Improving management and supervision for Health Surveillance Assistants in Malawi
Author: VSO Malawi
The health workforce crisis with inadequate trained doctors and nurses in Malawi has resulted in additional work pressure on Health Surveillance Assistants. In a nutshell, they confront the dilemma of leaving a patient untreated or performing duties they have never been taught how to do, and consequently feel the need for greater management and supervision support.
Over 10,000 Health Surveillance Assistants (HSAs) are deployed in rural areas of Malawi. Originally trained to work as environmental health monitors, data collectors and researchers, increasingly the duties of nurses are being imparted to these under-recognized but important health workers. To address this problem, VSO (and Malawi Health Equity Network (MHEN) are implementing a programme to empower and motivate the HSAs.
Interviews and assessments of both staff and management were conducted to understand the management and supervision needs of the HSAs. These findings contributed to the development of supportive supervision toolkits that would enable managers to conduct their roles more effectively. They may also influence new supervision structures as the tools are implemented, monitored and evaluated. This was combined with the introduction of performance monitoring. This helps identify training needs at all levels and therefore feeds into the districts training and development plans.
This project is in its infancy, yet already the HSAs are reporting their satisfaction with an opportunity to discuss their concerns and receive feedback on the observations and comments they make. The project implementers now have better understanding on the difficulties the HSAs face in their jobs and how under-trained they were for the tasks they were conducting.
The pilot will continue until January 2011, at which point it is expected to be rolled out to new districts within Malawi. It has received great support and commendation from the Government of Malawi and it is believed that in time this approach to HRH management and supervision will be introduced nationally.