Innovation in supervision and support of community health workers for better newborn survival in southern Tanzania.

BACKGROUND: Home visits by community health workers may help to improve newborn survival, but sustained high-quality supervision of community volunteers is challenging. OBJECTIVES: To compare facility-led and community-linked supervision approaches of 824 community health volunteers working to improve newborn care in Southern Tanzania. METHODS: Using a before-after design, we compared 6 months of supervision reports from each approach. RESULTS: During the community-linked approach over 50 times more supervision contacts were recorded than during the facility-only supervision approach (1.04 contacts per volunteer per month vs 0.02), and the volunteer-supervisor ratio reduced from 7.8 to 1.6. CONCLUSION: Involving community leaders has the potential to improve supervision of community health volunteers. ClinicalTrials.gov Identifier: NCT01022788; http://clinicaltrials.gov/ct2/show/NCT01022788?term=INSIST&rank=1.