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  • People drive health systems. I think a lot about health worker performance and productivity in my work with the HRH2030 Program. After all, a health system’s strength—and ultimately the health of any pop […]

    • Thank you for your blog and this landscape analysis—it is a valuable contribution! I enjoyed reading it. I agree that a health system is developed for and driven by people. People are at the center of all the work we do at MSH. While supportive supervision (SS) is an effective tool to improve provider competency and motivation, underlying gender dynamics also play an important role in supervisor-provider relationships. To date, gender has been largely ignored in efforts to improve competencies and conditions for the health workforce. In previous MSH work we applied a gender lens to supportive supervision that helped move away from gender-blind SS to gender-aware SS and ultimately gender transformative supportive supervision (GTSS). These approaches aim to influence health worker recruitment, retention, and performance while advancing gender equality among health workers. I’m interested in other SS approaches that address social, gender, and power dynamics.

    • This is very important work and terrific results; congratulations! I very much appreciate the use of data to support the supervision process in identifying specific areas for improvement at each level of care, and I really like the HNQIS application that was developed to assist not only in improving quality of care, but also in improving the quality of supervision.
      In the MESH-QI program, it mentions on-site education programs for all staff, and I’m curious about the topics and methods for those sessions. At MSH we are developing smart capacity building approaches that allow us to use the service delivery and facility data, as well as supervisor observations, to identify gaps in knowledge and skills. With that knowledge, we are able to develop capacity building activities tailored to the needs of the health worker cadres, the setting, and the content (whether knowledge- or skills-based). Then, the learning events are developed in a way that minimizes disruption to service delivery with staggered on-site training sessions, on-the-job coaching and mentoring, and peer learning.
      I also appreciate your mention of health systems-level improvements that support quality of care. MSH uses a systems-thinking approach to quality of care at all levels. The importance of evidence and participation in understanding the dynamics of a country’s health system cannot be emphasized enough in developing and improving health interventions that will lead to optimal health system performance, resilience, and access.
      Thank you, and I look forward to hearing about your results in phase II!

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