Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/12885
Appears in Collections:Management, Work and Organisation Journal Articles
Peer Review Status: Refereed
Title: The critical role of supervision in retaining staff in obstetric services: A three country study
Authors: McAuliffe, Eilish
Daly, Michael
Kamwendo, Francis
Masanja, Honorati
Sidat, Mohsin
de, Pinho Helen
Contact Email: md38@stir.ac.uk
Issue Date: Mar-2013
Publisher: Public Library of Science
Citation: McAuliffe E, Daly M, Kamwendo F, Masanja H, Sidat M & de Pinho H (2013) The critical role of supervision in retaining staff in obstetric services: A three country study, PLoS ONE, 8 (3, article e58415).
Abstract: Millennium Development Goal (MDG) 5 commits us to reducing maternal mortality rates by three quarters and MDG 4 commits us to reducing child mortality by two-thirds between 1990 and 2015. In order to reach these goals, greater access to basic emergency obstetric care (EmOC) as well as comprehensive EmOC which includes safe Caesarean section, is needed.. The limited capacity of health systems to meet demand for obstetric services has led several countries to utilize mid-level cadres as a substitute to more extensively trained and more internationally mobile healthcare workers. Although this does provide greater capacity for service delivery, concern about the performance and motivation of these workers is emerging. We propose that poor leadership characterized by inadequate and unstructured supervision underlies much of the dissatisfaction and turnover that has been shown to exist amongst these mid-level healthcare workers and indeed health workers more generally. To investigate this, we conducted a large-scale survey of 1,561 mid-level cadre healthcare workers (health workers trained for shorter periods to perform specific tasks e.g. clinical officers) delivering obstetric care in Malawi, Tanzania, and Mozambique. Participants indicated the primary supervision method used in their facility and we assessed their job satisfaction and intentions to leave their current workplace. In all three countries we found robust evidence indicating that a formal supervision process predicted high levels of job satisfaction and low intentions to leave. We find no evidence that facility level factors modify the link between supervisory methods and key outcomes. We interpret this evidence as strongly supporting the need to strengthen leadership and implement a framework and mechanism for systematic supportive supervision. This will promote better job satisfaction and improve the retention and performance of obstetric care workers, something which has the potential to improve maternal and neonatal outcomes in the countdown to 2015.
Type: Journal Article
URI: http://hdl.handle.net/1893/12885
DOI Link: http://dx.doi.org/10.1371/journal.pone.0058415
Rights: © 2013 McAuliffe et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Affiliation: Trinity College, Dublin
Socio-Management
University of Malawi
Ifakara Health Institute
Eduardo Mondlane University
Columbia University

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