Strengthening the role of community health workers through supportive supervision: A Scoping Review

Trimaya  Cahya Mulat; Tirta Asprimi Anggraeni; Wahyudi  Hardi; Muh Ihsan Kamaruddin; Jessy Andre Mangaya Takke

doi:10.61099/jih.v1i3.139

Authors

Trimaya Cahya Mulat Departement of Nursing https://orcid.org/0000-0002-0173-1177
Tirta Asprimi Anggraeni Department of Health Information Management, Politeknik Sandi Karsa, South Sulawesi, Indonesia https://orcid.org/0000-0002-6618-5680
Wahyudi Hardi Department of Health Information Management, Politeknik Sandi Karsa, South Sulawesi, Indonesia
Muh Ihsan Kamaruddin Department of Health Information Management, Politeknik Sandi Karsa, South Sulawesi, Indonesia https://orcid.org/0009-0003-7352-3689
Jessy Andre Mangaya Takke Department of Health Information Management, Politeknik Sandi Karsa, South Sulawesi, Indonesia

DOI:

https://doi.org/10.61099/jih.v1i3.139

Keywords:

Accountability, Capacity building, Community health workers, Digital supervision

Abstract

Introduction: Community health workers (CHWs) are critical in expanding access to primary healthcare, particularly in underserved areas. Despite their essential role, CHWs often face challenges such as inadequate supervision, limited feedback, and lack of professional development. Supportive supervision, which emphasizes mentorship, joint problem-solving, and performance improvement, has emerged as a key strategy to strengthen CHW effectiveness and retention.

Methods: This scoping review followed Arksey and O’Malley’s framework and the PRISMA-ScR guidelines. Relevant literature published between 2010 and 2025 was systematically searched in PubMed, Scopus, and Web of Science. Studies focusing on supportive supervision models, strategies, or outcomes for CHWs were included. Data were extracted and synthesized thematically to identify supervision approaches, implementation factors, and impacts on CHW performance.

Results: Thirty-seven studies met the inclusion criteria. The findings revealed that supportive supervision enhances CHW motivation, service quality, and community trust. Effective supervision models were characterized by regular feedback, participatory monitoring, and peer learning. Barriers included insufficient resources, supervisor workload, and weak institutional support. Digital tools and community-based supervision showed promise in improving supervision frequency and data-driven decision-making.

Conclusion: Supportive supervision plays a pivotal role in strengthening the performance and sustainability of CHW programs. Integrating structured, participatory, and technology-assisted supervision mechanisms into health systems can foster CHW empowerment, accountability, and long-term impact.

Downloads

Download data is not yet available.

References

E. Sacks et al., “Beyond the building blocks: integrating community roles into health systems frameworks to achieve health for all,” BMJ Glob. Heal., vol. 3, no. Suppl 3, p. e001384, 2019.

C. Sivamani, G. K. Saya, R. Ulaganeethi, and P. Chinnakali, “Self-care practices on hypertension: Prevalence and predictors in Puducherry, South India,” Clin. Epidemiol. Glob. Heal., vol. 31, p. 101883, 2025, doi: https://doi.org/10.1016/j.cegh.2024.101883.

Y.-J. Tsai et al., “Varied effects of sweeteners on pediatric hypertension: A multicenter study,” Clin. Nutr., vol. 53, pp. 199–210, 2025, doi: https://doi.org/10.1016/j.clnu.2025.08.034.

J. Shan and S. Panuthai, “Effects of an individual and family health literacy enhancement program for older adults with physical multimorbidity: A randomized controlled trial,” Patient Educ. Couns., vol. 141, p. 109319, 2025, doi: https://doi.org/10.1016/j.pec.2025.109319.

S. Suprapto and Z. Salah Jalal, “The role of obesity in increasing the risk of hypertension in the elderly,” J. Edukasi Ilm. Kesehat., vol. 2, no. 3, pp. 86–93, Nov. 2024, doi: https://doi.org/10.61099/junedik.v2i3.59.

J. M. Selemani et al., “Impact of pregnancy on hypertension and cardiovascular risks among reproductive aged Congolese women: Insights from the 2019 to 2024 May measurement month surveys,” Pregnancy Hypertens., vol. 41, p. 101246, 2025, doi: https://doi.org/10.1016/j.preghy.2025.101246.

S. Suprapto and M. Ihsan Kamaruddin, “Integration of digital technology by health analysts in health information systems: Systematic Review,” J. Interdiscip. Heal., vol. 1, no. 1, pp. 34–43, May 2025, doi: https://doi.org/10.61099/jih.v1i1.105.

S. V. Rocha et al., “Implementing regular physical activity for older individuals in the family strategy program using the RE-AIM framework to ensure feasibility and sustainability: EISI study protocol,” Contemp. Clin. Trials Commun., vol. 39, p. 101311, 2024, doi: https://doi.org/10.1016/j.conctc.2024.101311.

