Increasing the productivity of community health workers in rural Nigeria through supervision

This paper describes the application of an operations research (OR) approach to the resolution of operational problems in the supervision of community health workers (CHWs) in rural Nigeria. It illustrates the application of a modified form of the Multiple Criteria Utility Assessment (MCUA) model to assess the utility of alternative strategies for improving supervision, given system constraints, and to select a limited number for recommendation and field testing. The paper also demonstrates how MCUA can be used to accommodate the preferences, judgements and knowledge of a wide variety of health professionals in arriving at program decisions.