A Manual for Comprehensive Supportive A MANUAL FOR …

1 THE UNITED REPUBLIC OF TANZANIA. MINISTRY OF HEALTH AND SOCIAL WELFARE. A MANUAL for Comprehensive Supportive A MANUAL FOR Comprehensive Supportive . Supervision and Mentoring on SUPERVISION AND MENTORING ON. HIV and AIDS Health Services HIV AND AIDS HEALTH SERVICES. NATIONAL AIDS CONTROL PROGRAMME (NACP). MARCH 2010. i A MANUAL For Comprehensive Supportive Supervision and Mentoring on HIV and AIDS Health Services Table of Contents Preface iv Acknowledgments vi Acronyms vii Chapter 1: Background 1. HIV Epidemic in Tanzania 1. National Response to the HIV Epidemic 1.

2 HIV and AIDS Interventions 2. Health Care Delivery System in Tanzania 2. Situational Analysis of Supportive Supervision and Mentoring in Tanzania 4. Chapter 2: Introduction to the MANUAL 6. Rationale 6. Purpose of the MANUAL 7. Objectives 7. Target Audience of the MANUAL 7. Chapter 3: Concept of Supportive Supervision and Mentoring 8. Overview of Supportive Supervision 8. Traditional Supervision vs. Supportive Supervision 8. Overview of Mentoring 9. How Supportive Supervision and Mentoring Overlap 9. Chapter 4: Setting up a National Supportive Supervision System 11.

3 Attributes of a Supervisor 11. Core Competencies of a Supervisor 11. Training of Supervisors 11. Resources Needed for Supportive Supervision 12. Issues/Areas to be covered during Supervision 12. Chapter 5: Structure and Function of the National Supervision System 17. National Level 17. Regional Level 18. District Level 18. Internal Supportive Supervision 18. Supportive Supervision at the Community Level 19. ii A MANUAL For Comprehensive Supportive Supervision and Mentoring on HIV and AIDS Health Services Chapter 6: Supportive Supervision Process 20.

4 Chapter 7: Setting up a National Mentoring System 23. Attributes of a Mentors 23. Competencies of a Mentor 23. Training of Mentors 23. Resources Needed for Implementing a Mentoring 24. Issues/Areas to be covered during Mentoring 24. Chapter 8: Structure and Functions of the National Mentoring System 28. National Level 28. Regional Level 28. District Level 28. Health Care Facility and Community Levels 29. Chapter 9: Mentoring Process 30. Mentoring Process 30. Duration and Frequency 33. Mentoring Methodologies 33. Chapter 10: Synergy between Supportive Supervision and Mentoring 37.

5 Synergy at the National Level 37. Synergy at the Regional Level 37. Synergy at the District Level 38. Synergy at the Health Facility Level 38. Resources are needed for Synergy Meetings 38. Chapter 11: Monitoring and Evaluation of Supportive Supervision and Mentoring System 39. References and Resources 40. Annex 1: Framework for Comprehensive Supportive Supervision and Mentoring of HIV 41. and AIDS Health Services Annex 2: Roles and Responsibilities of Regional/Council Health Management Team 47. iii A MANUAL For Comprehensive Supportive Supervision and Mentoring on HIV and AIDS Health Services Preface Supportive supervision is recognised as critical part of human resource management for the delivery of quality health care services.

6 It is especially important for HIV and AIDS related health services, as the scope and the coverage of the services are rapidly expanding. In addition, health care workers are being asked to take on new and complex roles at a rapid pace, while continuing to provide the Comprehensive health care services to the populations they serve. Furthermore, there are numerous new interventions for HIV and AIDS prevention, that need to be integrated into ongoing general health service. The new interventions include, HIV Testing and Counselling (HTC), Prevention of Mother to Child Transmission (PMTCT), Home-based Care, management of Opportunistic Infections (OI), Anti-retroviral Therapy (ART), Syndromic Management of Sexually Transmitted Infections (STIs), laboratory tests for HIV diagnosis and monitoring patient on ART, OI.

7 Diagnosis and, management of Tuberculosis and HIV co-infection, medical male circumcision for HIV prevention. In this regard, the importance of Supportive supervision and mentoring at all levels, cannot be overemphasised for the delivery of quality HIV and AIDS health services. With the Health Sector Reform, the management of health care services in Tanzania, has been decentralised from the central to the regional and district levels. Supervision is supposed to take place at all levels the national, regional, council and health facility levels.

8 Supervision from the central level has been conducted by programme leaders and partners in a vertical manner, based on the interventions being implemented. This has resulted into a wide variation between one partner and another, from region to region and district to district. Furthermore, Supportive supervision for ensuring the quality of HIV and AIDS health services, has been a challenge due to limited implementation capacity. Mentorship is a system of practical training and consultation, that fosters the ongoing professional development in order to yield sustainable high-quality clinical care outcomes.

9 It should be recognised as part of the continuum education, that is required to create competent health care providers. In Tanzania, however, it is still a new concept and implemented by a few partner organisations, with limited capacity. Both Supportive supervision and mentoring are complementary activities, that are both necessary to build a continuum of care and support. World Health Organisation (WHO) recommends that, the two activities shall be conducted by different teams in a synergetic manner. As HIV and AIDS health services in Tanzania are decentralised to district hospitals, health centres and dispensaries, supervisors need to take up expanded roles and responsibilities.

10 At the same time, skilful and experienced practitioners at national and regional levels, need to be capacitated as mentors to provide clinical/technical support to less skilled health practitioners, to ensure that quality services are provided at facility level. This MANUAL is therefore a milestone for the MOHSW, for improving the supervision and setting up of the national mentoring system and standardising the two activities. The MANUAL accompanied with appropriate tools is for use by managers, programmers, implementers and evaluators of Supportive supervision and mentoring system.