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Assessing the cost of supervision is difficult, because it cuts across multiple practice areas.
Although many peripheral health facilities do not have the infrastructure to handle complicated testing [ 38], the main limitations we identified for decentralized MTB/RIF testing - algorithms, power, temperature and numbers of tests expected - can all be overcome with proper support, although in some remote areas supervision is difficult and seemed to complicate performance.
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The benefits of process-oriented group supervision are difficult to evaluate, as the validity and reliability of the existing instruments have been questioned.
Thus the antidote to the workforce shortage may provoke a demand for supervision that is difficult to meet.
And with the huge pressures on services at the moment, finding workers to provide high quality supervision is increasingly difficult.
Without additional funding to pay for more staff, appropriate training and better and increased supervision for staff, it is difficult to foresee how improvements can be made.
Model based supervision of most process engineering plants is difficult due to the complexities arising out of the energetic couplings in the model.
This implies that self-management of diabetes is difficult without close and consistent supervision.
In addition, it is difficult to rationalize the negative impact of frequent supervision.
While it is difficult to be certain of the long-term effectiveness of supervision activities in low-income contexts due to limited published evidence, supervision from higher to lower levels of the health service is widely recommended as a mechanism for supporting staff and ensuring quality of care [ 16]. 'Supervision' is an ill-defined, complex activity [ 17].
Balancing the risks and benefits of infant feeding choices is difficult and training counsellors to understand the complexities of feeding practices takes time and dedicated supervision.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com