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Table 1 Effectiveness of supervision strategies on the practices of professional health care providers

From: The effectiveness of supervision strategies to improve health care provider practices in low- and middle-income countries: secondary analysis of a systematic review

Strategies testeda

No. of study comparisons (risk of bias: low, moderate, high, very high)

Outcome scale

Median MESb, in %-points (IQR; range)

Intervention arm

Reference arm

Routine supervision

 Routine supervision

Controls

9 (3, 1, 4, 1)

Percentage

10.7 (6.9, 27.9; 2.1, 67.8)

 Routine supervision

Controls

2 (0, 1, 1, 0)

Continuous

–29.5 (NA; –90.4, 31.4)

 Routine supervision plus

other strategy components

Other strategy components

4 (0, 0, 2, 2)

Percentage

4.1 (NA; 0, 7.1)

 Routine supervision plus

other strategy components

Other strategy components

1 (0, 0, 1, 0)

Continuous

24.9 (NA; NA)

Routine supervision combined with benchmarking

 Routine supervision plus benchmarking plus other strategy componentsc

Other strategy components

1 (0, 0, 1, 0)

Percentage

2.2 (NA; NA)d

Continuous

–0.6 (NA; NA)d

Audit with in-person feedbacke

 Audit with in-person feedback

Controls

4 (1, 1, 2, 0)

Percentage

15.0 (NA; 2.4, 33.5)

 Audit with in-person feedback

Controls

1 (0, 0, 0, 1)

Continuous

–3.0 (NA; NA)

 Audit with in-person feedback plus

other strategy components

Other strategy components

1 (1, 0, 0, 0)

Percentage

5.0 (NA; NA)

Audit with in-person feedback combined with peer reviewe

 Audit with in-person feedback plus

peer review

Controls

1 (0, 0, 1, 0)

Percentage

19.0 (NA; NA)

Audit with written feedbacke

 Audit with written feedback

Controls

2 (2, 0, 0, 0)

Continuous

17.4 (NA; 17.3, 17.5)

Audit with written feedback combined with benchmarking

 Audit with written feedback plus benchmarking plus other strategy components

Other strategy components

1 (0, 1, 0, 0)

Percentage

0.2 (NA; NA)d

Continuous

19.1 (NA; NA)d

Audit with in-person feedback combined with audit with written feedbacke

 Audit with in-person feedback plus

audit with written feedback

Controls

2 (2, 0, 0, 0)

Percentage

10.1 (NA; 8.5, 11.7)

Audit with in-person feedback versus audit with written feedback

 Audit with in-person feedback

Audit with written feedback

1 (0, 0, 0, 1)

Percentage

22.2 (NA; NA)d

Continuous

16.7 (NA; NA)d

Peer review and support from non-supervisory staff

 Peer review plus

other strategy components

Other strategy components

1 (0, 1, 0, 0)

Percentage

3.6 (NA; NA)d

Continuous

33.0 (NA; NA)d

 Health care provider received support from non-supervisory staff plus other strategy components

Other strategy components

2 (0, 2, 0, 0)

Percentage

–7.3 (NA; –16.9, 2.4)

  1. %-points percentage-points, IQR interquartile range, MES median effect size, NA not applicable
  2. aSee Boxes 1 and 2 for descriptions of the strategies and the comparisons, respectively. This table only includes comparisons from non-equivalency studies
  3. bEffect sizes calculated as the intervention arm improvement minus reference arm improvement
  4. cOther strategy components include audit with in-person and written feedback
  5. dResults for the percentage and continuous outcomes in this row are from the same study
  6. eFor six study comparisons for percentage outcomes involving audit with in-person feedback alone or combined with written feedback: median MES = 10.1%-points; IQR = 6.2, 23.7; range = 2.4, 33.5. For seven study comparisons for percentage outcomes involving audit with in-person feedback alone or combined with either peer review or audit with written feedback: median MES = 11.7%-points; IQR = 6.2, 23.7; range = 2.4, 33.5
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Human Resources for Health

ISSN: 1478-4491