Field supervision for quality control of local family planning workers in developing countries.

On-the-job supervision is the most crucial and most often neglected mechanism for promoting program effectiveness. This article focuses on promoting the quality of worker performance, based on experience with the community-based distribution of contraceptives in Zaire and Zimbabwe. A three-tiered approach to evaluating worker performance, based on testing distributor acknowledge, observing distributors in the field, and interviewing their clients, proved overambitious for routine evaluation purposes, but elements from it are included in a proposed supervisory system. Under this system, the supervisor reviews the performance of workers relative to each other based on output prior to a supervisory visit and tries to identify explanations for observed deficiencies. During the visit, he/she evaluates distributor performance and records these observations on a supervisory chart, presented herein. These charts are reviewed and updated on subsequent visits. Quantitative data on distributor performance may be interpreted in light of such factors as the difficulty of working in a specific area or competing demands on distributors' time. The proposed system is presented for relevant modification rather than as a rigid set of procedures.