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For example, the recent Lancet series on mental health identified low numbers of mental health specialists as a barrier to the improvement of mental health services in low-income and middle-income countries with the deficit reflecting not only on the delivery of specialist services but also on needed training and supervision of primary and general health care workers[25].
Vaccination services are provided primarily by nurses and midwives under the supervision of primary care facility general practitioner physicians.
This implies first and foremost strong financial support for primary health care, as well as training and supervision of primary health care staff.
However, successful implementation of mental health care at the primary care level requires specialists for the training and ongoing supervision of primary care workers [ 8, 9].
Supervision of primary health care providers was tested through a randomized trial in Zimbabwe, which showed that, following supervision, overall drug management improved significantly compared with control and comparison groups.
48 49 However, a US based telephone outreach led by trained study nurses under close supervision of primary care physician champions showed a significant reduction in patient lipid profiles compared to usual care.
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We included all 89 reports in the database from January 2008 until December 2011 concerning care for women with an early low risk pregnancy profile, under supervision of a primary care midwife (and additional primary care providers).
Place of birth was categorized into home birth and hospital birth, both under the supervision of a primary care midwife (i.e. primary care).
The vast majority of pregnant women (78%) start their maternity care in a primary care setting, 44% start labour in primary care, and eventually 33% of women give birth under supervision of a primary care midwife [ 3].
It is envisaged that the intervention will be primary delivered by the TB DOTS facilitator based in the diagnostic centre with the help and under the supervision of the primary care doctor (Table 1).
An HMO provides health care services under the supervision of a primary care physician.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com