Immunization managers in both intervention and control districts felt capable of carrying out supportive supervision both at baseline and follow up, and were persistent in declaring a high professional motivation to provide supportive supervision to subordinated staff.
The intervention group reported an increase in receiving two or more supervision visits in the past 6 months, from 52% at baseline to 79% at endline (P = 0.038).
For total daily energy intake assessments, subjects completed a 3-day food record, at baseline and at week 12, under the supervision of a dietician.
The patients completed the questionnaires for the first two time points (at baseline and 6 weeks) under the direct supervision of either the trial co-ordinator or the trial research nurse to ensure understanding.
The patients completed the questionnaires for the first 2 time-points (at baseline and 6 weeks) under the direct supervision of either the trial co-ordinator or the trial research nurse so that they could go through the questions and answer any queries they had on how to complete.
The two questionnaires were self-administered at baseline, and again after 6 months under the supervision of the investigators, in the same order, in booklet form.
In the comparison group, receipt of supervision was moderately high at both time points (69%and73%3%).> -wrap-foot> a P value from χ at baseline or at endline.
A possible explanation is that concerted efforts to improve uptake, such as the supervision of teachers by the district health team during MDA, were concentrated on schools with very low uptake at baseline.
Interviews revealed that the CHWs in operation at baseline felt that the work was tiring and time-consuming, and were dissatisfied with the supervision and motivation received for their work (on average 2 days per week).
This study shows that at baseline, under routine conditions at rural health facilities, and without any particular targeted increase in training or supervision of health care workers outside the national framework, there is agreement in the clinical judgement of NPCs and physicians with respect to the evaluation and initiation of ART in patients at rural health facilities.
