IMNCI has been implemented in India with a view to reduce neonatal and infant mortality by strengthening community based management of neonates, infants and children. First 10 days of neonatal life are very critical. IM(N)CI envisages 3–6 home visits to neonates within first 10 days of life. It has been shown in several studies that home visit by a health worker reduces the chances of neonatal death. A field-worker trained in supportive supervision of IMNCI, visits previously trained IMNCI worker, evaluates her field activities and skills and provides her hands-on in-situ training. The worker is revisited and supported six times over a period of 1 year and her performance reviewed again on key indicators. The changes in field performance, skills and its outcomes are noted by the field worker through a structured format and analysed by a data analyst in excel. The trained workers were given composite scores on four key areas of performance viz. Assessment, Classification, Treatment and Counselling over six supportive supervision visits.
There is a significant improvement in the scores of all four areas of performance that is, from 50 to 78% for Assessment, 2–70% for classification, 10 to 74% for treatment and 9 to 51% for counselling. Hands-on in-situ supervision (supportive supervision) has the potential to be a potent tool in improving the efficacy of IMNCI and thereby reducing neonatal mortality in the country.
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