Voice from the Field: Supportive Supervision For Auxiliary Nurse-Midwives

“Supportive supervision helped me gain the confidence to perform up to standards.”

Rajabeti, an Auxiliary Nurse-Midwife in the Firozabad district of Uttar Pradesh, India, was nervous and couldn’t pass her first follow-up examination after IUD insertion training as part of the Innovations in Family Planning Services (IFPS) Project. Her supervisor, Kusma Devi, a Lady Health Visitor, promptly invited her to the Usaini Primary Health Center and provided additional guided practice. When the follow-up team returned again to Firozabad, Rajabeti met them with confidence and inserted two IUDs without hesitation, scoring 85% on her skills test.

Rajabeti and Kusma Devi illustrate the role that supportive supervision plays in ensuring transfer of new skills to the work site. This transfer is an integral element of the IFPS Project, which has been implemented by the State Innovations in Family Planning Agency, an autonomous organization formed by the Government of Uttar Pradesh and funded by USAID. PRIME II provides technical assistance to IFPS, including design of interventions that improve supportive supervision.

IFPS aims to bring half of all Lady Health Visitors into at least two interactions per month with each of the workers they supervise. A team of validators oriented by PRIME clinical and evaluation staff visited five districts in March 2001 and found 90% of the Lady Health Visitors providing appropriate supportive supervision. Validators also confirmed that 893 trained Auxiliary Nurse-Midwives and Lady Health Visitors—almost twice the project’s goal—were providing IUD insertion and care to their high standards of quality.

In rural Uttar Pradesh, less than 20% of married women of reproductive age use a modern method of contraception. Teamwork between primary-care providers like Rajabeti and supportive supervisors like Kusma Devi will help to close that gap—and improve the lives and health of thousands of women.

The PRIME II Project works around the world to strengthen the performance of primary-care providers as they strive to improve family planning and reproductive health services in their communities.

PRIME Voices #2, India: Supportive Supervision for Auxiliary Nurse-Midwives, 6/15/01.