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Symposium: From Efficacy Trial to Public Health Impact: Improving Delivery and Utilization of Nutrition Programs

Assessing Supervisory and Motivational Factors in the Context of a Program Evaluation in Rural Haiti^1–3,

⁴ Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853; ⁵ International Potato Center (CIP-SSA), Kampala, Uganda; ⁶ Food Consumption and Nutrition Division, International Food Policy Research Institute (IFPRI), Washington, DC 20006

^* To whom correspondence should be addressed. Email: pm38{at}cornell.edu.

Staff supervisory and motivational factors were assessed in the context of an ongoing program evaluation in Haiti comparing 2 models of targeting an integrated health and nutrition program. The study objectives were to 1) understand and improve supervisory and motivational factors influencing program implementation and 2) compare these factors between the 2 program models being evaluated. Qualitative methods (focus group discussions and semistructured interviews) were used to understand factors related to supervision and motivation. Quantitative measures of supervisory and motivational factors were designed, and factor analysis was used, to develop summary scales of motivational factors and supervision. T-tests were used to compare mean scores on the scales between the 2 program models. Results from the qualitative research were discussed with program management and staff to help develop solutions to implementation bottlenecks. Staff at all levels of the program seemed motivated and generally well supervised. Constraints to motivation included perceived inadequacy of wages (before changes were made to salaries), heavy workloads, and logistical constraints. We found no salient differences between the 2 program models that could contribute to differential implementation or differences in impact. This lack of salient differences between the program models suggested that supervisory and motivational factors were unlikely to contribute to differences in impact. Assessing supervisory and motivational factors was feasible and desirable in the context of this evaluation and deepened understanding of the program context and constraints to implementation.

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