New components to address stigma were then added to the intervention, the collaborative nature of service provision was strengthened, a multi-level supervision system was developed, and delivery of components was made more flexible.
In California, where Gov. Arnold Schwarzenegger, a Republican, has called for $400 million to be cut from the state's corrections budget, officials are seeking to remove low-level drug offenders from the parole supervision system and to provide them treatment options instead.
Niger's experience suggests that it is important to strengthen the supervision system at the district level and assure the availability of essential drugs before the implementation of IMCI.
Interventions included technical assistance to revive the district supervision system and develop a district level management team.
Their model for task sharing was based on 2 to 3 weeks of training for the CHEWs, followed by high-frequency supervision from 1 to 8 visits within the following 6 months a level that the project itself struggled to provide and which the existing supervision system cannot maintain.
There were irregularities in supply, lack of reporting/recording, monitoring and supervision system, and lack of transportation funds to distribute VTDL from sub-district to the lower level.
Lastly, a feasible system of direct observed intake of the medication, organized at the community level (i.e., by health promoters paid per patient that completes treatment), could be an option, requiring, however, a good supervision system and attractive incentives.
Today the post-prison supervision system is rife with inconsistencies.
In 2001, the new coal mine safety supervision system was composed of 19 provincial administration of coal mine safety bureaus and 68 sub-administration of coal mine safety offices, which was three-level and vertical supervision system included the state, province and region levels.
The project's integration of supportive supervision into the government-run supervision system is likely to increase the sustainability of such a support system for CHEWs.