T. M. Pratamawati et al., “Clinical profile of hypertension patients in primary health Care in Cirebon Regency, Indonesia,” Endocr. Metab. Sci., vol. 18, p. 100232, 2025, doi: https://doi.org/10.1016/j.endmts.2025.100232.

N. Sharma et al., “Association of exposure to violence and risk of hypertension: Systematic review and meta-analysis,” Public Health, vol. 243, p. 105722, 2025, doi: https://doi.org/10.1016/j.puhe.2025.03.034.

D. A. Suprapto Maria Kurni Menga, Trimaya Cahya Mulat, “The Role of Home Care in the Management of Hypertensionin the Elderly,” J. Heal., vol. 1, 2025.

A. D. Rule et al., “Trends in the Incidence of Hypertension Among Healthy Adults Across 6 Decades,” Mayo Clin. Proc., vol. 100, no. 5, pp. 778–789, 2025, doi: https://doi.org/10.1016/j.mayocp.2024.10.025.

W. Wang, H. Zhou, S. Qi, H. Yang, and X. Hong, “The association between physical activities combined with dietary habits and cardiovascular risk factors,” Heliyon, vol. 10, no. 7, p. e28845, 2024, doi: https://doi.org/10.1016/j.heliyon.2024.e28845.

Z. Hill et al., “Supervising community health workers in low-income countries — A review of impact and implementation issues,” Glob. Health Action, vol. 7, p. 24085, 2014, doi: 10.3402/gha.v7.24085.

H. B. Perry, C. Westgate, D. Musoke, and L. Crigler, “Community health workers at the dawn of a new era: Recent advances in supervision,” Heal. Res. Policy Syst., vol. 19, no. Suppl 3, 2021, doi: https://doi.org/10.1186/s12961-021-00754-6.

M. C. Kok, J. E. W. Broerse, S. Theobald, H. Ormel, M. Dieleman, and M. Taegtmeyer, “Performance of community health workers: situating their intermediary position within complex adaptive health systems,” Hum. Resour. Health, vol. 15, p. 59, 2017, doi: https://doi.org/10.1186/s12960-017-0234-z.

S. Nida and A. S. A. Tyas, “A systematic review of the types, workload, and supervision mechanism of community health workers: Lessons learned for Indonesia,” BMC Prim. Care, vol. 25, p. 82, 2024, doi: https://doi.org/10.1186/s12875-024-02319-2.

T. Ludwick, E. Turyakira, T. Kyomuhangi, K. Manalili, S. Robinson, and J. L. Brenner, “Supportive supervision and constructive relationships with healthcare workers support CHW performance: use of a qualitative framework to evaluate CHW programming in Uganda,” Hum. Resour. Health, vol. 16, no. 1, p. 11, 2018.

M. C. Kok et al., “Does supportive supervision enhance community health worker motivation? A mixed-methods study in four African countries,” Health Policy Plan., vol. 33, no. 9, pp. 988–998, 2018.

G. E. Khumalo, E. E. Lutge, P. Naidoo, and T. P. Mashamba-Thompson, “Barriers and facilitators of rendering HIV services by community health workers in sub-Saharan Africa: a meta-synthesis,” Fam. Med. Community Heal., vol. 9, no. 4, p. e000958, 2021.

A. Manzi, L. R. Hirschhorn, K. Sherr, C. Chirwa, C. Baynes, and J. K. Awoonor-Williams, “Mentorship and coaching to support strengthening healthcare systems: lessons learned across the five Population Health Implementation and Training partnership projects in sub-Saharan Africa,” BMC Health Serv. Res., vol. 17, no. Suppl 3, p. 831, 2017.

Y. Tseng et al., “Integrating community health workers into the formal health system to improve performance: a qualitative study on the role of on-site supervision in the South African programme,” BMJ Open, vol. 9, no. 2, p. e022186, 2019.

N. Oprea, G. Giacomelli, M. Sartirana, E. Trinchero, and I. Georgescu, “Meso-organisational determinants of healthcare workers’ resilience: results of a scoping review,” Health Policy (New. York)., vol. 161, p. 105412, 2025, doi: https://doi.org/10.1016/j.healthpol.2025.105412.J. Morrison, D. Rimal, I. Pradhan, N. P. Luitel, and K. Rose-Clarke, “How can sport promote adolescent mental health? A qualitative study from the rural plains of Nepal,” SSM - Ment. Heal., vol. 8, p. 100491, 2025, doi: https://doi.org/10.1016/j.ssmmh.2025.100491.

S. K. Zainal Badri and N. Z. Zulkarnain, “Spirituality and personal growth of muslim working women: The moderating role of family supportive supervision,” Soc. Sci. Humanit. Open, vol. 10, p. 101201, 2024, doi: https://doi.org/10.1016/j.ssaho.2024.101201.

