1. Integrated Monitoring and Supervision Approaches The Gambia
Olimatou Kolley
SMC Focal Person
NMCP
14 February 2017

2. Outline Objectives Roles of different Supervisors
Digital data collection
Data Quality Assurance Team
Purpose of doing supervision this way
Benefits
Challenges of supervisor

3. SMC Monitoring and Supervision
Aim:
Assess performance of CHWs, HFWs and other supervisors during SMC
Provide feedback on their performance
Identify opportunities for improvement within a supportive environment
Encourage and motivate them to do a good job

4. 4 different levels of supervision
Team
District
Regional
Central

5. Tools Central level monitoring checklist Team supervisors form
District supervisors form
National supervisors form
Health Facility End of cycle report
Referral form
ADR or PV form
Community worker competency checklist
Ipad/Adroid devices

6. Roles of Team Supervisors
Observe 4-6 distribution teams and each team consisting of 1 CHW and 1 data collector
Ensure every household is reached and every eligible child is treated
Support distribution teams to be well prepared before each SMC cycle with all needed materials
Ensure the safety of children who receive SP+AQ
Ensure SMC medicines are delivered timely, safely and correctly
Ensure all children with fever are referred to the health facility to be tested for malaria
Provide on site mentoring, coaching and feedback to distribution teams as needed

7. Roles of District Supervisors
Supervises 4 to 5 team supervisors
Uses a vehicle to ensure that all their teams are seen on a daily basis
Conduct spots checks to ensure that:
-right dose and quantity has been administered
-caregivers understand messages given by CHW
-completeness of distribution card
-any missed household or child
Review and collate data from team supervisors and send to regional data manager
Conduct Nightly meetings with team supervisors to discuss challenges and coverage so that informed decisions can be made in preparation for the following day
Complete supervisor end of cycle report

8. Roles of Central & Central level supervisors
Regional
Responsible for regional coordination and oversight of all SMC activities during the four cycles
Central
Responsible for the overall coordination of SMC activities and there is one present in every district during delivery
Report any issues that may arise to national coordinator

9. Role of Health Facility Workers
Receives, store and distribute SMC drugs to team supervisors
Manage all referrals
Manage children with AEs and SAEs and complete the National pharmacovigilance forms
Complete and submit health facility End of Cycle report to the district supervisor on the last day of each cycle

10. Digital Data Collection
Central Level monitor observing data being entered into the iPad

11. We use Digital Data Collection tools and processes in The Gambia
Digital SMC Register
SMC Register
T Treated
M Sick
R Refused
E Excluded
Treated – Sick – Refused - Excluded

12. Process
An ICT4D strategy utilizing digital monitoring, evaluation, accountability and learning platform (eValuate), where teams of data collectors and community health workers utilize tablets and android phones through house-to-house:
Register beneficiaries (and households/ caregivers)
Issue beneficiary cards with a distinctive QR code (this contains a digital profile of bio, household and treatment data that is scanned before each SMC distribution to identify the beneficiary within the system) and distribute SMC over four cycles.
All beneficiary (and household) data is captured digitally on the devices utilizing iFormBiulder (a digital representation of paper forms) and synced to the CRS iCloud (in real time or near real time) for more quality data, rapid analysis, and systematic problem-identification and problem-solving

13. Roles of Data Quality Assurance Team
To ensure that data collected was of quality, a data quality team led by the MoH Monitoring and Evaluation Coordinator was set up in 2016 to:
Do the monitoring and auditing of data
Correct any errors and inconsistencies if present before synching data
Produce reports in real time for use in the field

14. Methodology for Conducting Data Quality Assurance
Quality checked at each level from distribution site before synching to regional and national level
Field data quality team review the data to make sure that all the forms are filled and save correctly before they can be synced
Regional Quality assurance team check the data to further ensure completeness and accuracy and report any inconsistences observed in the data to the district supervisor.
The NMCP MEAL Coordinator, CRS MEAL Officer and the regional data managers conduct the last data checks before building and sharing the report.

15. Purpose of doing supervision this way
Ensure every household is reached and every eligible child is treated equitably
Observe distribution teams to ensure that SMC drugs are delivered safely and correctly
Provide on site mentoring, coaching and feedback to distribution teams to improve performance
Ensure every level of supervisor is performing their role correctly
Ensure each drug administered is accounted for
Ensure data collected digitally is of quality by setting up a data quality team to conduct data audits in the field
Solve technical issues that may arise while collecting data
Ensure that data collected is available at the end of each day

16. Benefits Distribution done correctly and professionally
Biographical and distribution records of beneficiaries captured electronically and available for all four cycles
Records of beneficiary available for consequent cycles so that SMC is not administered to children not eligible
Timely management of AEs and SAEs by Health Facility Workers
Availability of near real time data to be able to make informed decisions in preparation for the next day

17. Benefits Cont’d Data collected are reliable and of good quality
Having information on daily coverage by district so that more focus and effort can be put where needed for improvement
Using eValuate allows permanent record of beneficiary data and enables quick analysis of data for decision making
Everyone including the donor can see the same data for more transparency

18. Heavy rains and flooding causing damaged and impassable roads especially in URR making it difficult for supervisors to reach certain communities
Data synchronization was a problem in most communities due to poor internet connectivity
Challenges

19. Thank you for your kind attention