Supportive supervision: an effective intervention in achieving high quality malaria case management at primary health care level in Jos, Nigeria

Ann Afr Med. Oct-Dec 2013;12(4):243-51. doi: 10.4103/1596-3519.122695.


Background: Supportive supervision is a form of supervision that promotes quality at all levels of health system by strengthening relationships within the system through prompt identification and resolution of problems among others. It is an effective intervention in improving health worker performance in low resource settings. Malaria is responsible for majority of outpatient consultations in Nigeria at all levels of care.

Materials and methods: This was a facility-based interventional study with pre and post-intervention phases conducted among two groups.The study subjects were selected through a multistage sampling technique and data collection was done using both semistructured interviewer administered questionnaire and supervisory checklist.

Results: The mean knowledge scores of malaria within the intervention group showed an increase from 10.3 ± 1.4 at preintervention to 11.3 ± 1.5 at post-intervention (P < 0.0015). The proportion of respondents who correctly followed malaria management guidelines increased from 32.73% at first supervisory visit to 70.91% by the third supervisory visit (P < 0.001). An analysis of the supervisory checklist showed improvement in performance of healthcare workers with each supportive supervisory visit in most of the variables examined.

Conclusions: This study has demonstrated that supportive supervision is a feasible and practicable tool in improving knowledge and practice of malaria case management among PHC workers.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Antimalarials / therapeutic use*
  • Case Management / standards*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Personnel / organization & administration*
  • Humans
  • Malaria / diagnosis
  • Malaria / drug therapy*
  • Male
  • Middle Aged
  • Nigeria
  • Primary Health Care / standards*
  • Process Assessment, Health Care
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Treatment Outcome
  • Young Adult


  • Antimalarials