ss training facilitators guide_dec_2011.doc

8/14/2019 SS Training Facilitators Guide_Dec_2011.doc

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Ethiopia Urban Health ExtensionProgram

USAID/UHEP Supportive SupervisionTraining Facilitator Guie


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Supportive supervision Training Facilitator GuideJanuary, 2012Urban Health Etension !rogra"

The Ethiopia Urban Health Extension Program is implemented by


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+-+/0+, and do not necessarily reflect the $iew of US!I# or the United

States 1o$ernment.


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Table o# $ontents

Session &+ (limate Setting an Training ,vervie)*****************************************************&

Session $+ Urban Health Extension Program ,vervie)***********************************************-

Session .+ Introuction to Supportive Supervision **************************************************&&Session -+ asic S0ills 1or Supportive Supervision ***************************************************$.

Session 2+ 3e" Elements o1 Supportive Supervision*************************************************.$

Session 4+ (urrent Practice o1 Supportive Supervision in UHEP *******************************.4

Session 5+ Practicing Supportive Supervision***********************************************************26

Session 6+ Action Plan Development************************************************************************44

7e1erences ***************************************************************************************************************46

Annex ********************************************************************************************************************** 8%


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Supportive supervision training agenda

S*9o

Sessions

Topic Time Table 7esponsibleperson

Da" one& 7egistration $+.% : $+-2 USAID/UHEP

$Session

&(limate setting $+-2 : .+.% Facilitator

.Session

$

UHEP ,vervie) ;h" Urban Health Ethiopian UHEP Implementation strateg" USAID/UHEP bac0groun an implementation

approaches

.+.% : -+&2 Facilitator

- (o11ee brea0 -+&2 : -+.2 USAID/UHEP

2 Session.

Introuction to supportive supervision De1inition# (oncepts an principles o1 supportive

supervision T"pes o1 supervision Functions o1 Supportive supervision

-+.2 < 4+.% Facilitator

4 =unch 4+.% : 5+%% Iniviual

8Session

.

(ontinue Introuction to supportive Supervision

(omparison o1 traitional >s supportive supervision

5+%% : 6+%%

5 Session-

asic s0ills 1or supportive supervisionTechnical# mentoring an coaching s0ill (ommunication s0ill arriers o1 e11ective communication

6+%% : &%+%% Facilitator

6 (o11ee brea0 &%+%% : &%+$% USAID/UHEP&% Session

-(ontinue asic s0ills 1or supportive supervisionTechnical# mentoring an coaching s0ill (ommunication s0ill

&%+$% : &&+.% Facilitator


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arriers o1 e11ective communication

Da" T)o&&

Session2

3e" Elements o1 Supportive Supervision $+.% : .+&2 Facilitator

&$ Session4 (urrent practice o1 supportive supervision in UHEP .+&2 : -+.% Facilitator

S*9o

Sessions

Topic Time Table 7esponsibleperson

&. (o11ee brea0 -+.% : -+2% USAID/UHEP

&- Session8

Implementation steps o1 supportive supervision Planning an preparation (onucting Supportive Supervision

-+2% : 4+.% Facilitator

&2 =unch 4+.% : 5+%% Iniviual

&4 Session8

(ontinue implementation steps o1 supportive

supervision Problem ienti1ication# Anal"sis an Action planning 7ecoring an 7eporting Decision ?a0ing# Follo)


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$8 (o11ee brea0 -+%% : -+.% USAID/UHEP

$5 Session6Action Plan Development -+.% : 4+.% Participants

$6 =unch 4+.% : 5+%% Iniviual.% Action plan presentation 5+%% : 6+.% Participants.& (o11ee brea0 6+.% < 6+2% USAID/UHEP

.$Session

&%;a" 1or)ar an closing 6+2% : &%+.% USAID/UHEP

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Session 1& $li"ate Setting and Training 'vervie(

'b)ectives

In this session# participants )ill be able to+

Get to 0no) each other an 1acilitators

=in0 their expectations to the ob@ectives o1 the training

Ti"e

-2 minutes

Session $ontent

;elcome an opening remar0s &% min*B Introuce participants an 1acilitators &% min*B

Establish groun rules 1or the course 2 min*B

Participant expectations 2 min*B

Training overvie) an revie) o1 scheule 2 min*B

Training ob@ective &% minB

*aterials

=(D# po)er point presentation# 1lipchart stan# 1lipchart paper# mar0er# mas0ing tape# >IIP/blan0 cars# anbages/name tags

&% P a g e


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Training scheule/agena

+ctivity 11& -elco"e and opening re"ar.s /10 "in

Step 1&;elcome participants an than0 them 1or attening the course* Introuce "oursel1# other 1acilitators# anguests*

Step 2&Invite the guest o1 honor to ma0e opening remar0s*

+ctivity 12& ntroduce participants and #acilitators /10 "in

The Participants shoul introuce themselves b" name# )or0 place an @ob title*

+ctivity 1& Establish the ground rules #or the course, and create a tas. roster /3 "in

Step 1&Explain that the group )ill agree on 1e) groun rules or guielines 1or ho) to interact uring the training*This )ill be one through a brainstorm* Encourage participants to suggest help1ul groun rules*

Step 2&;rite participant responses on a 1lipchart*

+ctivity 14& !articipant epectations /3 "in

Step 1&As0 participants to )rite their expectations on >IPP cars an to post them onto the expectation 1lipchart*

Step 2&Gather an summariCe participant responses on the 1lipchart*

+ctivity 13& Training overvie( and revie( o# schedule /3 "in

Step 1&Explain brie1l" the training scheule/agena* Invite uestions 1or clari1ication*

Step 2&Explain an" logistic issues*

Step &Than0 participants 1or their active participation in the training*

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+ctivity 15& Training 'b)ective /10 "in

