Professional Assessment of Primary Healthcare Supervision Systems in South South Nigeria

Supervisory support for primary healthcare workers is a critical determinant of service quality, yet supervision systems in South South Nigeria are inconsistently implemented, inadequately resourced, and rarely linked to performance improvement. This study professionally assessed PHC supervision systems in Rivers, Delta, and Bayelsa States. A mixed-methods assessment design was employed, combining structured questionnaires administered to 90 PHC facility officers-in-charge, document review of supervisory visit records for the preceding 12 months, and key informant interviews with 15 LGA health supervisors and three state PHC development agency officers. Assessment dimensions covered supervisory visit frequency, visit quality, feedback provision, mentoring components, and supervisory tool use. Results showed that scheduled monthly supervisory visits were completed as planned in only 34.4 percent of facilities over the 12-month review period. Where visits occurred, structured mentoring was provided in only 28.9 percent of cases. Feedback reports were shared with facility staff in 41.1 percent of visited facilities. Supervisory tools and checklists were used in 51.1 percent of visits. Fuel availability and transport costs were cited by 86.7 percent of LGA supervisors as primary barriers. The assessment concludes that PHC supervision in the South South zone is significantly deficient in frequency, quality, and follow-up. Recommendations include budget-protected fuel allocation for supervision, digitalised supervisory checklists, and integration of facility peer-review mechanisms as supplementary quality improvement strategies.

Keywords: primary healthcare supervision, service quality, South South Nigeria, health systems, PHC management