As opposed to didactic instruction, supportive supervision entails a two-way communication between mentors and less experienced individuals. Through supportive supervision, mentors provide guidance on how things are properly done. Supportive supervision, initialized SS, is gaining popularity as a professional development tool for health workers, more so for immunization workers at the frontline. Because it offers constructive feedback, and positive reinforcement as well, in a relaxed atmosphere, supportive supervision motivates workers to do better at their job.

How supportive supervision works

Step 1 A team of supportive supervisors are trained

Step 2 Supervisors prepare a “supervisory checklist” containing priority issues which they must observe and record

Step 3 Supervisors plan the details of regular supportive supervision visits: location, frequency, duration, and objectives

Step 4 Supervisors conduct the supervisory visit where they collect information, provide feedback, conduct on-the-job training, and record results

Step 5 Supervisors follow up on the visit

GHD|EMPHNET, working in tandem with national plans in the Eastern Mediterranean, has relied on supportive supervision and monitoring to enhance the performance of frontline immunization workers. For over five years, GHD|EMPHNET supported investments made by public health authorities in supportive supervision for a clear purpose-ultimately reverse low immunization coverage in countries where adverse circumstances of aspects have impacted the performance of health workers.

Starting in Afghanistan, a high priority country, GHD|EMPHNET provided technical and logistic support to provincial supervisors of the Expanded Program on Immunization (EPI) whereby they were able to visit health facilities and conduct on-the-job training for frontline workers. Sixteen provinces have been selected that were either endemic for polio, security compromised, underserved, or hard-to-reach. The GHD|EMPHNET team based in Afghanistan was also involved in the supervision, conducting two missions to two provinces each month.

Thinking beyond the box to assure monitoring of these visits where it is needed and difficult in remote areas, GHD|EMPHNET initiated innovative ways for supportive supervision: (1) remote monitoring and (2) the engagement of community leaders as a third-party monitor.

Capitalizing on its experience in Afghanistan, GHD|EMPHNET decided to expand to other priority countries in the region, beginning with in Somalia and Yemen where the humanitarian crises displaced many of the health workers and compromised health facilities. A different approach was used. First, GHD|EMPHNET worked with the authorities to review and update supervisory checklist. Then, it supported training of provincial and regional supervisors on supportive supervision who later trained the EPI focal points at the district levels on the same topic.