Training and supervision of health workers

community health nursing - unit IV- role of community health nurse in training and supervision of health workers -

1. Training and supervision of health workers Prepared by Krupa M athew . M Assistant professor 1

2. LEARNING OBJECTIVES The students will be able to: define training and supervision mention the objectives of training and supervision state various training programmes of health workers discuss training of Local Dais and Multi purpose Health workers describe training of of ANMs, AWWs and ASHAs 2 2

3. INTRODUCTION In health care setting just an education improves the knowledge of the person, training entrances the attitude, skills and abilities of employees to perform specific job better. Training and supervision have, in all places, been a vital aspect of higher education. One of the purpose is to help the individual in becoming a useful member of society 3

4. TRAINING Training is the act of increasing the knowledge and skills of an employee for doing a particular job. The  Training  is a systematic activity performed to modify the skills, attitudes and the behavior of an employee to perform a particular job. The main purpose of training is to ensure that all employees have the technical skills needed to perform the job efficiently and smoothly. 4

5. OBJECTIVES OF TRAINING Increase Motivation and Engagement. Quick learning Higher productivity Standardization of procedures Less supervision Economical Operations Higher Morale Preparation of Future Managers Better Management 5

6. TRAINING OF AUXILLARY NURSE MIDWIFE(ANM) 6

7. ANMs is a village level female health worker in India who is the first contact person between the community and health services ANMs are playing important and vital role in Maternal Child Health and Family welfare services in the rural areas. Therefore it is essential that the proper training to be given to them so that quality services will be provided to the rural population. They are posted in Subcentre , Primary Health Centre and Rural Family Welfare Centres and other Health Centres . 7

8. The training duration of ANM course is two years with minimum qualification is 10 th pass . Senior ANM with 5 years of experience is given 6 months promotional training to become Lady Health Visitor/Health Assistant(Female). The Lady Health Visitor/Health Assistant are giving supportive supervision and technical guidance to ANMs in sub-centres. 8

9. TRAINING OF MULTI PURPOSE HEALTH WORKERS 9

10. TRAINING OF MULTI PURPOSE HEALTH WORKERS This is approved during 6 th Five Year Plan and by 1984 it became 100% Centrally Sponsored Scheme. Training duration is one year. On successful completion, they posed at the sub centre along with an ANM/Health worker The functions of MPHW are mainly in the areas of National Health Programmes like Malaria Leprosy Tuberculosis limited involvement in Universal Immunization Programme Diarrhoea Control Program and in family welfare services 10

11. TRAINING OF VILLAGE HEALTH GUIDE 11

12. TRAINING OF VILLAGE HEALTH GUIDE The village health guides are mostly women and this scheme was started on 1977. They are chosen by the community in which they work. The village health guide must be a permanent resident of the local community and have minimum formal education VI class. Training is conducted every month. The criteria's includes she must be a woman of the village who will visit everyone, represent every one by village communities themselves 12

13. After selection they undergo training in nearest PHC for 200 hours in 3 months. Each village health guide covers 1000 rural population. 13

14. TRAINING OF LOCAL DAIS They are expected to play vital role in propagating small family norms, emphasis is given on asepsis so that home deliveries are conducted under safe hygiene to reduce maternal and child mortality. Training: The training is for 30 working days. She is a paid a stipend of Rs.300 during her training period . Training is given at the PHC, Sub-centre or MCH centre for 2 days in a week, and on the remaining four days of the week they accompany the health worker After successful completion of training, each dais is provided with a delivery kit and a certificate 14

15. TRAINING OF ANGANWADI WORKERS 15

16. Under the ICDS(Integrated Child Development Services) scheme, there is an anganwadi for a population of 1000, there are about 100 such workers in each ICDS project. Training: Training in various aspects of health, nutrition and child development for 4 months. She is a part-time worker and is paid an honorarium of Rs.200-250 per month for the services rendered, which include health check-up, immunization, supplementary nutrition, health education, non-formal pre-school education and referral services. The beneficiaries are especially nursing mothers, other women(15-45 years) and children below the age of 6 years. 16

17. TRAINING OF ACCREDITED SOCIAL HEALTH ACTIVIST (ASHA) 17

18. ASHA training comes under the National Rural Health Mission. ASHA must be a woman resident of the village. Married/divorced preferably in the age group of 25-45 years. She should be literate woman qualified up to 10 th standard. ASHA will be chosen through community groups, self-help groups, Anganwadi Institutions, Village Health Committee and the Gram sabha 18

19. At the village level it is recognised that ASHA cannot function without adequate Institutional support, Women Committees, village health and sanitation committee of the Gram Panchayat , peripheral health workers especially ANMs and Anganwadi workers. She will counsel women on birth preparedness, importance of safe delivery, breast feeding, complementary feeding, immunization, contraception and prevention of common infectious diseases like RTI and STD 19

20. SUPERVISION Supervision means overseeing the employees at work. It has been defined as the authoritative direction of work of one’s subordinates It means observing the subordinates at work to see that they are working according to plans and policies of the organization and keeping the time schedule, and to help them in solving their work problems 20

21. OBJECTIVES OF SUPERVISION To help the staff to do their job skillfully and effectively to give maximum output with minimum resources-cost effectiveness Help to develop the individual capacity to the fullest extent with a view to channelize the same in favour of work Guide or assist in meeting predetermined work objectives or targets. In nursing preventive, promotive, curative and rehabilitative care to people 21

22. OBJECTIVES OF SUPERVISION Help to promote effectiveness of the subordinates/staff ensuring that the subordinate staff or supervise does what he/she supposed to do. Help to motivate subordinates to maintain high morale Help the members of the team to recognize problems, identify solutions and to take actions Help to develop team spirit and promote team work for effective functioning Help to improve the attitudes of the members towards the work program. 22

23. Principles of Supervision  Supervision should not be overburdened to any individual or group.  Supervision causing unreasonable pressure for achievements results in low performance and low confidence in the supervisor.  Supervise diagnosis do not overestimate his understanding and memory .  Human behavior with due consideration to human weaknesses. This should be kept in minds of supervisors. 23

24.  Supervisors should create atmosphere of cordially and mutual trust.  Supervision should be planned and adopted to the changing conditions. It calls for good planned and organization.  Supervisor must possess sound professional knowledge.  Supervision to be exercised without giving the subordinate a sense that they are being supervised.  Supervision strives to make the unit a good learning situation. It should be a teaching-learning process. 24

25.  Supervision should foster the ability of each staff member to think and act for herself/himself.  Supervision should encourages worker’s participation in decision making.  Supervision needs good communication.  Supervision is a process of cooperation and coordination.  Supervision should create suitable climate for productive work. Supervision should respect the personality of the staff.  Supervision should stimulate the workers/staff ambitions to grow in effectiveness.  Supervision should focus on continued stag growth and development.  Supervision is responsible for checking and guidance.  Good leadership is part of good supervision 25

26. Technique of Supervision Individual and group conference Anecdotal record Supervision of nursing procedure Reassurance Incidental teaching Observation (Check List) and rating scale Written Policies 26

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