The Visiting Supervisor Model What’s the evidence?

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

0102030405060708090100

1996 1997 1998 1999

% 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

Identify problemsand opportunities

Take action Monitor and assessperformance

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?