Step 1&Explain brie1l" the training ob@ective 1lip chart &*&B

Step 2&=in0 the training ob@ective )ith participants expectation poste on the )all*

Flip $hart 6 11

Training 'b)ectives

At the en o1 this training participants )ill able to+

To evelop a common unerstaning o1 )hat supportivesupervision means an the supervisor" roles an responsibilities

o1 each level To strengthen/evelop s0ills in preparing 1or supervision#

conucting supportive supervision an eveloping agree plans1or 1ollo)


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Session 2& Urban Health Etension !rogra" 'vervie(

'b)ectives

+t the end o# the session, participants (ill be able to&7

Unerstan an explain about UHEP an its rationale in Ethiopia Unerstan USAID/UHEP bac0groun an implementation approach

Ti"e

-2 minutes

Session contents

UHEP implementation in Ethiopia $2 minuteB USAID/UHEP implementation approach $% minuteB

*aterials

=(D# po)er point presentation# 1lipchart stan# 1lipchart paper# mar0er# mas0ing tape# >IIP/blan0 cars

!re7preparation

All materials liste above an revie)ing o1 the presentation

+ctivity 21& UHE! overvie( /23 "in

Step 1&Introuce the session ob@ectives

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Step 2& As0 the participant to 1or a group those sit in their seatB* Provie t)o i11erent color o1 >IPP car 1orparticipants to iscuss an )rite their response on rational 1or UHEP an implementation approach/strateg" o1 UHEPseparatel"*

As0 the 1ollo)ing uestions to the participants+

;hat is the rational 1or UHEP ;hat is the implementation approach o1 UHEP

Step &As0 participants to spea0 loul" there response an post the response on the 1lip chart in t)o columns*

Step 4&Discuss )ith participants on their response i1 there is an" uestion an clari1ication

Step 3&Present 1lip chart 1lip chart $* $*$ an $*.

Flip $hart 6 21

UHE! de#inition

"0t


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Flip $hart 6 22

The rational #or UHE!

&* The expansion o1 urban areas an the population gro)th o1 the countr"are increasing tremenousl"*

;hat o1 Ethiopian population lives in urban areas

&66-+ &2************ L 5 million people* $%%8+ &4*********** L && million people*

$%-%+ L .2 accoring to mathematical moeling$* ?igration o1 the people 1rom rural to urban areas in search o1

emplo"ment# eucation an better li1e*

.* Facilities that provie social services an the per capital income unparallel evelopment )ith the expansion o1 urban areas

-* Population gro)th contributes 1or the sprea o1 several health an healthrelate problems in urban areas*

2* H"giene an environmental sanitation problems#4* Shortage o1 suitable )ellings an suppl" o1 clean )ater#

8* =o) health a)areness#

5* Shortage o1 1oo an malnutrition an usage o1 substance#

6* Spreaing o1 non communicable isease 1rom time to time# etc

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In orer to alleviate these intert)ine problems )ith communit"


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Ho) i the program 1unctioning

Step 2& ;rite the response participants on the 1lip chart an than0 1or their active participation

Step &Present 1lipcharts $*-# $*2# $*4 an $*8Flip $hart 6 24

US+89UHE! progra" su""ary

USAID/Ethiopian Urban Health Extension Program UHEPB is a three "earprogram ,ctober $%%6 to September $%&$ implemente b" !SI* Inc *Theprogram aims to support the implementation an monitoring o1 thegovernment o1 Ethiopia UHEP an to improve accesses to an eman 1orhealth service* Speci1icall" the program aims to strengthen the capacit" o1Urban Health Extension Pro1essionals to ienti1" an provie basic publichealth services li0e HI> prevention# care an support to vulnerableiniviuals or populations

Flip $hart 6 23

US+89UHE! progra" ob)ective

&* Increase eman 1or public health services*$* Improve ualit" o1 UHEP service eliver" though training an

pro1essional evelopment o1 UHE;*

.* Improve accesses an ecrease barriers to public health services 1orvulnerable population

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-* Support 1or the evelopment an implementation o1 the communit"base management in1ormation s"stem to support a multi/AIDS an health program

Flip $hart 6 25

!rogra" i"ple"entation area

&* Tigra" 7egion 1our cit"/to)n?e0elle# Aigrat# Axum# ShireB

$* Amhara 7egion 1our cit"/to)n ahir Dar# Gonar# Debre ?ar0os#DessieB

.* ,romia 7egion 1our cit"/to)n Aama# !imma# Shashamane# an9e0emteB

-* S99P7 7egion 1our cit"/to)nHossana# Ha)assa# Arba ?inch an;ol"ta SooB

2* Harari 7egionHarari to)nB

4* Dire Da)a Aministration Dire Da)a cit"B

8* Ais Ababa (it" AministrationRe0a an Araa sub cit"B

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Flip $hart 6 2:

!rogra" i"ple"entation strategies

&* 7each >ulnerable populations$* Provie access to HI> as )ell as broaer public health in1ormation

.* Integrate gener strategies

-* Strengthen partnerships

2* DecentraliCe technical support4* 7eplicate )or0ing moels an introuce innovations

8* Promote communit" involvement an o)nership

5* Promote evience


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Session & ntroduction to Supportive Supervision

'b)ectives


(rate a common unerstaning o1 e1ining supportive supervision* Explain principles an t"pes o1 supportive supervision

Di11erentiate the traitional supervision an supportive supervision

Ti"e

&5% minutes

Session $ontent

De1inition# concept an principles o1 supportive supervision -% min*B T"pes an 1unction o1 supportive supervision an practice 8% min*B

(omparison o1 traitional >s supportive supervision 8% min*B

*aterial

Flipchart stan# =(D# 1lipchart paper# mar0er# mas0ing tape an po)er point presentation# (ase Scenario*

+ctivity 1& $oncept and principles o# supportive supervision /40 "in

Step1& Explain the session ob@ectives

Step2& Divie the participants in to - to 2 groups 4 : 8 participants in each groupB an as0 to iscuss on the1ollo)ing uestions*

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&* ;hat is supervision

$* ;hat is supportive supervision

.* ;hat are the principles o1 supportive supervision

Step & ,ne or t)o group )ill present their iscussion points an the other groups )ill contribute on issues notraise in the previous t)o groups*

Step 4& Present 1lip chart .*& an .*$ to summariCe the session

Flip chart 1

Supervision is to )atch over an activit" or tas0 being carrie out b" somebo" anensure that it is per1orme correctl"*

Supportive supervisionis the process of g"iding, helping and enco"raging staff toimpro$e their performance so that they meet the defined standards of theirorgani2ation.

