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Supervisory Applications: The Secret to Government Adoption Success

By Catholic Relief Services on October 10, 2018

supervisory ICT4D success

Arguably, the best option for digital development sustainability is for the government to fully adopt your technology intervention and integrate it into government systems.

However, funding from governments for high tech innovations is competing with urgent needs like; education, health, food assistance, and emergency response, which means many of the flashier applications are abandoned after the external funding ends.

CRS has seen the greatest success in scaling technology with governments using supervisory applications for government-managed frontline workers. While the original success was with supervising health workers, our success has since expanded to Nutrition and Water Sanitation as well.

Why Are Supervisory Applications Effective?

Supervisory applications provide the ability to see trends in areas needing improvements, making follow-up with staff easy and targeted, and further improving service delivery.  In many cases we are talking about simple checklists.  Checklists that supervisors use when they are supporting the performance of a worker or volunteer.

However, the strength of supervisory applications lies with aggregating this information across multiple employees on a dashboard allowing the supervisor to target locations, actions, or areas of efficiency/deficiency. This gives supervisors the simplicity to look at multiple actions of multiple employees and have a few actions to target for improvement instead of a sea of data complexity.

The Reality of Supervisory Usage

Keeping technology at the supervisor level also implies less cost for governments to assume than having one smart phone for each frontline government worker.  While this may not be where many of us want to be, I would argue it is better and more realistic to build in supervisory apps into sustainability plans.

We need to stop assuming that every government worker or service provider will be armed with a smartphone at the end of the project.  We need to not only look at the minimal viable product but also at which user level technology is most likely to be of greatest value and thus continue to be used.

Even with the onset of open source software with paid support, like CommCare, there is still an ongoing cost for hardware that will not go away and reaching supervisors with smart phone applications is much more achievable than reaching every frontline worker.

Two Examples of Supervisory Application Success

The trend of supervisory application success has appeared in two different countries in very different contexts for CRS.

In India, the ReMiND supervisory app is used to supervise health workers for pre and postnatal care. It was scaled to 5 districts jointly by government with 523 health supervisors using the application to improve service delivery for 10,385 accredited social health activists that cover a population of 17.7 million.

There has been a 40% increase in the health supervisors guiding the health workers in tasks they could not complete in the prior month.  Discussions of covering marginalized community members has increased by 64%.  This improved guidance and supervision has trickled down to the community level as there has been a reduction in resistance to health worker messages and support by 22%.

In Zambia, at the closing of the USAID Feed the Future and PEPFAR-funded Mawa project that addresses chronic malnutrition, the government kept using the supervision application for the nutritional volunteers.  The health facility-level supervisors using the supportive supervision checklist and dashboard have supported frontline workers to improve their counseling skills in the areas of greatest weakness.

This has let USAID to extend the program and CRS will now apply the lessons from Nutrition to provide a supervisory app for Water Sanitation and Hygiene frontline workers.

Where Have You Seen Supervisory Application Success?

Our successes in India and Zambia are exciting, but only two examples of what should be a widespread trend in digital development. Where have you, or one of your colleagues, had supervisory application success with government adoption? Please let us know in the comments.

By Kathryn Clifton, Erin Baldridge, and Satish Kumar Srivastava of CRS

Filed Under: Management
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Catholic Relief Services (CRS) provides humanitarian aid and development across the globe by responding to major emergencies, fighting disease and poverty, and nurturing peaceful and just societies. For almost 75 years CRS has assisted people and organizations on the basis of need, not creed, race or nationality. CRS seeks out and assists the most poor and vulnerable overseas.
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7 Comments to “Supervisory Applications: The Secret to Government Adoption Success”

  1. Chris Watson says:

    The Government of Colombia has adopted Premise as their platform for Zika and Dengue surveillance and remediation. The Health Directorate uses our operations console and smartphone app to manage both their frontline health inspectors and ordinary citizens who do more simple surveillance and door-to-door outreach tasks. This year they moved their workforce over to a gig-based payment model instead of salaries and stipends. I think we’ve been successful for a few reasons:
    1. All dashboards and workflows were designed in partnership with the Health Director
    2. The predictive model for surveillance and remediation activities works – so local politicians are able to brag about how they have lowered outbreak risk to <5%

    Email me if you want to find out more: [email protected]

    • Kathryn Clifton says:

      Finding incentives is always a great way to create motivations in use! Well done in making a predictive system accurate, no small task. Well done!

  2. Jim Teicher says:

    There is another reality of supervisor use — entering inaccurate data. Most of us working in developing nations are very familiar with issues relating to data reliability. For example, supervisors may be reluctant to enter correct data because it might have a negative impact on an employee’s job stability; and the net result might put a family’s welfare in jeopardy. I’ve witnessed this problem first hand — many times — and I’m confident that many others will concur.

    • Kathryn Clifton says:

      I find this to be true not only with digital tools but also paper. Data quality and accuracy is something to continue to work on and motivate rather than punish. Verification checks are equally necessary in paper and digital systems

  3. Elaine Baker says:

    The Government of Tanzania’s Digital Health Investment Roadmap and Data Use Partnership is investing in more coordinated health facility supervision enabled by digital tools. See “Strengthen systems for management and supervision of facility performance” in http://moh.go.tz/images/eHealth_Initiatives/TZ_Investment_Recommendations_Roadmap.pdf This goes beyond checklists to consider action plans and follow up, and use of data before, during, and after supervision visits.

  4. Kathryn Clifton says:

    This is great! Congratulations. It is always great when such things are made sustainable, rare, but wonderful.