The first Monitoring and Supervision in 11 districts in Ashanti Region

The MCH RB Project (The project) trained 990 health workers in focus 11 districts with 3-day training curriculum in 2019. The Project conducted the first monitoring and supervision (M&S) to monitor the skills of health workers as well as the general conditions of health facilities for the provision of the Nutrition Counseling Services and Respectful Care (NCSRC) using MCHRB. The first monitoring and supervision (M&S) in the focus 11 districts was conducted in January and February 2020. 37 Districts and 4 Regional Facilitators visited 129 facilities and assessed the skills of 265 health workers, mothers’ experiences, as well as the general conditions of health facilities for the provision of the NCRRC using MCH RB.

Skills for the introduction of the MCH RB and the provision of health education messages to women had improved. During the skill observation, measurement skills for weight were done properly: while the measurement of length for children and the plotting in the growth curve needed more practice. Counseling was done well while the recording of counseling was not done well. 79.1% of observed cases of health workers were familiar with the 3As (Assessment, Analysis, and Action) approach; 80.0% of them at ANC and 81.4% at CWC (Child Welfare Clinic) completed assessment and analysis before taking action. The filling rate of the nutrition counseling table was 57.6% for women and 51.9% for children. Health workers expressed concerns about difficulties in providing counseling with the standardized flow of service delivery and filling the counseling table. The completion and recording sometimes interfered with the time pressure of providing services to large numbers or to cope with the record inappropriately filled by other health workers outside of the focus districts.

Among the observed cases (111), around 90% of the mothers remembered well the content of the counseling. More than 90% of the mothers were able to answer danger signs and next visit. 89.3% of the mothers felt free to ask questions.

The project will continue periodic M&S to strengthen health workers skills by on-site coaching especially on the measurement of length for children, the plotting in the growth curve and recording nutrition counseling table of ANC/CWC.