The i"portant #actors in this de#inition are as #ollo(s&

Supportive supervision is a processIt is not a one


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)ell in all aspects o1 their @ob# but the" can o it little b" little

Involves helping sta11 to improve their per1ormance so that they"eet the de#ined standards o# their e"ployer*

oThis is a crucial 1actor* I1 there is no clear statement o1 )hat peopleare meant to o @ob escriptionB an ho) the" are meant to o it theexpecte stanar o1 per1ormanceB then ho) are the" meant to 0no))hat the" shoul be oing An ho) is the supervisor meant to be ableto assess )hether the" are oing the right things in the right )a"

+ctivity 2& Type and #unctions o# supportive supervision /:0 "in

Step 1& rain storm on t"pe an 1unction o1 supportive supervision b" as0ing the participants the 1ollo)ing uestion

1 ;hat are the common t"pes o1 supportive supervision2 ;hat are the basic 1unctions o1 supportive supervision

Step 2& The 1acilitator )ill list the responses o1 the participants in the 1illip chart

Step + Divie the participants in to 1our or 1ive small groups an istribute the case scenario case Scenario .*.*$ an .*.B to each group an as0 the group to iscuss on the 1ollo)ing uestions base on the scenario

;hich t"pe o1 supportive supervision is the case scenario ;hat 1unctions o1 supportive supervision are conucte in the case scenario

Step 4& The group )ill present their 1inings on t"pe an 1unction o1 supportive supervision base on the casescenarios

Step 3&Present 1lip chart .*. an .*- summariCe the t"pe an 1unction o1 supportive supervision

Step 5&Present 1lip chart .*2 an as0 participants to re1lect on the case scenario 1or 1urther unerstaning anclari1ication*

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Flip $hart

Types o# Supervision

ntegrated Supervision 7 ntegrated supportivesupervision is the periodic assess"ent o# all theactivities #or (hich a particular #acility isresponsible

Technical Supervision 7 Speci#ic progra"s "ayre


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Flip chart 6 3

+ns(er #or case scenario on #unction and type o# supportive supervision

$ase ;o Type o# Supportive SupervisionFunction o# Supportive

Supervision(ase & Technical Supportive Supervision < Eucational

Function

< Supportive Function(ase $ Integrate Supportive Supervision

Technical supportive supervision

< EucationalFunction

< Supportive Function

< ?anagerialFunction(ase . Emergenc" Supportive Supervision < Supportive Function

Facilitator ;ote 6 1

Types o# Supervision

I. Integrated Supportive Supervision

Integrate supportive supervision is the perioic assessment o1 all the activities 1or)hich a particular 1acilit" is responsible* ;hilst not all activities can be superviseat one time# ever" activit" shoul have been supervise at least once in the courseo1 one "ear*

Integrate supportive supervision is most e11ectivel" carrie out b" multi prevention strategies# an he also go through the HI>testing protocols the" are currentl" using to ensure the ualit" o1 testing the"provie* A1ter he 1inaliCes his assessment he iscusses )ith the UHE pro1essionalson the 1inings he got 1rom the supportive supervision* He provie a reorientationon the gaps ienti1ie an recommens some solutions base on the stanar*Finall" he evelope an action plan )ith the UHE pro1essional an their supervisoran set the 1ollo) up supervision ate*

$ase Scenario 6 2 7 Supportive Supervision Types and Functions

A team o1 supervisors 1rom i11erent epartments o1 ,romi"a regional health bureauhas conucte a supportive supervision at Aama to)n on urban health extension

program 1or three a"s* The supervision )as conucte at three i11erent levels atHouse hol level# at to)n health o11ice an at the UHE pro1essional levelB* Thissupervision is the part o1 uarterl" supportive supervision plan # )ith a purpose o1trac0ing program progress# ienti1"ing challenges# proviing 1eebac0s#recommening solutions an ra) action plans* The team share their report to themanagement an other concerne unit 1or their in1ormation an 1urther ecision*

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$ase Scenario 6 = Supportive Supervision Types and Functions

The health promotion# isease prevention Department o1 )olaita Soo to)n Heltho11ice has in1orme that an un0no)n outbrea0 has been observe throughout0ebele %2* The hea o1 the epartment gather the o11icers an ecie to ma0e a

supportive supervision in 0ebele %2 )ith the 0ebeles urban health extensionpro1essional# supervisors an health center representatives to investigate the causeo1 the problem an to trace out cases to manage the out bra0e* As per the irection1rom the hea# the team 1rom the to)n health o11ice in collaboration )ith the0ebeles UHE pro1essionals accomplishes its mission an elivers the report to theepartment*

+ctivity & $o"pare traditional supervision >s supportive supervision /:0 "in

Step 1&Divie the participants in smaller group o1 2


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;hen oes supervisionhappen 1reuenc"BHo) o supervisorsprepare;hat happens uring

supervision;hat happens a1tersupervision

Step & ,ne or t)o group )ill present an the other groups )ill contribute on issues not raise in the previous t)ogroups

Step 4& Present 1lipchart .*4 to summariCe the comparison bet)een traitional supervision an supportivesupervision*

