North East Delhi's Response to Theme- Supportive Supervision

What according to you is Supervision?

The goal of supportive supervision for DAPCU is to promote efficient, effective, and equitable HIV services in district. Checklists help organize the work of supervisors to make it regular and reliable. Supervisees find this objective process motivating, because it helps them identify and address the highest priority issues. They know what is expected of them and when they have met those expectations.

The three main ’Rs’ for an effective supportive supervision system are: 

1. Right supervisors — a core set of supervisors, well trained on supportive supervision techniques and with updated information and skills on HIV issues.
   
2. Right tools — availability of training materials and job aids to update skills of counselors & other staff during supervision visits, and checklists and forms for recording recommendations and following up.
   
3. Right resources—sufficient vehicles, per diems, time allocated for supervision and follow-up.

How do you plan and implement your visit for supportive supervision?

Planning for supportive supervision visits is an integral part of the monthly work-planning exercise. It is important to look at the data when you plan for supervision visits. 

The plan should indicate:

1. Where to conduct visits: The most common criteria used for selecting priority areas include:

• Highest client load  and positivity rate
  
• High missed or LFU HIV infected cases
• Insignificant values observed
• Poor performance observed during previous supervision visits
• Areas with few or no visits in the past
  
• Frequent stock problems (overstock or stock-outs)
• New staff who may need monitoring/training 
• Good coverage in the past but drop in coverage or low coverage now
• Facilities submitting no reports or incomplete reports.

2. When to conduct visits: Once we have prioritized areas to be visited, we need to prepare a supportive supervision schedule. The following issues should be considered.

• The supervisees under supervision should be informed of the schedule.
• The time permitted by In-charge. 
• The time when other linked facilities could also be visited to strengthen the referral & linkage.
  
• The schedule should be feasible and practical, taking into account the distance, transportation difficulties, or constraints due to weather and travel conditions.
• The supervisor should schedule enough time to visit the site fully, and if possible provide on-site training.
  

3. What are the objectives to cover during the visit: It is important to have a clear understanding of the main objectives of the visit. This could include main tasks to observe, or main topics on which training should be given, etc. A review of previous supervision reports, checklists, or data analysis, can assist in identifying which topics to cover during supportive supervision visits. 

• Prepare an agenda for the visit in advance. The agenda should include one or two issues that have already been identified as priorities for the area
• Always be prepared to use data:
  
• review the data on site during the visit;
• Bring summary data, monthly reports, etc. as reference material.

What should DAPCU’s keep in mind while undertaking supervision?

During a supervisory visit to the HIV facility, the supervisor should conduct the following main steps.

1. Collecting information:  Observing the facility environment and the staff worker providing services; listening to staff workers; reviewing the records; using a checklist; reviewing recommendations from past visits.
   
2. Problem-solving and feedback: Describe the problem (if there any) and its impact, discuss the causes of the problem with staff, implement solutions and monitor regularly
3. On-the-job training: Explaining the skill or activity to be learned. Demonstrating the skill or activity.  Reviewing the practice session and giving constructive feedback. Practicing the skill or activity with clients under a trainer’s guidance. Evaluating the participant’s ability to perform the skill according to the standardized procedure, if possible as outlined in the competency-based checklist.
   
4. Recording the results of supervision: This should record the date of the visit, main observations, training given and agreed follow-up actions. List the tasks and responsibilities of the supervised persons and comment on how well they are performed; discuss each item in the supervision checklist; describe what immediate corrective actions were taken during the visit; be shared with the supervisee.
   

DO’s and DON’T

Do’s

• The visit report should be shared with the supervisee.
• Supportive supervision does not end with the conducted visit. Back in the office the supervisor should plan for follow-up.
  

DON’T

• Should not demotivate & blame the supervisee.