Effectiveness of Supervision on the Consistency of Neonatal Sepsis Management Skills of Health Extension Workers

  • Gizachew Tadele Tiruneh
  • Ali Mehryar Karim
  • Bantalem Yeshanew Yihun
  • Bizuhan Gelaw Birhanu
  • Agazi Amaha
  • Bereket Mathiwos
  • Biruk Tensou Tessema
  • Abera Workneh Wanboru
  • Wuleta Aklilu Betemariam


Introduction: Ethiopia has implemented community-based neonatal sepsis management as one strategy to reduce its persistently high neonatal mortality rate since 2012. The key strategies to maintain the quality of community-based management of neonatal sepsis are training, supportive supervision, and woreda-level performance review.

Objectives: Examine the effects of supervision visits provided to health posts on the consistency of neonatal sepsis management skills of health extension workers in Ethiopia.

Methods: The study domain was limited to 6,416 health posts in 269 woredas of Ethiopia. Longitudinal program monitoring data captured from registers between January 2014 and June 2016 was used for this study. The health post-level repeated measures were accounted for using random effects multiple logistic regression models

Results: All health posts (6,416) received at least one supportive supervision visit, 20% (1,289) received two, and 5% (301) received more than two visits. The consistency of neonatal sepsis management was 71%, 76%, and 84% during the first, second, and third supervision visits, respectively. The effects of supportive supervision that were observed between the first and third rounds of supervisory visits were statistically significant.

Original Article