Flip $hart 6 5+ction Traditional

SupervisionSupportive Supervision

;ho oes thesupervision

Supervisorsesignate b" the

managementstructure

Supervisors esignate b" themanagement structure

Peer revie)s

(olleagues;hen oes supervisionhappen

During perioicvisits b" supervisors

(ontinuousl"+ uring routine )or0

During team meetings

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(on1irmation visits b" supervisorHo) o supervisorsprepare

=ittle or nopreparation

Supervisors revie) previoussupervisor" reports

Supervisors revie) reporte

achievements

Supervisors ecie be1ore thesupervision visit on )hat the" neeto 1ocus on

;hat happens uringsupervision

Inspection

7evie) o1 recorsan supplies

Focus on 1ault1ining

=ittle 1eebac0 oriscussion o1supervisorobservations

Supervisors ma0emost ecisions

,bservation o1 per1ormance ancomparison to stanars

Immeiate 1eebac0 1romsupervisor

!oint problem solving on possiblesolutions to per1ormance problems

Provision o1 technical upates anguiance

,n


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,ngoing monitoring

Follo)


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Step 2&Divie the participant in to - < 2 small groups an as0 them to iscuss on the 1ollo)ing points in a group*Provie 1ive >IPP car 1or each group to list the ans)ers 1or the 1ollo)ing uestions*

&* ;hat are the basic s0ills neee 1or supportive supervision$* ;hat is the bene1it o1 having these supportive supervision s0ills

Step &,ne or t)o group )ill present an the other groups )ill contribute on issues not raise in the previous t)ogroups

Step 4&Present 1lip chart -*& to summariCe the iscussion

Flip chart 6 41

So"e o# the basic s.ills #or supportive supervision

Technical s0ill/0no)lege ?entoring s0ill (oaching s0ill (ommunication s0ill Problem solving s0ill

Technical s.ill is having 0no)lege about the sub@ect matter* The supervisorshoul have a competent technical s0ill on the sub@ect matter he/she is going tosupervise* It is a s0ill that is reuire 1or the accomplishment o1 a speci1ic tas0*$oaching is a process that enables learning an evelopment to occur an thusper1ormance to improve* To be success1ul a coach reuires 0no)lege an

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unerstaning o1 process as )ell as the variet" o1 st"les# s0ills an techniues thatare appropriate to the context in )hich the coaching ta0es place**entoring involves a relationship )here a person )ith speci1ic 0no)lege anexperience provies guiance an support to a more inexperience part"* Amentoring relationship can ta0e shape in man" i11erent 1orms incluing+ 1ormal

mentoring moels# group mentoring an net)or0s# compan" mentoring programan in1ormal relationship*!roble" solving isthe process o1 )or0ing through etails o1 a problem to reach asolution* Problem solving ma" inclue s"stematic operations an can be a gauge o1an iniviuals critical thin0ing s0ills*

Flip $hart 6 42

ene1its o1 Having Supportive supervision s0ills

Foster open communication Able to provie constructive 1eebac0

Able to Share 0no)lege an s0ill

Helps to be 1ocuse an practical

Ensure ualit" o1 service

Facilitator note 6 41

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$oaching and "entoringshare man" similarities so it ma0es sense to outline thecommon things coaches an mentor o )hether the service are o11ere in a paipro1essionalB an unpai philanthropicB role*

Facilitate the exploration o1 nees# motivations# esires# s0ills an thoughtprocess to assist the iniviual in ma0ing real# lasting change*

Use uestioning techniues to 1acilitate clients o)n thought process in orerto ienti1" solutions an actions rather than ta0es a )holl" irective approach

Support the client in setting appropriate goals an methos o1 assessingprogress in relation to these goals

,bserve# listen an as0 uestions to unerstan the client situation

(reativel" appl" tools an techniues )hich ma" inclue oneIPP car 1or each participant an as0 them to )rite one 0e" 1eature o1 e11ectivecommunication s0ill in each car

Step 2& Post the >IPP car on the )allan group them accoring to their similarit"

Step &ase on the groupe >IPP car iscuss on the 0e" 1eature o1 e11ective communication

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Step 4& Present 1lip chart -*. an -*- an summariCe the 0e" 1eatures o1 communication

Flip chart 6 4

So"e o# the .ey #eatures o# e##ective co""unication s.ill

3e" 1eatures o1 e11ective communication s0ills can be ivie in to verbal an nonverbal

=istening E"e contact

Posture

Simple language

Spea0 slo)l" an clearl"

uestioning

e consierate

Give complement

Have con1ienceFacilitator note 6 44

E##ective co""unication

;';7>E@?+A

?aintain e"e contact )ith ever"one in the group as "ou spea0* Dont appear to1avor certain people in the group*

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Avoi pacing or aressing the group 1rom a place )here "ou cant be easil" seen*

7eact to )hat people sa" b" noing# smiling# or other actions that sho) "ou arelistening

Its important to appear relaxe an at the same time be irect an con1ient*

>E@?+A

As0 uestions that encourage responses* ,pen


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As0ing them to repeat )hat )e have sai in their o)n )ors As0ing them to appl" )hat "ou have sai to another situation

Encourage them to as0 uestions

+ctivity 4& ?arriers to e##ective co""unication /40 "inute

Step 1& As0 the participants to be in pair anas0 them to iscuss on the common barriers 1or e11ectivecommunication an olutions to minimiCe the barrier* Provie t)o i11erent color o1 >IPP car# one 1or barriers an theother one 1or solutions*

;hat are the barriers 1or e11ective communication ;hat coul be one to minimiCe the barriers o1 e11ective communication

Step 2&Post their response on the )all an group them to iscuss )ith participants on the barrier o1 communicationan solution to each*

Step &Present 1lip chart -*2 an -*4* 7elate barriers o1 e11ective communication )ith their solutions uringpo)er point presentations*

