M, Vallieres F, Tulloch O, Kumar M, Kea A, Karuga R, et al. Does supportive supervision enhance community health worker motivation? A mixedmethods study in four African countries. Health Policy and Planning. 2018; 33:988-98.
- Hernández et al. More than a checklist: a realist evaluation of supervision of mid-level health workers
in rural Guatemala. BMC Health Services Research 2014; 14:112. https://doi.org/10.1186/1472-6963-14-
- Bailey C, Blake C, Schriver M, Cubaka V, Thomas T, Hilber A. A systematic review of supportive
supervision as a strategy to improve primary healthcare services in Sub-Saharan Africa. International Journal of Gynecology and Obstetrics 2016; 132:117-25.
- Adeyemo, M. The role of supportive supervision in enhancing and sustaining health education in home management and prevention of malaria among mothers of under-five children. International Journal of Nursing and Midwifery 2017; 9(5):53-57.
- Bradley, S. Kamwendo, F. Masanja, H. Pinho, H. Waxman, R. Boostrom, C. McAuliffe, E. District health managers’ perceptions of supervision in Malawi and Tanzania. Human Resources for Health 2013, 11:43.
DOI:10.1186/1478-4491-11-43 12- WHO. Training for mid-level managers (MLM), Module 4, Supportive supervision. Geneva: World Health Organization; 2008. Available from: http://
www.who.int/immunization/documents/MLM_ module4.pdf.
- Som M, Panda B, Pati S, Nallala S, Anasuya A, Chauhan AS, et al. Effect of supportive supervision on routine immunization service delivery-a randomized post-test study in Odisha. Global Journal of Health Science 2014; 6(6):61-7.
- Kasonde M, Steele P. The people factor: An analysis of the human resources landscape for immunization supply chain management. Vaccine 2017; 35(17):2134-40.
- Nkomazana O, Mash R, Wojczewski S, Kutalek R, Phaladze N. How to create more supportive supervision for primary healthcare: Lessons from Ngamiland district of Botswana: co-operative inquiry group. Glob Health Action 2016; 9:31263. DOI:10.3402/gha. v9.31263
- Moran AM, Coyle J, Pope R, Boxall D, Nancarrow SA, Young J. Supervision, support and mentoring
interventions for health practitioners in rural and remote contexts: an integrative review and thematic
synthesis of the literature to identify mechanisms for successful outcomes. Human Resources for Health
; 12(1):10. DOI: 10.1186/1478-4491-12-10
- Hill Z, Dumbaugh M, Benton L, Kallander K, Strachan D, ten Asbroek A, et al. Supervising
community health workers in low-income countries- -a review of impact and implementation issues. Glob
Health Action 2014; 7:24085. DOI: 10.3402/gha. v7.24085.
- Tseng Y-h, Griffiths F, de Kadt J, Nxumalo N, Rwafa T, Malatji H, et al. Integrating community health workers into the formal health system to improve performance: a qualitative study on the role of on-site supervision in the South African programme. BMJ Open 2019; 9(2):e022186. doi:10.1136/bmjopen-2018-022186.
- Karuga RN, Mireku M, Muturi N, McCollum R, Vallieres F, Kumar M, et al. Supportive supervision of close-to-community providers of health care: Findings from action research conducted in two counties in Kenya. PLoS One 2019; 14(5):e0216444. DOI: 10.1371/journal.pone.0216444.
- Sousa A, Scheffler RM, Nyoni J, Boerma T. A comprehensive health labour market framework for
universal health coverage. Bulletin of the World Health Organization 2013; 91(11):892-94.
- WHO. Mental health policies and programmes in the workplace. Mental Health Policy and Service
Guidance Package. World Health Organization Library Cataloguing-in-Publication Data. Geneva:
World Health Organization; 2005. Available from: http://www.who.int/mental_health/policy/services/2_
policy%20plans%20prog_WEB_07.pdf.
- WHO, Regional Office for the Eastern Mediterranean: Country Cooperation Strategy for WHO and the Islamic Republic of Iran, 2010 – 2014. Cairo: World Health Organization. 2011. Available from: http://www.who. int/countryfocus/cooperation_strategy/ccs_irn_en.pdf.
- Tabrizi JS, Gholipour K, Farahbakhsh M, Hasanzadeh A. Managerial barriers and challenges
in Iran public health system: East Azerbaijan health managers’ perspective. Journal Of Pakistan Medical
Association 2017; 67(3):409-15.
- WHO. Primary healthcare improvementglobal stakeholder meeting. global stakeholder meeting. 2016
-8 April; Genva.
- Keshvari M, Mohammadi E, Farajzadegan Z, Zargham-Boroujeni A. Experience of Behvarzes
(Iranian primary healthcare providers) from giving primary health services in health houses. Journal
of education and health promotion 2016; 5:7. DOI: 10.4103/2277-9531.184569.
