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This article explores the evidence, types of evidence, and the effectiveness of supervisory visits in various countries. It discusses the frequency of visits, activities during visits, factors that contribute to effectiveness, and reviews literature on supervisors' visits.
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The Visiting Supervisor Model What’s the evidence?
Kinds of evidence • What we know • What’s in the literature
What do we know? • How many planned/actual visits? • What usually happens during a visit? • What helped to make it effective?
What’s in the literature? • Do supervisors visit? • What happens during a visit? • What makes it effective?
Do supervisors visit? • DR Congo • Nepal • Niger • Sudan • Peru
DR Congo • Planned visits: 12/year
DR Congo • Planned visits: 12/year • Actual: 3-4/year
Nepal • Planned visits: 6 per 6 months
Nepal • Planned visits: 6 per 6 months • Actual: 1.5 per 6 months
Niger % scheduled visits completed
Niger % scheduled visits completed ?????????
Sudan • Proportion of sites receiving 1 or more visits per 6 months:
Sudan • Proportion of sites receiving 1 or more visits per 6 months: less than 50%
Peru • Average annual supervisory visits:
Peru • Average annual supervisory visits: 0.19
Effective supervision Set Expectations Take action Monitor and assess performance Identify problems and opportunities
What happens-Congo • Overall error rate of 58.7%: • Incomplete documentation • Lack of follow-up • Poor controls over equipment and supplies
What happens-Botswana • Ask about problems: 65% • Examine clinic records: 50% • Observe service delivery: 43% • Make suggestions for improvement: 38%
What happens-Sudan • Supervision book found: 26% • Supervision records found: 15% • Observation of case management: 21%
What makes it effective? • Increasing freq or duration of visits not effective • Relationship most important for effect • Direct (on-site) supervision works best
What’s in the literature? • Do supervisors visit? • What happens during a visit? • What makes it effective?