Effectiveness of peer supervision on appropriate treatment of pneumonia symptoms
Examination of health system effects due to peer supervision at district level revealed that appropriate treatment of pneumonia symptoms using antibiotics may be achieved on a long term rather than short term basis. These results are in agreement with those obtained by Li Zhen and colleagues while looking at the impact of prescription audit and feedback for antibiotic use in rural clinics36. The difference is that while Li Zhen and colleagues used a single group comparison, the investigators of this study used a reference group which may have strengthened the validity of the findings. Evidence from different settings shows that even among trained community health workers, diagnosis and rightful classification of children with pneumonia symptoms remains a challenge37-39. As such, several studies emphasize the importance of supervision in improving appropriate treatment of acute respiratory tract infections which are associated with community pneumonia in children under five years of age40,41. This further strengthens the importance of peer supervision among drug sellers in rural settings where supervision has been inadequate. Thus, even though drug sellers in both districts were trained prior to introduction of peer supervision, the continuous professional development received through peer supervision improved diagnosis of pneumonia symptoms