8 However, integration of TBAs with the formal health system may require the capacity development and supervision of TBAs, collaboration skills for health workers, involvement of TBAs at health facilities and improved capacity on communication and referral systems.
In many developing countries, decentralization has confused supervision responsibility, diminished technical supervision capacity, and reduced the number of supervision visits [ 17, 18].
The CS trial has distinguished itself by the special emphasis put on laboratory activities via a tailor made approach to capacity building, monitoring and supervision of technical staff both at initiation and throughout the study.
Paul et al. [ 37] note that the Indian primary healthcare system aimed to improve maternal and child health outcomes is challenged because of a "lack of capacity for training and supervision, lack of ownership…, lack of review and monitoring nationally and in states, inability to integrate the referral component and non-availability of line supervisors".
There are significant challenges in effective implementation of the HMIS including lack of human resources and the capacity for supervision and monitoring of data collected by different vertical programs [ 11].
These variable results have been ascribed to implementation challenges, particularly poor quality and low availability of some services due to weak technical capacity, inadequate infrastructure and management capacity, and poor monitoring and supervision [ 10, 11].
Note: (5-point Likert Scale: 1 = strongly disagree, 5 = strongly agree) The main themes that emerged from the data addressed the organization of the immunization program, support and feedback, mechanisms for management and supervision, capacity and knowledge to manage and supervise, work motivation, and barriers relating to the health system and immunization.
Yet for many of these member-owned institutions, scaling up savings services is impaired by challenges related to management and staff capacity, governance, and oversight and supervision.
Data quality since 2006 improved alongside the logistical capacity supporting data collection and supervision.
Several studies have examined policies and interventions to strengthen management and supervision capacity in post-conflict settings.
