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  3. Friday, 11 April 2008
POST 01252E: Cost-effectiveness of peer training and supervision to enhance immunization services 11 APRIL 2008 This paper offers the first attempt to quantitatively evaluate the supportive supervision framework in Andhra Pradesh In Andhra Pradesh, India, traditionally, supervision of immunization services has been non-existent. In November 2003, an Immunization Service Delivery Support (ISDS) model was launched in all districts covering a population of 76 million. The Andhra Pradesh ISDS model is a well-established immunization supervision system and builds upon the existing health infrastructure. The objectives of implementing this model are to: (1) identify areas of high performance and those that need improvement, (2) assist staff in identifying and correcting wrong practices, (3) improve staff skills, (4) motivate staff, and (5) initiate corrective actions at appropriate levels through information sharing. With the total combined number of urban health centres and primary health centres ranging from 70 to 80 per district with only one district immunization officer (DIO) in each district, a supervision visit can accommodate only five to ten health centres (HCs). To establish an effective supportive supervision system, the ISDS model initially used both external and government supervisors to monitor immunization practices and to ensure quality immunization service delivery. Twenty-one districts were included in the programme during the first two years of implementation. The external consultant mode was coordinated by designated persons at PATH and used a team of external consultants and regional coordinating officers (RCOs), retired state or district level health officers, to implement the model in 14 districts. In time, assistance from PATH and the external consultants was phased out. Total costs of activities in 16 districts over the evaluation period were US$ 110 630 (US$ 36 877 per round). The statistical significance of results on effectiveness suggests that performance at health centres and immunization sessions have been greatly improved since the ISDS programme was launched. Use the following link to access the entire paper: Cost and effectiveness analysis of immunization service delivery support in Andhra Pradesh, India Authored by: Chutima Suraratdecha, CBS Venkata Ramana, Satish Kaipilyawar, JVG Krishnamurthy, Srilatha Sivalenka, Naveena Ambatipudi, Sanjay Gandhi, K Umashankar, James Cheyne Bulletin of the World Health Organization: Volume 86, Number 3, March 2008, 161−240 Post generated using Mail2Forum (http://www.mail2forum.com)


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