Flip $hart 6 43$'**'; ?+@@E@S T' $'**U;$+T';

Environ"ental

(ompeting emans 1or attention e*g* soun# extremes o1 temperature Insu11icient time

'rganiDational

Di11icult managers ?ultiple lin0s in the communication chain/(hain o1 bureaucrac" Harsh relationship

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Failure to communicate missions# goals an ob@ectives Absence o1 clear @ob escriptions an stanars =ac0 o1 transparenc" Failure to ta0e inputs or give 1eebac0

$ontent o# the "essage =ac0 o1 relevance =ac0 o1 timeliness (omplexit" o1 the message

!ersonal

Frame o1 re1erence/personal i11erence in terms o1 Social status# culture# eucation# age# sex elie1s# values# an pre@uices/intolerance Previous experience

Selective perception Disturbe emotional state : illness# 1inancial crisis etc* Inconsistenc" bet)een action an )ors =ac0 o1 empath"

Flip chart 6 45

Ho( to overco"e barriers

Put the persons at eas"

Sho) the person "ou )ant to listen

7emove estructions Empath"

e patient

Hol "our temper

Go eas" on agreement an criticism/be 1lexible

As0 uestions

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=earn to use 1eebac0 )ell

e sensitive to receive points o1 vie)

=isten to unerstan

Use irect an simple language or use language appropriate to thereceiver

=earn to use supportive communication# not e1ensive communication

Step 4&SummariCe session - b" pla"ing hot potato game to summariCe 0e" learning points* As0 participants tostan in a circle aroun "ou* Give a ball to one o1 the participants* The ball represents a potato* (lose "our e"es anstart sa"ing 1aster an 1aster# The potato is )arming upq** is getting )armer an )armer q** it hot] As "ou sa"these )ors# the participants have to pass the ball 1rom one another aroun the circle 1aster an 1aster* ;hen "ousa" the )or hot# the person )ho has the ball )ill share something that she/he has learne uring the session*

Then she/he goes in the mile an replace "ou continue the game# an so on*

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Session 3& Bey Ele"ents o# Supportive Supervision

'b)ectives


Ienti1" the 0e" elements o1 Supportive Supervision

Ti"e

-2 minutes

Session $ontent

3e" elements o1 supportive supervision -2 minuteB

*aterials

=(D# 1lipchart stan# 1lipchart paper# mar0er an mas0ing tape# >IPP/lan0 car*

+ctivity 31& denti#ying Bey ele"ents o# Supportive Supervision /43 "inutes

Step 1& Explain the ob@ective o1 the session

Step 2& As0 the participants to be in pair an provie >IPP car to iscuss an )rite some elements o1 supportivesupervision

;hat are the 0e" elements o1 supportive supervision

Step &Post the responseon the )allan group the response an iscuss

Step 4& Presenting 1lipchart 2*& an iscuss each point using the 1acilitators note 2*&

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Flip chart 6 31

Bey Ele"ents o# Supportive Supervision1 *anage"ent co""it"ent2 Standards o# per#or"ance

!lanning #or supervision

4 !reparation #or supervision

3 Sta.eholder involve"ent

5 Supervisory tools

: 8ocu"entation o# supervisory #indings

!reparation o# an action plan

Sharing o# supervision #indings

10 Sel# assess"ent

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Bey Ele"ents o# E##ective Supervision

For a supervision s"stem to be e11ective# there are a number o1 elements that nee

to be present+&* *anage"ent $o""it"ent+ ?anagers must be committe to supervision* I1managers o not emonstrate their belie1 in the value o1 supervision an 1ailto ensure that supervision is carrie out as intene# sta11 )ill recogniCe thisan )ill not ta0e supervision seriousl"*

$* Standards o# !er#or"ance&There must be ocumente an )ell


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6* Sharing o# Supervision Findings&The results o1 the supervision shoul beshare )ith 0e" o11icers 1rom the supervisors o11ice an 1rom the supervisesite* This ensures that all sta11 is a)are o1 results# incluing actions to be ta0en*

&%*Sel# +ssess"ent&Improve per1ormance can onl" be sustaine )hen sites

ta0e responsibilit" over their o)n per1ormance* Iniviual sites shoul conuctsel1 assessments )ith the same tools use b" their external supervisors# anmeasure their per1ormance against establishe stanars*

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Step 4& SummariCe the session b" as0ing participants the 0e" learning points the" have learne 1rom the sessionan ho) the" can appl"

Session 5& $urrent !ractice o# Supportive Supervision in UHE!

'b)ectives


Ienti1" an anal"Ce the current practice o1 supportive supervision in UHEP

Ti"e

-2 minute

Session $ontent

Ienti1" the current practice o1 supportive supervision in UHEP -2 minuteB

*aterials

=(D# 1lipchart stan# 1lipchart paper# mar0er# mas0ing tape# >IPP/blan0 car

+ctivity 51& $urrent practice o# supportive supervision /43 "inute

Step 1& Explain the session ob@ective

Step 2&Divie the participants in to small group o1 1our an iscuss on the 1ollo)ing points to assess the currentpractice o1 supportive supervision* The 1irst t)o groups )ill iscuss on uestion A# an c an the secon t)ogroups )ill iscuss on uestions D# E an F%

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A* ;ho oes the supervision* ;hen oes supervision happen

(* Ho) an )here the supervision happen

D* Ho) o supervisors prepare

E* ;hat happens uring supervision

F* ;hat happens a1ter supervision

Step & ,ne group 1rom each )ill present an the other groups )ill contribute on issues not raise in the previoust)o groups

Step 4& Present 1lip chart 4*& to iscuss on common mista0es o1 supervision

Flip $hart 6 51

$o""on "ista.es o# Supervision

Supervision )as not conucte 1reuentl" or regularl"* Supervision )as not planne*

Supervisor" visits )ere not communicate to the organiCations to besupervise*

Supervision )as generall" vertical

A1ter 1iel visits there )as little or no sharing o1 the 1inings o1 supervision )ith

