The relationship between primary healthcare providers and their external supervisors in Rwanda

African Journal of Primary Health Care & Family Medicine

 
 
Field Value
 
Title The relationship between primary healthcare providers and their external supervisors in Rwanda
 
Creator Schriver, Michael Cubaka, Vincent K. Nyirazinyoye, Laetitia Itangishaka, Sylvere Kallestrup, Per
 
Subject Primary health care supportive supervision; managerial supervision; supervisory relationship
Description Background: External supervision of Rwandan primary healthcare facilities unfolds as an interaction between supervisors and healthcare providers. Their relationship has not been thoroughly studied in Rwanda, and rarely in Africa.Aim: To explore perceived characteristics and effects of the relationship between providers in public primary healthcare facilities and their external supervisors in Rwanda.Setting: We conducted three focus group discussions with primary healthcare providers (n = 16), three with external supervisors (n = 15) and one mixed (n = 5).Methods: Focus groups were facilitated under low-moderator involvement. Findings were extracted thematically and discussed with participating and non-participating providers and supervisors.Results: While external supervision is intended as a source of motivation and professional development in addition to its managerial purpose, it appeared linked to excessive evaluation anxiety among Rwandan primary healthcare providers. Supervisors related this mainly to inescapable evaluations within performance-based financing, whereas providers additionally related it to communication problems.Conclusion: External supervision appeared driven by systematic performance evaluations, which may prompt a strongly asymmetric supervisory power relation and challenge intentions to explore providers’ experienced work problems. There is a risk that this may harm provider motivation, calling for careful attention to factors that influence the supervisory relationship. It is a dilemma that providers most in need of supervision to improve performance may be most unlikely to benefit from it. This study reveals a need for provider-oriented supportive supervision including constructive attention on providers who have performance difficulties, effective relationship building and communication, objective and diligent evaluation and two-way feedback channels.
 
Publisher AOSIS
 
Contributor Karen Elise Jensen Foundation, Denmark
Date 2017-11-01
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Qualitative research
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/phcfm.v9i1.1508
 
Source African Journal of Primary Health Care & Family Medicine; Vol 9, No 1 (2017); 11 pages 2071-2936 2071-2928
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://phcfm.org/index.php/phcfm/article/view/1508/2317 https://phcfm.org/index.php/phcfm/article/view/1508/2316 https://phcfm.org/index.php/phcfm/article/view/1508/2318 https://phcfm.org/index.php/phcfm/article/view/1508/2312
 
Coverage Rwanda; Africa; Low- and middle-income country — —
Rights Copyright (c) 2017 Michael Schriver, Vincent K. Cubaka, Laetitia Nyirazinyoye, Sylvere Itangishaka, Per Kallestrup https://creativecommons.org/licenses/by/4.0
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