TTC data monitoring and supportive supervision April 2015

Tools for data monitoring and supervision for ttC Guidelines for TTC Data Collection and Reporting Illustrative log frame Eligible women and girl register Referral / counter referral tool TTC Registers & Tally Sheets TTC Tracker Guidelines for TTC Supportive Supervision Core competencies for ttC-HV Qualitative supervision tools Performance audit Case evaluation checklist Observation assessment checklist Health knowledge assessment checklist Core competencies evaluation

LEVELS OF FUNCTIONALITY  0 = Non-Functional  1 = Partially Functional  2 = Functional  3 = Best Practice

ActivityPercent cover Observation of service delivery (Job Aids, RDT ) 18.8 Coaching and skill development6.3 Hygienic practice6.3 Trouble shooting (technical advice)25.0 Problem solving (non technical)18.8 Home visit25.0 Record review (Register, stock cards)62.5 Supply check (Medicines, equipment)18.8 Example of a CHW AIM assessment of supervision activities

Module Country Exercise What gaps exist in terms of promoting quality and a supportive environment? What are the reasons for the gaps? Who are the supervisors?

Qualitative elements Case evaluation / spot check Observation of service delivery Debriefing / meetings Supportive elements Observation of service delivery Trouble shooting Health knowledge check and revisions Debriefing meeting

TTC DATA COLLECTION AND REPORTING

What kinds of data might we want to collect? Community Case Statistics (per reporting period) – # of eligible women population – # of cases per life cycle stage – # of deaths by lifecycle stage Performance based indicators (per reporting period) – % completed TTC visits – % male / partner participation – % referral / follow up completion – % early registration in pregnancy Health practice Indicators (per completed case / supervision period) – Pregnancy HP indicators – Newborn HP indicators – Infant HP indicators – Child HP indicators – Optional or added indicators according to country requirements CASE LOAD / COVERAGE Adverse events CHW / HV PERFORMANCE MANAGEMENT TRIGGERS FOR ACTION

TTC REGISTERS Pictorial registers with  checklist at HH visit TTC Registers have four life cycle stages/ cohorts: o Pregnancy o Newborn o Infant 1-6m o Child 6-23m Health practice data is tallied when the life cycle stage is completed o As per sentinel time point collection but only 4 points o Supervisors can track performance indicators and do data validation at any time point Registers have space for any number of visits o including more than scheduled – e.g. additional visits for vulnerable cases o Adapted to country context o Are summarised as yes / no answers

TTC supervisor tally sheets Are identical in appearance to TTC registers Are adapted to country context by deleting rows Can align to HMIS by adding rows as needed 2 options for collection: – Per woman – Per TTC home visitor / CHW Can be collated during group supervision

CHW supervision & data flow TTC DATA FLOW Supervisor WV TTC REGISTER Supervisor MoH CHW RECORDS HHHV COMM : DM HV qualitative info TTC-HV reports compiled by data manager Debriefing meeting SUPERVISOR FEEDBACK Quantitative data Qualitative data Feedback

TTC Threshold score cards Identical order to Registers for easy reference Used to give a rough interpretation – Feedback given to ttC-HVs from this first analysis – Action plans made in situ Tally sheets are submitted to field office – data management will happen remotely (ADP, DHMT) GOODNEEDS IMPROVEMENT CRITICAL

Step1. Supervisor tallies the data Step 2. Identify values that are good, need improvement or poor, using the scorecard, and red or green pen Step 3. Check for trends in the data compared to previous months;

Step 7.Validate the data Step 8.Select an appropriate response, and create an action plan : individual / group Step 9.Feeding back to community representatives. ‘Sugar and salt’ technique Find something to praise Be selective about what you improve Step 4. Identify and investigate success areas. Give positive feedback Step 5. Select three or four improvement focus areas. Step 6. Use dialogue technique to discuss the underlying ‘barrier’ and solution.

Use negotiation and dialogue counselling methodology to get the ttC-HV to plan improvements Too much negative feedback is demotivating Create a realistic action plan – individual / groups