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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?
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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?