Four district level managers and 13 peripheral health workers were included in the interviews with health workers.
Through regular and personal contact, supervisors were mandated to improve the competence of peripheral health workers.
Among the peripheral health workers, 3 were trained as general nurses and 10 received basic midwifery training.
" In our district, feedback is given during half-year review meetings where peripheral health workers are invited to the district health administration to clarify issues based on the discrepancies detected in their IDSR reports submitted".
Information unit, Informant # 4 " In our district, feedback is given during half-year review meetings where peripheral health workers are invited to the district health administration to clarify issues based on the discrepancies detected in their IDSR reports submitted".
The introduction of malaria rapid diagnostic tests and the availability of wireless communications present an opportunity to open direct data transmission and feedback between peripheral health workers and central managers.
Data have shown that families in rural areas usually visit informal providers, such as village doctors, homeopathic providers, and traditional healers, before seeking formal providers such as doctors, nurses, midwives, or peripheral government workers for health care [ 4, 25, 30].
The Malaria Mothers Providers (MAMOP) study was a cluster-randomized controlled effectiveness trial to evaluate the feasibility and effectiveness of an intervention designed to improve case management of malaria in 1,081 pre-school children through mothers supported by mother-groups and peripheral health workers (26).
A recent review of the peer-reviewed literature on supervision of peripheral health workers, including CHWs, identified several promising approaches for strengthening supervision [ 59], all of which could benefit from collaborative engagement by actors from both the community and the health system.
While some vertical programmes are relevant to child health, no other comprehensive approaches have yet been proposed that cover all leading causes of child deaths, and reflect the fact that all care is inevitably linked at the level of the peripheral health worker.
