Better together: a multi-country partnership evaluates best practices in malaria case management supervision

Health workers make decisions every day about how to care for a sick child. Should a child with a fever be tested for malaria? Based on the test results, should the child receive antimalarial treatment? Supervision is an important strategy to ensure that health workers have the knowledge and skills to provide quality services. The U.S. President’s Malaria Initiative (PMI) is funding a program evaluation through the PMI Insights project to assess and explain which components of supportive supervision improve the quality of malaria case management in different contexts, with the aim of improving the quality of care received by children.

PMI Insights formed a partnership between the Centre de Recherche en Reproduction Humaine et en Démographie (CERRHUD) in Benin, the Ifakara Health Institute (IHI) in Tanzania, and the London School of Hygiene & Tropical Medicine (LSHTM) in the United Kingdom to conduct the evaluation of supportive supervision in Benin and Tanzania.

Each of the three organizations bring their own expertise and country-specific experience to the partnership. As the IHI team explained, “we are passionate to contribute evidence to strengthen the implementation of supportive supervision in our country and share our country experience to other settings in an effort to strengthen health systems and save lives.” The program evaluation team prioritized creating a partnership that values scientific leadership and contributions from each institution. Central to this approach is having a co-principal investigator (co-PI) from each of the three institutions. With the guidance of the co-PIs, the study team worked together to design the study, protocol, and data collection tools, and analyzed the data through joint analysis sessions. The close collaboration is made possible through weekly virtual team meetings and frequent multi-hour working sessions aided by online tools (e.g., Jamboard and MindMeister). When reflecting on the partnership, the IHI team shared “The way we work openly, expressing our ideas in the different phases of implementing the work, is very empowering.”   

The cross-institution team also generated an activity development plan defining each team members’ self-identified learning goals and strengths. Over the last year, members of the team have facilitated knowledge-sharing sessions in their respective areas of expertise to facilitate a common understanding of research methods and strategies and to support each team member’s learning goals. To date, knowledge sharing sessions have covered key topics relevant to the evaluation including data coding and analysis methods (led by CERRHUD), interviewing techniques (led by IHI), and scoping review strategies (led by LSHTM). A member of the CERRHUD team explained, “We value the interaction of ideas and learning contributions not only for the improvement of the research project, but also for the evolution and acquisition of new professional and research skills.”

The impact of this knowledge sharing approach extends beyond the PMI-supported program evaluation activity. The CERRHUD team reflected, “Seeing that others benefit from the knowledge we have strengthens individual and collective confidence.” CERRHUD anticipates that “the knowledge gained will be disseminated within our organization for the benefit of scientific staff working on malaria-related issues and also on other major public health issues.” Reflecting on how the approaches used within this evaluation could contribute to the wider malaria control and elimination landscape, the LSHTM team shared that "the evaluation, and in particular the novel team based analytical approaches developed during this study, provides the potential for increased explanation of how, why, where and for whom malaria strategies work and importantly how their implementation can be improved”.

The results of the evaluation, scheduled to be completed in 2023, will be used to inform the design of programs to ensure that healthcare workers receive effective supervision that will ultimately help them provide life-saving care to children and families in need of malaria care.

Visit here to learn more about the supportive supervision program evaluation.