Supervision for diarrhoea case management at the oral rehydration therapy corners and diarrhoea training units in Sindh.

The role of supervisors in diarrhoea case management at the Oral Rehydration Therapy (ORT) corners of Sindh was assessed by a random sample of 62 ORT corners in rural and urban areas of Sindh. The supervisors at each facility included, Medical Superintendents, District Health Officers, Senior Medical Officers, Civil Surgeons and Medical Officers. In 65% cases the supervisors were working at the same facility and in 35% the supervisors were based elsewhere. In 33.7% cases, there had been no meeting with the supervisor in the past 3 months which incidently was the diarrhoea season. In 6.5% cases there had been only 1 meeting, in 8.5% there had been 2-3 meetings and in the remaining 41.3% cases there had been more than 3 meetings with the supervisor. In majority of the cases the supervisors did not do anything related to improvement of diarrhoea case management. Supervisors had given some importance to case management in the urban areas and the Diarrhoea Training Units (DTU). The supervision at ORT facilities was found to be at a rudimentary level and it is suspected that this might be adversely affecting the quality of diarrhoea case management.