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Facilitative * Supervision. “ a process implemented by many parties…” Together!. What is supervision?. The process of “directing and supporting staff so that they may effectively perform their duties.” 1. What is Facilitative / Supportive Supervision?.

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Facilitative * Supervision

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Facilitative* Supervision

“ a process implemented by many parties…”


What is supervision?

The process of

“directing and supporting staff

so that they may effectively

perform their duties.”1

What is Facilitative / Supportive Supervision?

A process that promotes qualityat all health system levels by strengthening relationships, focusing on identification and resolution of problems, and helping optimize the allocation of resources.2

Supervision: essential functions

Management, education, and support

  • Set objectives / expectations

  • Monitor performance / provide feedback

  • Ensure supplies

  • Address training and development needs

  • Solve problems jointly

  • Motivate and support providers to improve performance

Why supportive supervision?

MAQ/ program review for RH in developing countries:

Evidence from the past two decades: need to change not only the frequency, duration and structure of supervisory encounters, but also the nature and objective of supervision to make it more supportive and facilitative.2

US / UK literature review on post-graduate medical education and clinical practice:

Single most important factor associated with better supervisory or performance outcomes was the quality of the supervisory relationship.3

Supervision process1

What is Supportive Supervision?

  • Involves multiple parties

    • Leadership team

    • External supervisors

    • Facility quality improvement (SS/CQI) teams

    • Peers

    • Community committees

  • Focuses on the results of processes and program outcomes (data-driven)

  • Fosters relationships and teamwork

What is Supportive Supervision?

  • Facilitates a culture of communication and problem solving

  • Monitors individual performance against expectations

Lessons learned for using supportive supervision

  • Top management must be committed

  • Requires motivation on the part of supervisors and staff alike

  • Takes time and investment to establish

  • Should be integrated into the existing HRM system, not as a parallel system

Lessons learned

  • Requires simple, short, locally appropriate and tested tools

  • Some decision-making authority must be decentralized


1. Marquez, Lani and Linda Kean, “ Making Supervision Supportive and Sustainable: New Approaches Problems”, MAQ Paper no. 4, 2002; USAID.

2. Kilminster S.M. and Jolly, B.C. (2000). Effective supervision in clinical practice settings: a literature review. Medical Education, 34, 827-840.

3. Rowe K Alexander, Don de Savigny, Claudio F. Lantana, Cesar G Victora, “How can we achieve and maintain high-quality performance of health worker sin low-resource settings?” the Lancet August 9, 2005

4. D.K. McNesse-Smith, “The Influence of Manager Behavior o Nurses’ Job Satisfaction, Productivity, and Commitment,” Journal of Nursing Administration vol. 27, no. 9 (1997): 47-55.

5. Barkauskas, Violet, H. “Perspectives about and Models for Supervision in the Health Professions”, University of Michigan, nd.

6. Coles, Tom, “Evidence-based Supportive Supervision for Health Workers: a practical system for improving family planning services”, unpublished internal document, John Snow, Inc, October 2005.

7. Walsh, K. et al (2003) Development of a group0 model of clinical supervision to meet the needs of a community mental health nursing team. International Journal of Nursing Practice, 9, 33-39.

8. Loveinsohn, B.P., ET Guerrero, S.P. Gregorio, “Improving Primary Health Care through Systematic Supervision: A Controlled Field Trial,” Health Policy and Planning vol. 15, no. 3 (1984): 112-120.


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