@article {e2100667, author = {African Health Initiative Partnership Collaborative for Supportive Supervision and Mentoring}, title = {Improving Primary Care Quality Through Supportive Supervision and Mentoring: Lessons From the African Health Initiative in Ethiopia, Ghana, and Mozambique}, volume = {10}, number = {Supplement 1}, elocation-id = {e2100667}, year = {2022}, doi = {10.9745/GHSP-D-21-00667}, publisher = {Global Health: Science and Practice}, abstract = {Key FindingsBenefits arose from supportive supervision and mentoring strategies that addressed multilevel factors surrounding the point of care. These factors include worker-level attitudes and individual barriers to performance improvement, the extent to which learning and adapting are accepted and encouraged in the wider environment, and district-level collaborative structures and resources available to managers and teams for monitoring performance.Peer exchanges between primary health care (PHC) teams, including embedded implementation researchers, were instrumental to the success of supportive supervision and mentoring.Key ImplicationsStakeholders that have influence over the practice, processes and context of supportive supervision and mentoring in primary care settings must be engaged in diagnosing quality problems and using data to cocreate solutions that address the factors that affect quality.Managers and implementing partners may consider ways to incorporate learning and collaboration between PHC teams across jurisdictions and foster multisectoral partnerships to sustain motivation and build capacity for better supportive supervision, mentoring, and performance improvement.Introduction:Supportive supervision and mentoring (SSM) is crucial to primary care quality and effectiveness. Yet, there is little clarity on how to design and implement SSM and make it sustainable in primary health care (PHC) systems. The 3 African Health Initiative partnership projects introduced strategies to do this in Ethiopia, Ghana, and Mozambique. We describe: (1) how each partnership adapted SSM implementation strategies, (2) the dynamics of implementation and change that ensued after intervening within PHC systems, and (3) insights on the SSM sustainability as a mainstay of PHC.Methods:Researchers from each project collaboratively wrote a cross-country protocol based on those objectives. For this, they adapted implementation science frameworks{\textemdash}the Exploration, Preparation, Implementation, and Sustainment model and the Consolidated Framework for Implementation Research{\textemdash}through a qualitative theme reduction process. This resulted in harmonized lines of inquiry on the design, implementation, and potential sustainability of each project{\textquoteright}s SSM strategy. In-depth interviews and focus group discussions were conducted with stakeholders from PHC systems in each country and thematic analyses ensued.Results:Across the projects, SSM strategies acquired multiple components to address individual, systems, and process-related determinants. Benefits arose from efforts that addressed worker-level attitudes and barriers, promoted a wider learning environment, and enhanced collaborative structures and tools for monitoring performance. Peer exchanges and embedded implementation research were critical to the perceived effectiveness of SSM strategies.Discussion:Despite differences in their approach to SSM implementation, there are common crucial ingredients across the SSM strategies of the 3 AHI partner projects from which important lessons arise: (1) positioning learning and adaptation opportunities within the routine workings of PHC systems, facilitation, and technical support to reflect and utilize new knowledge; (2) multisectoral collaboration, particularly with academic organizations; and (3) building PHC decision-makers{\textquoteright} and implementation teams{\textquoteright} capacity for evidence-informed change.}, URL = {https://www.ghspjournal.org/content/10/Supplement_1/e2100667}, eprint = {https://www.ghspjournal.org/content/10/Supplement_1/e2100667.full.pdf}, journal = {Global Health: Science and Practice} }