We need supervision and enhanced integration between public powers".
Given anticipated investments in training and supervision for CHWs and integration of CHWs into all tiers of the health care system, it will be necessary to explore innovative methods including remuneration in order to motivate and retain these valuable workers.
Nowadays, the strategy that is required for developing the quality and standards takes over the integration of academic standard, academic supervision and interaction of face to face learning in developing distance learning.
Proposed solutions included development and dissemination of guidelines across facilities, creation of supervision and mentoring systems, integration into clinical audits and reviews, and strengthened referral systems.
Non-functional referral strategies, constrained health systems, poor community health worker (CHW) training and supervision and lack of integration have been reported as major obstacles to effective PHC delivery [ 9].
During training and supervision sessions, integration of services will be discussed, monitored and adjusted if needed.
Due to this complementarity, the economy can be trapped in an inferior equilibrium with both too little central supervision and too little financial integration.
However, international observations have highlighted that workplace learning during clerkship assignments and final year education still shows severe deficits, with a lack of structure, integration, supervision and personal feedback [ 9– 12].
Possible strategies to minimise this phenomenon include improving trainees' orientation and integration in their first weeks of employment, increasing intensity of supervision in more advanced trainees, and developing early programmes aimed at improving technical and teamwork skills.
Initial observations indicate that the work environment at the district level and integration of nursing vocation with religious desire to serve others may be important conditions influencing supervisions' orientation in this setting.