- Mohammad-Alizadeh CS, Wahlstrom R, Vahidi R, Nikniaz A, Marions L, Johansson A. Barriers to
high-quality primary reproductive health services in an urban area of Iran: views of public health providers. Midwifery 2009; 25(6):721-30.
- USAID. Management Sciences for Health. Health Systems in Action: An eHandbook for Leaders and
Managers. Cambridge, MA: Management Sciences for Health, 2010.
- WHO, Guidelines for Implementing Supportive Supervision. A step-by-step guide with tools to support immunization. Genva: World Health Organization; 2003. Available from: http://www.path.org/
vaccineresources/files/Guidelines_for_Supportive_ Supervision.pdf
- Berdzuli N, Ippolito L, Haffey J. Supportive supervision: Training of trainers and external
supervisors (Facilitator’s Guide). Cambridge, MA: USAID, 2008.
Available from: http://pdf.usaid.gov/pdf_docs/ PNADT950.pdf
- Nabeela Ali. Assessment of District Health Supervisory System. Pakistan initiative for mothers and
newborns (PAIMAN). Cambridge, MA: USAID, 2006. Available from: http://paiman.jsi.com/Resources/Docs/ assessment-of-district-health-supervisory-system.pdf.
- Daneshkohan A, Ramezankhani A, Zarei E, Ahmadi F, Foruzanfar F. Development and Psychometric
Evaluation of Tools for Assessing Supportive Supervision from the Perspective of Health Workers
and Supervisors. Journal of Rafsanjan University of Medical Sciences 2016; 14(12):1001-14 (In Persian).
- Henny R, Nantongo L, Wagner A, Embrey M, Trap B. Competency in supportive supervision: A study of public sector medicines management supervisors in Uganda. Journal of Pharmaceutical Policy and Practice. 2017; 10:33. DOI: 10.1186/s40545-017-0121-y.
- Paraprofessional Healthcare Institute. Creating a culture of retention: a coaching approach to
paraprofessional supervision. A PHI Technical Series Publication. Bronx NY: USA; 2008.
- Yazdi-Feyzabadi V, Emami M, Mehrolhassani MH. Health Information System in Primary Health Care: The Challenges and Barriers from Local Providers’ Perspective of an Area in Iran. International Journal of Preventive Medicine 2015; 6:57. DOI: 10.4103/2008- 7802.160056.
- Agoro OO, Osuga BO, Adoyo M. Supportive supervision for medicines management in government
health facilities in Kiambu County, Kenya: a health workers’ perspective. The Pan African
Medical Journal 2015; 20:237-37. doi: 10.11604/ pamj.2015.20.237.5872.
- Shim M. Factors influencing child welfare employee’s turnover: Focusing on organizational
culture and climate. Children and Youth Services Review 2010; 32(6):847-56.
- Lee J, Forster M, Rehner T. The retention of public child welfare workers: The roles of professional
organizational culture and coping strategies. Children and Youth Services Review 2011; 33(1):102-109.
- Larson E, Mbaruku G, Mbatia R, Gage A, Haneuse S, Kruk M. Can investment in quality drive use? A cluster-randomised controlled study in rural Tanzania. The Lancet Global Health 2018; 6:S9. DOI: 10.1016/S2214-109X(18)30138-4
- Rabbani, F., Shipton, L., Aftab, W. et al. Inspiring health worker motivation with supportive supervision: A survey of lady health supervisor motivating factors in rural Pakistan. BMC Health Services Research 2016; 16:397 (2016) doi:10.1186/s12913-016-1641-x.
- Khetan A, Patel T, Hejjaji V, Barbhaya D, Mohan SKM, Josephson R, et al. Role development of
community health workers for cardiovascular disease prevention in India. Evaluation and Program Planning 2018; 67:177-83.
- Ludwick T, Turyakira E, Kyomuhangi T, Manalili K, Robinson S, Brenner JL. Supportive supervision constructive relationships with healthcare workers support CHW performance: Use of a qualitative framework to evaluate CHW programming in Uganda. Human Resources for Health 2018; 16(1):11. DOI: 10.1186/s12960-018-0272-1.
- Hassani SA, Mobaraki H, Bayat M, Mafimoradi S. Right place of human resource management in
the reform of health sector. Iranian Journal of Public Health 2013; 42(1):56-62.
- Hooshmand E, Tourani S, Ravaghi H, Ebrahimipour H. Challenges in evaluating clinical governance
systems in iran: a qualitative study. Iranian Red Crescent Medical Journal 2014; 16(4):e13421-e21.
DOI: 10.5812/ircmj.13421.
- Garrison K, Caiola N, Sullivan R, Lynam P. Supervision Manual. Supervising Healthcare Services:
Improving the performance of People. Jhpiego, Cambridge, MA: USAID, 2004.
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