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: 1.068_HHR Effectiveness of Supportive Supervision Visits on the Consistency of Community-Based Neonatal Sepsis Management Skills of the Health Extension Workers in 167 districts of Ethiopia G. Tiruneh, A.M. Karim, W. Betemariam, B. Yihun, B. Birhanu, A. Ameha, B. Mathiwos, A. Wanboru; JSI Research & Training Institute, Inc., Addis Ababa, Ethiopia, JSI Research & Training Institute, Inc., Arlington, Virginia, USA, UNICEF, Addis Ababa, Ethiopia, Save the Children International, Addis Ababa, Ethiopia Background: The health extension program of Ethiopia initiated Community-Based Newborn Care (CBNC) strategy to reduce its persistently high neonatal mortality rate. The strategy trained 7,010 health extension workers (HEWs) in 3,952 health posts in 167 districts to provide community-based management of neonatal sepsis, conducted prompt post-training follow-up, continued coaching through supportive supervision, and conducted review meetings. This study examines the effects of the supportive supervision on the consistency of neonatal sepsis management skills of the HEWs. Methods: The study domain was limited to the 3,924 health posts in 167 districts covering 18 million people supported by the Last Ten Kilometers Project of JSI. A historic longitudinal program monitoring data captured during follow-up visits from case record registers in the intervention health posts between January 2014 and June 2016 was used for this study. Consistency of neonatal sepsis management was defined as consistency of the recorded classification, treatment, and follow-up for neonatal sepsis cases according to the national CBNC protocol. The health post level repeated measures were accounted using random effects multiple logistic regression models. The models also accounted for secular trend to assess the effects of frequency of supportive supervision on the probability that a health post consistently conducted management of neonatal sepsis. Findings: About 72% (2,864) health posts received at least one supportive supervision visit, 21% (815) received two, and 6% (245) received more than two visits. The consistency of neonatal sepsis management by the health posts improved significantly (p<0.05) over the observation periods-from 60% in January-June 2014 to 72% in January-June 2016. The consistency of neonatal sepsis management was 65%, 68%, and 79% during the first, the second, and the third supervision visits, respectively. The regression analysis indicated that the effect of supportive supervision that was observed between the first two and the third rounds of supervisory visits were statistically significant (p<0.05). Interpretation: The findings of this study suggest supportive supervision visits were effective intervention in improving the consistency of skills of neonatal sepsis management. As such, at least three rounds of supervision are needed to maintain the consistent skills of management of neonatal sepsis at community level. Source of Funding: None. Abstract #: 1.069_HHR: 1.069_HHR PREventing Maternal And Neonatal Deaths in Rural Northern Ghana (PREMAND): Access to Basic and Comprehensive

annals of global health

Effectiveness of Supportive Supervision Visits on the Consistency of Community-Based Neonatal Sepsis Management Skills of the Health Extension Workers in 167 districts of Ethiopia