Supervision at Adishindhun Health Center

Overview

In February 2026, the Rheumatic Heart Disease (RHD) Prevention and Control Program conducted a supportive supervision visit to Adishindhun Health Center in Mekelle to assess the implementation of services related to the prevention and management of streptococcal throat infections, acute rheumatic fever (ARF), and rheumatic heart disease (RHD). The supervision aimed to evaluate the knowledge and practices of healthcare providers, identify strengths and challenges in service delivery, and provide recommendations to improve the quality and continuity of care.

Key Findings

The supervision team observed that healthcare professionals at Adishindhun Health Center demonstrated strong knowledge and understanding of the diagnosis, treatment, and prevention of streptococcal sore throat, acute rheumatic fever, and rheumatic heart disease. Staff were familiar with the national clinical guidelines and showed confidence in identifying patients requiring timely antibiotic treatment and referral when necessary.

The team also noted good clinical practice during routine service delivery. Healthcare providers were appropriately assessing patients presenting with sore throat symptoms, providing health education to patients and caregivers, documenting cases, and promoting adherence to treatment. Staff showed commitment to preventing the progression of untreated streptococcal infections into acute rheumatic fever and ultimately rheumatic heart disease.

Furthermore, the health center demonstrated a positive attitude toward implementing the RHD Prevention and Control Program, with healthcare workers actively participating in supervision discussions and quality improvement activities.

Challenges Identified

Despite the encouraging performance, the supervision team identified a critical shortage of essential medicines, particularly Benzathine Penicillin G (BPG) and Adrenaline.

The shortage of Benzathine Penicillin G poses a significant challenge, as it is the recommended first-line antibiotic for the secondary prevention of rheumatic fever recurrence and for preventing the progression of rheumatic heart disease. Interruptions in its availability may place patients at increased risk of recurrent rheumatic fever and long-term cardiac complications.

The limited availability of Adrenaline, which is required for the emergency management of allergic reactions and anaphylaxis following penicillin administration, further restricts the safe provision of Benzathine Penicillin injections. The absence of both medicines can negatively affect service continuity and reduce healthcare providers' ability to deliver guideline-based care safely.

Recommendations

To strengthen service delivery and ensure uninterrupted prevention of rheumatic heart disease, the supervision team recommends:

• Ensuring a continuous and adequate supply of Benzathine Penicillin G and Adrenaline through strengthened procurement and supply chain management.
• Regular monitoring of essential medicine stock levels to prevent stock-outs and enable timely replenishment.
• Continuing supportive supervision and on-site mentoring to sustain the high level of knowledge and clinical practice demonstrated by healthcare provider.
• Strengthening coordination between the health center, district health authorities, and pharmaceutical supply agencies to improve the availability of life-saving medicines.

Conclusion

The supportive supervision visit confirmed that Adishindhun Health Center has competent and committed healthcare professionals who are effectively implementing services for the prevention and control of rheumatic fever and rheumatic heart disease. Their strong clinical knowledge and good service delivery practices provide a solid foundation for quality patient care. However, addressing the shortage of Benzathine Penicillin G and Adrenaline is essential to ensure uninterrupted, safe, and effective implementation of the RHD Prevention and Control Program and to protect patients from preventable complications.