A. M. Oladayo et al., “Evaluation of the Oral Health Education for Nurses and Community Health Workers (Project OHE-NCHeW) in Nigeria,” Int. Dent. J., vol. 75, no. 5, p. 100891, 2025, doi: https://doi.org/10.1016/j.identj.2025.100891.

M. Ryan et al., “Implementing the ‘Integrated Model for Supervision’ for mental health and psychosocial support programming within humanitarian emergencies: A mixed-methods evaluation across six humanitarian contexts,” Compr. Psychiatry, vol. 139, p. 152584, 2025, doi: https://doi.org/10.1016/j.comppsych.2025.152584.

A. P. Bondre et al., “A character-strengths based coaching intervention to improve wellbeing of rural community health workers in Madhya Pradesh, India: Protocol for a single-blind randomized controlled trial,” Contemp. Clin. Trials Commun., vol. 42, p. 101377, 2024, doi: https://doi.org/10.1016/j.conctc.2024.101377.

K. O. Siddiqi, M. H. Rahman, J. Rahman, and M. Radulescu, “Effect of perceived supervisor support, technological self-efficacy and technostress on nurses turnover intention: A moderated mediation model,” Acta Psychol. (Amst)., vol. 260, p. 105631, 2025, doi: https://doi.org/10.1016/j.actpsy.2025.105631.

S. Mansouri, C. C. M. Pereira, T. Sultana, M. Ruiz-Casares, and J. I. Nazif-Muñoz, “Family-friendly labor policies and child supervision: Evidence from the Gambia, Mauritania, and São Tomé and Príncipe,” Child Prot. Pract., vol. 6, p. 100226, 2025, doi: https://doi.org/10.1016/j.chipro.2025.100226.

M. Hussain, T. T. Luu, and T. Marjoribanks, “How and when paternalistic leadership influences service innovative behaviour while inhibiting counterproductive work behaviour among healthcare professionals: the roles of perceived supervisor support and public service motivation,” J. Health Organ. Manag., vol. 39, no. 9, pp. 71–95, 2025, doi: https://doi.org/10.1108/JHOM-08-2024-0333.

S. Shrestha et al., “Strengthening cancer care for the LGBTQIA+ population in Nepal: A narrative review to set priorities for equitable oncology services,” Dialogues Heal., vol. 7, p. 100229, 2025, doi: https://doi.org/10.1016/j.dialog.2025.100229.

U. B. Okafor, I. Obasanjo, and D. Ter Goon, “Important but Neglected: Job Description of Community Health Workers in the Eastern Cape: A Qualitative Study,” Open Public Health J., vol. 17, 2024, doi: https://doi.org/10.2174/0118749445334086240915172733.

W. Seekey et al., “Challenges and opportunities of human resource management activities for neglected tropical diseases in Liberia,” SSM - Heal. Syst., vol. 5, p. 100092, 2025, doi: https://doi.org/10.1016/j.ssmhs.2025.100092.

S. Bassi, N. Thapliyal, N. Chaturvedi, A. Radhakrishnan, and M. Arora, “Peer Education Initiatives for Promoting Adolescent Health in the South-East Asia Region: Findings From Desk Review and Key Informant Interviews,” AJPM Focus, vol. 4, no. 3, p. 100325, 2025, doi: https://doi.org/10.1016/j.focus.2025.100325.

K. O. Siddiqi, M. H. Rahman, M. A. Esquivias, and L. M. N. Hutapea, “The effect of perceived organizational and supervisor support on nurses’ turnover intention in Bangladesh: Does work-family conflict play a role?,” Soc. Sci. Humanit. Open, vol. 10, p. 100992, 2024, doi: https://doi.org/10.1016/j.ssaho.2024.100992.

F. Wei, S. Samad, and K.- Rahman, “Digital dialogue and creative outcomes: Unpacking AI-focused supervisory communication,” Acta Psychol. (Amst)., vol. 260, p. 105534, 2025, doi: https://doi.org/10.1016/j.actpsy.2025.105534.

C. Zemp et al., “Addressing the unique supervisory needs of humanitarian volunteers: Insights from piloting the ‘Integrated Model for Supervision’ in Bangladesh,” SSM - Ment. Heal., vol. 7, p. 100403, 2025, doi: https://doi.org/10.1016/j.ssmmh.2025.100403.

B. N. Morey et al., “Structural supports and challenges for community health worker models: Lessons from the COVID-19 response in Orange County, California,” SSM - Qual. Res. Heal., vol. 7, p. 100510, 2025, doi: https://doi.org/10.1016/j.ssmqr.2024.100510.

R. J. Jarden et al., “Clinical supervision and resilience in nurses: A scoping review,” Nurse Educ. Today, vol. 155, p. 106870, 2025, doi: https://doi.org/10.1016/j.nedt.2025.106870.