Strengthening supportive supervision: A case study of the Expanded Programme on Immunization in Sindh, Pakistan

Sindh, one of the provinces of Pakistan, has been showing a consistently low coverage of immunization. Evidence supports the independent role of supportive supervision in improving the performance of immunization services. However, there is a dearth of evidence regarding the implementation of suppor...

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Bibliographic Details
Published in:Journal of global health 2021-01, Vol.11, p.06004-06004, Article 06004
Main Authors: Tanzil, Sana, Suleman, Yasmeen, Akram, DureSamin, Baig, Lubna, Khalid, Faraz
Format: Article
Language:English
Subjects:
Case studies
Data collection
Global health
Humans
Immunization
Immunization Programs
Interviews
Measles
Motivation
Pakistan
Qualitative research
Research Theme 2: Pakistan Embedded Implementation Research for Immunisation Initiative
Rural areas
Supervision
Tetanus
Training
Vaccination
Vaccines
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Summary:Sindh, one of the provinces of Pakistan, has been showing a consistently low coverage of immunization. Evidence supports the independent role of supportive supervision in improving the performance of immunization services. However, there is a dearth of evidence regarding the implementation of supportive supervision by the Expanded Programme on Immunization (EPI) Sindh and factors affecting its implementation in the local context. An exploratory case study was conducted in two districts of the province, Sindh ie, Hyderabad and Thatta. In total, 11 key informant interviews (KII) and 5 focus group discussions (FGDs) were conducted to obtain perspectives of various stakeholders of EPI, who play different roles in implementation of supportive supervision. Observations of EPI Checklist and review of current EPI policy and Module-4 of 'Mid-Level Manager training' by World Health Organization (WHO) for supportive supervision was also conducted. This study reveals a lack of clarity regarding the potential role of supportive supervision amongst the stakeholders. Lack of human resources, limited competencies of supervisors, lack of specific training of concerned personnel and feedback mechanisms are major bottlenecks affecting the implementation of supportive supervision by EPI Sindh. The study concludes that supportive supervision is severely affected by challenges such as a lack of comprehensive EPI policy, unavailability of selection criteria for supervisors, training guidelines and proper logistic support to supervisors. There is a lack of training, motivation, and accountability amongst EPI personnel.
ISSN:2047-2978
2047-2986
DOI:10.7189/jogh.11.06004