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other program supervisors*

Supervision 1inings )ere o1ten not ocumente*

There )as o1ten no )ritten 1eebac0 to a sta11 that ha been supervise*

Supervision tene to be 1ocuse on 1ault 1ining an criticism rather than onsupport*

The supervisee )as rarel" involve in eciing 1ollo)


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Session :& "ple"entation Steps o# Supportive Supervision

'b)ectives


Unerstan the implementation steps o1 supportive supervision* (onuct supportive supervision base on the implementation steps*

Ti"e

$4% minute

Session $ontent

Steps o1 supportive supervision -% minuteB Activities uner each steps o1 supportive supervision 5% minuteB

Problem ienti1ication an action planning &2% minuteB

*aterials

Flipchart stan# 1lipchart paper# mar0er# mas0ing tape# >IIP/blan0 car

+ctivity :1& denti#ying the steps o# supportive supervision /40 "inute

Step 1& Explain the session ob@ectives

Step 2& As0 theparticipants to be in a group o1 three those )ho sit next to each otherB istribute 1ive >IPP cars toeach group an tell them to )rite steps o1 supportive supervision on each car* one step on one carB

Step & As0 the group to post their cars accoring to their iscussion steps

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Step 3&SummariCe the iscussion using 1acilitator note 8*$

Facilitator note 6 :2

Step 1& +ctivities under !lanning and !reparation

8evelop annual9


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$o""unicate the schedule to relevant depart"entand the supervisee

*eet as tea" to de#ine areas o# #ocus, shareresponsibilities and set (or.ing rules

8evelop9revise supportive supervision chec.list

@evie( previous supervisory report9s and actionplans, H*S data

$ollect additional in#or"ation #ro" depart"ents

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*a.e su##icient copies o# the supportive supervision

chec.list #or all tea" "e"bers

+rrange all the necessary logistics #or supportivesupervision

Supervisee level preparation

@evie( the previous supervisory report and actionplan /identi#y gaps

$onduct a sel# assess"ent, using the supportivesupervision chec.list

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Ensure the presence o# all .ey sta## on the date o# thesupervision visit

*a.e available all necessary docu"ents #orveri#ication

Step 2& $onducting Supportive Supervision

Start the Supervision

@evie( o# progress in i"ple"entation o# planedactivities

ntervie(s and record revie(s

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'bservations

Follo(7up o# issues #ro" previous supervision

Step & Gap identi#ication, +nalysis and +ction planning

+gree on identi#ied gap9s /the supervisors and the

supervisee

!rioritiDe identi#ied gaps by using the criteria on"agnitude o# the gaps , its i"pact on health

services, the #easibility o# #illing the gap, andavailability o# resources to #ill the gap

+nalyDe priority gaps to deter"ine the underlyingcauses

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denti#y appropriate solutions to the gap9s,

re"e"bering that both the supervisors and thesupervisees "ay need to contribute to the solution

!roviding i""ediate #eedbac.

8evelop action plan on site

Step 4& @ecording and @eporting (riting

8ocu"ent #ollo(7up action plan to address anyshortco"ings

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8ocu"ent a brie# su""ary o# their #indings

8ocu"ent co"pleted supportive supervision chec.list

!repare Supportive supervision report

Share the report to all sta.eholders

Ta.ing notes on each steps

$o"plete the chec.list

Step 3& 8ecision *a.ing, Follo(7up a#ter supportive

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supervision

Use supportive supervision #indings #or decision

"a.ing #or issues identi#ied at all level

Use supportive supervision #indings #or progra"revie(ing

Follo( up the issues be#ore the net supportivesupervision happen

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+ctivity :& !roble" identi#ication, analysis and action planning /10 "in

Step 1& As0 the participants )hat root cause anal"sis is an the common tools/methoolog" that are use 1orproblem anal"sis

Step 2+ )rite their responses on the 1lip chart

Step &SummariCe the responses using 1lip chart 8*$

Step 4&The 1acilitator )ill explain the 1ive )h" problem solving methos b" using 1lip chart 8*.

Step 3&As0 the participants to be in a group o1 2


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.* (hange anal"sis < an investigation techniue o1ten use 1or problems or accients* It isbase on comparing a situation that oes not exhibit the problem to one that oes# inorer to ienti1" the changes or i11erences that might explain )h" the problemoccurre*

-* 2 ;h"s as0 )h" )h" )h" )h" over until exhauste

Flip chart 8*.

The 3 -hys proble" solvingtool

The 2 ;h"s proble" solvingtool helps "ou )ith root cause analysis* It gets "ou to theheart o1 a proble"* ;hen "ou ienti1" an issue or an abnor"al condition# as0 )h" itoccurre* ut ont stop there* (ontinue to as0 2 ;h"s# or at least continue until "ou can nolonger ienti1" another cause* That is the point )here "ou have 1oun the core o1 the problemthe original reason it happene*

The 3 4hys Example

Why

Why

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=o) institutional eliver"

=o) a)areness o1 communit"
http://en.wikipedia.org/wiki/Change_analysishttp://en.wikipedia.org/wiki/5_Whyshttp://www.velaction.com/problem-solving/http://www.velaction.com/problem-solving/http://www.velaction.com/root-cause/#RootCauseAnalysishttp://www.velaction.com/problems/http://www.velaction.com/issues/http://www.velaction.com/abnormal-conditions/http://en.wikipedia.org/wiki/Change_analysishttp://en.wikipedia.org/wiki/5_Whyshttp://www.velaction.com/problem-solving/http://www.velaction.com/problem-solving/http://www.velaction.com/root-cause/#RootCauseAnalysishttp://www.velaction.com/problems/http://www.velaction.com/issues/http://www.velaction.com/abnormal-conditions/


