Some have hypothesized that poverty, with which single-parent and families with low parental education are associated, increases the likelihood of adolescent risk behaviors because of limited and low-quality social and educational resources in low-income neighborhoods and economic stress leading to lower parental supervision [ 55].
Although the intervention in this study will be highly supervised, it lends itself to being performed at a lower level of supervision in practice, and part of the program is already designed to be undertaken in the home setting.
In-charges with a HFMC described HFMC roles in similar ways, but a much lower percentage considered supervision of facility staff a HFMC role (34.5%).
Children's perceptions of family interactions in this group were characterized as having higher factor scores than the other groups for family conflict and lower scores for supervision.
Such involvement has been seen as being essential in developing students' clinical reasoning abilities, as well as preparing them to manage their own patients, with lower levels of supervision, after graduation.
Hospital factors such as more supervision, lower workload related to routine patient treatment and working in university hospitals or central hospitals reduced the time to attain the specialist qualification.
A candidate with, for example, more research experience in biomedicine may benefit from a program with greater emphasis on appropriate laboratory research with lower levels of supervision and direction.
One study showed that a lower frequency of supervision resulted in lower performance of CHWs in Madagascar (Smith et al. 2013) while another study in Kenya found no effect of frequency of supervision on CHW guideline adherence (Rowe et al. 2007a).
This may be the result of a multiple factors, like diminished numbers of and expertise of staff available, reduced access to diagnostic tests and procedures, a lower degree of supervision of residents, long-duration shifts and tiredness of personnel, no in-house obstetricians, anaesthesiologists and paediatricians, delays in availability of necessary personnel in case of emergency.
However, we found that relative to other community subgroups they had lower risk estimates during supervision and relatively higher risk estimates post-supervision.
