Managerial supervision to improve primary health care in low- and middle-income countries: effects are uncertain

Added April 13, 2020

Citation: Bosch-Capblanch X, Liaqat S, Garner P. Managerial supervision to improve primary health care in low- and middle-income countries. Cochrane Database of Systematic Reviews 2011; (9): CD006413

What is this? The COVID-19 pandemic is placing a great strain on health systems and healthcare workers. Primary healthcare (PHC) workers in low- and middle-income countries (LMICs) frequently work alone without managerial support but it is important to know if healthcare managerial supervision can help improve the quality of services.

In this Cochrane systematic review, the authors searched for randomized trial, interrupted time series and controlled before-and-after (CBS) studies from PHC settings in LMICs on the impact of supervisory site visits and activities from higher-levels of the health system. They did not restrict their searches by date, type or language of publication and did their searches in March 2011. They identified 5 cluster randomized trials and 4 CBA studies. The studies were from Africa, Asia and Latin America. The PHC was located in a rural area in five studies and in urban and rural in 4 (with one not specifying the PHC setting).

What works: Nothing noted.

What doesn’t work: Nothing noted.

What’s uncertain: It is uncertain whether managerial supervision produces substantive benefits on the quality of primary health care in low‐ and middle‐income countries, and long-term effectiveness has not been studied. If supervision is implemented, this should be done together with activities to evaluate its effects on health outcomes and costs.

 

Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.

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