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Why

Why

Step & SummariCe the activit" b" as0ing the participants Ho) much oes the tool/methoolog" help "ou toanal"Ce the root cause an evelop an action plan

Facilitator note 6 :

General principles of root cause analysis

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=o) communit" mobiliCation

=ac0 o1 s0ill person on ((


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&* To be e11ective# 7(A must be per1orme s"stematicall"# usuall" as part o1 aninvestigation*

$* The purpose o1 ienti1"ing all solutions to a problem is to prevent recurrence at lo)estcost in the simplest )a"*

.* To be e11ective the anal"sis shoul establish a seuence o1 events or timeline tounerstan the relationships bet)een contributor" causalB 1actors# root causesB anthe e1ine problem or event to prevent in the 1uture*

-* (orrecting a root cause gets ri o1 problems permanentl"# improving satis1action*

2* ;atch out 1or bias*

4* Spen time 1ining the right person to ans)er "our uestions*

8* e care1ul not to rel" onl" on 7(H metho 1or critical problems*

Facilitator note 6 :4

-or. through the ea"ple above&

During supervision# it is 1oun that a UHE pro1essionals lac0 o1 s0ill 1or not conucting

grauate moel house hol 1ollo) up* This is the observe problem*

The next step 1or the supervisor is to as0 ;h" are no 1ollo) up 1or moel 1amil" In the

example given# there are several possible ans)ers+< The cit"/to)n health o11ice ma" not incorporate in the routine plan

< The UHE pro1essional not incorporate in their )or0 plan

< The UHE pro1essionals not prioritiCe grauate moel 1amil" 1ollo) up as a ut"

< The UHE pro1essionals ma" not a)are on the importance o1 grauate moel 1amil" 1ollo)

up

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A1ter this 1irst roun o1 anal"sis# the next step is again to as0 ut ;h" again to tr" to

etermine the unerl"ing causes o1 the $nlevel problems*

This time# the example on the above 1ocuses onl" upon the problem UHE pro1essionals ma"

not a)are on the importance o1 grauate moel 1amil" 1ollo) up* T)o possible causes o1 this

problem are ienti1ie in the example+

< UHE pro1essional s not oriente

The action plan has to be developed )ointly (ith the supervisee


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The Five -hyI *ethodology #or proble" +nalysis

,n the recent supportive supervision conucte at Arbaminch to)n 0ebele %$ )ith

Sr Hana* She )as explaine ho) she is oing her ail" routine sa"ing that a1ter Iprovie the health eucation 1irst an then re1er m" client 1or 1urther meical ansocial support* she re1erring her client most o1 the time orall" an some timeprovie a sheet paper that has her clients name an complaint* Since she oesnthave re1erral irector" she usuall" re1er her clients to onl" Arbamich H( an 3aleHi)ot (hurch (are an Support Program*

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@oot cause analysis te"plate = ?UT -HC "ethod #or

proble" analysis

'bserved !roble"

?UT -HC

*ETH'89+!!@'+$H

?UT -HC

/@oot $auseUnderlying $ause

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Action planning template 1or the ienti1ie root causes

S;o

denti#ied rootcauses

Jointly proposedSolutions

@esponsible person

Ti"e table Support needed

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aroun the circle 1aster an 1aster* ;hen "ou sa" the )or hot# the person )ho has the ball )ill sharesomething that she/he has learne uring the session* Then she/he goes in the mile an replace "oucontinue the game# an so on*

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Session & !racticing Supportive Supervision

'b)ectives


Practice Ho) to conuct supportive supervision

Ti"e

$$% minute

Session $ontent

Supportive supervision chec0list 4% minuteB Practicing supportive supervision &4% ?inuteB

*aterials

Flipchart stan# 1lipchart paper# mar0er# mas0ing tape# chec0 list an case scenario

+ctivity 1& @evie( supportive supervision chec.list /50"inute

Step 1& Explain the session ob@ective

Step 2&As0 the participants to be in a group o1 a group o1 t2 to 4 an use the chec0 list that the regional/sub cit"/cit"/to)n health o11ice or supervisors are currentl" using i1 the cit"/to)n int have a supportive supervisionchec0list use USAID/UHEP chec0 list*

Step &Distribute the cop" o1 revie) chec0list guie see 1acilitator note 5*$B to each group to use to revie) theirsupportive supervision chec0list*

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Facilitator ;ote 61

# the group has "ore than one supportive supervision chec.list select one

and proceed the group (or. # ti"e allo(s the group can (or. on both

supportive supervision chec.lists

Step 4+ All the groups )ill present the result o1 their revie)

Step 3&summariCe the activit" b" as0ing the participants )hat the" have learne 1rom the revie)*


Guide to revie( chec.listS;o

ssues to consider Ces !artially

;o @e"ar.

Simplicit" o1 chec0list(ompleteness area coe#ate# Introuction# programcontent# etcB(omprehensiveness allpac0agesBAssess the per1ormance o1

the programFollo) chronological orerAction planning templateDoes the chec0list inclueprevious visit agree actionplan 1or iscussionAc0no)legement

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+ctivity 2& !racticing supportive supervision /150 "inute

Step 1&The same group 1rom the prior activit" )ill )or0 together* The participants assign themselves as one

supervisor# one supervisee an the remaining group members )ill be an observer to practice ho) to conuctsupportive supervision base on case scenario 5*& an 5*$

Step 2&Distribute a cop" o1 observer chec0 list 1rom 1acilitator note 5*. to those group members assigne as anobserver*

Step &Those participants assigne as an observer )ill chec0 the steps o1 supportive supervision using the chec0list

Step 4&An observer 1rom each group )ill present the 1ining o1 the observation

Step 3&As0 the remaining group members o1 the presenter to a 1eebac0s using the observer chec0 list*

