Therefore, implementation of a remote supervision model like this in other centres will require the installation of quality equipment and the training of staff in its use as well as the establishment of working relationships between rural and tertiary sites.
This paper examines the implementation of training, supervision, drug supply, and job aids during the scale-up of a national CCM program in Malawi.
Understanding the influences shaping the different approaches observed in this study can indicate directions for strengthening implementation of supportive supervision.
Insight into the contribution of humanized support and professional ethos to implementation of supportive supervision for MLHWs was gained from the operation of supervision in one health post.
Indeed, successful implementation of professional supervision relies on organization time and resources [ 19], since organizational issues, such as lack of choice around a supervisor, have been found to be key barriers to effective supervision [ 20].
Therefore, the study set out to identify factors related to the organization and implementation of APE supervision and how these influence APE motivation and ultimately performance.
Likewise, these results supported the implementation of personalized supervision in research, since it can optimize patient's adherence to and compliance with interventions.
Although the provision of supportive supervision falls under the mandate of the AARHB, there are currently no formal guidelines for the implementation of supportive supervision at the health center level.
The insights gained through analysis of the cases are used to refine the program theory that guided the study and offer recommendations for how implementation of MLHW supervision can be strengthened.
While other studies have emphasized the need for managerial training to fortify implementation of supportive supervision, this study suggests that promoting supervisors' professional ethos can contribute to strengthened support for health workers [ 12, 31, 32].