Step 5& SummariCe the activit" b" as0ing the participants )hat the" have learne 1rom the revie)*

Facilitator note 6

;? It is ver" i11icult to construct a case scenario 1or the )hole process* Each group isexpecte to complete the missing parts o1 the case scenario* Please instruct the

participants to o accoringl"*

$ase Scenario6 1 practicing supportive supervision

The last supervisor" visit to one o1 the UHE pro1essionals in the to)n )as in !anuar"

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$%%.* T)o health pro1essionals in the to)n )ere assigne to conuct supportive

supervision to Sr Aster *

,n the speci1ie a"# the" presente )ith copies o1 the supervisor" chec0list 1or the

UHE pro1essionals an communit"# plus a cop" o1 the previous supervisor" reportcomplete chec0list an signe 1ollo)


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supervision so that the" 0ne) the ates o1 the visits an coul ma0e sure that all

UHE pro1essionals )ere prepare*

The last supervisor" visit to one S/r AlemB o1 the UHE pro1essionals uner his

catchment area )as in April $%# $%%.*,ne )ee0 be1ore the visit# Alemu revie)elast time supportive supervision 1inings an @ointl" planne activities uring

supportive supervision an ienti1ie issues that he 1ocuse on uring supportive

supervision

,n the speci1ie a"# he presente )ith copies o1 the supervisor" chec0list 1or the

UHE pro1essional an communit"# plus a cop" o1 the previous supervisor" report

complete chec0list an signe 1ollo)


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Facilitator note 6 4

'bserver chec.list

S

;o!oints to observe

Ces9

;o'bservation

& 7evie) H?IS ata$ Ienti1" issues 1rom other epartment. 7evie) previous supportive supervision

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1inings/action plan- (ommunicate the scheule to the supervisee

2Introuce the ob@ective o1 supportive supervisionclearl"

4 ,bservation

8 (omplete the chec0list5 (ommunication s0ill6 ?entoring an coaching/on @ob training

&% Issues/problems ienti1ie&& !oint action plan evelope&$ Feebac0 immeiate an )rittenB&. Ac0no)legement&-

Step 7: SummariCe session 8 b" as0ing the participants to 1orm a circle aroun "ou* The 1acilitator )ill through a ballto one o1 the participants to share the most use1ul things he/she has learne 1rom this session# an ho) theactivities are relevant to their @ob* The participant )ill through a ball to other participants to continue the game li0ethe previous one*

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Session & +ction !lan 8evelop"ent

'b)ectives


Develop action plan

Ti"e

&$% min

+ctivity 1& +ction plan develop"ent #or each city9to(n /50 "inute

Step 1& ?a0e a group o1 participants base on their cit"/to)n i1 the all participants are 1rom the same cit"/to)nma0e the grouping base on their )orea/0ebeleB

Step 2&Provie to) copies o1 action plan template an let the participants evelop an action plan 1or implementinga supportive supervision 1or UHEP*

+ctivities to be consider during action plan develop"ent

Develop/7evie) supportive supervision chec0list

HarmoniCe supportive supervision chec0list

Plan @ointl" supportive supervision

(onuct supportive supervision regularl"

Provie supportive supervision 1eebac0

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,thers

Step &Present the action plan o1 each group

Step 4&SummariCe the iscussion

Action plan template for implementation of supportive supervision for UE!

7egion/(it" Aministration+ XXXXXXXXXXXXXXXXXXXXXXXX

(it"/To)n+ XXXXXXXXXXXXXXXXXXXXXXXX

;orea/3ebele+ XXXXXXXXXXXXXXXXXXXXXXXX

Date+ XXXXXXXXXXXXXXXXXXXXXXXXX

S;o

+ctivities@esponsible !ersons

Ti"e period @e"ar.

+ctivity 2& $losing /40 "inute48% P a g e


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Step &Rou are at the en o1 the course* e1ore 1ormal closing remar0s# 0inl" reuest that participants completetheir 1inal tas0s+

The en


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@e#erencesGuieline 1or Implementing Supportive Supervision+ A step


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+nne+nne 1& End7o#7$ourse Evaluation For" and -ay For(ard

Training perio+ FromXXXX to XXXX# $%XXX

>enue+ XXXXXXXXXXXXXXXXXX

Instructions+ This 1orm is to be 1ille b" participants* ?ar0 an B b" the choice that "ou 1eel most closel" represents"our vie)s*

6 Section & Facilitation Ecellent

>Good

Good

;eedsi"prove"

ent

& Facilitators 0no)lege about 0e" topics o1 this

course$ Facilitators use o1 training materials

.Facilitators abilit" to communicate/trans1erin1ormation an 0no)lege

- Facilitators abilit" to let participants ra) o)nconclusions about the topics iscusse

2Facilitators abilit" let participants re1lect upon anconsoliate learning

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4 Facilitators abilit" to arouse an sustain interestamong participants

8Facilitators organiCation an management o1sessions

5Facilitators abilit" to use i11erent trainingmethoologies to achieve the course ob@ectives

6Facilitators encouragement o1 trainees toparticipate# an responsiveness to group )henappropriate

&%

Facilitators use o1 1lipcharts/slies/hanouts

&&

Facilitators time management an aherence toscheule

Section & Cour learning achieve"ents >"uch

So"e +little

;ot at all

&$

To )hat extent has "our unerstaning o1 theissues explore in this course improve orincrease as a result o1 the training

&.

To )hat extent has "our a)areness o1 "our o)nattitues an ho) the" ma" impact "our )or0change/improve as a result o1 this course

&-

To )hat extent have "our s0ills to conuctinteractions )ith iniviuals an groupsimprove/increase as a result o1 this training

&2

To )hat extent has this course helpe "ou toenhance "our appreciation an unerstaning o1

"our @ob as a )hole

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ss training facilitators guide_dec_2011.doc

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