Publications
HST provides free electronic access to over 500 health systems research related reports, publications and papers. Close to 300 of these are publications that have been commissioned and funded by the Trust. Topics include among others district systems development, drug supply management, human resource development, informatics, legislation, finance, environmental health, mental health, lessons learnt, nutrition and sexually transmitted diseases / HIV/AIDS. The main publication of the HST is the annual South African Health Review. From 2005 all HST publications will be available in low resolution only. To explore the range of publications HST offers use the Advanced search to search using a variety of criteria.

The role of a clinic supervisor is an interesting and challenging one. This is because clinic supervisors find themselves working between the world of management and the world of people directly providing health services. The role of a clinic supervisor is dynamic and should include such activities as mentoring (especially new staff), seeing that clinics are well supplied and staffed, coordinating in-service training programmes, identifying training needs, and monitoring the quality of service delivery. Yet, there can be difficulties within this position such as:

• Lack of a clear job description
• Lack of coordination between clinic supervisors and programme coordinators
• Time spent on non-supervisory tasks
• Clinic time not being used effectively
• Lack of adequate training for supervisors in key areas of interpersonal skills and supervisory techniques. (WHO, 1993)

Effective supervisors must be able to strike a balance between monitoring and evaluating services and providing support and encouragement to staff. Broadly defined, supervision includes setting realistic goals for clinics (in consultation with the district management team and clinic staff) and assisting clinic staff to meet such goals. (WHO, 1993) As one ISDS facilitator explains Supervision should no longer be seen as a policing or inspection function only, but one that involves consultation, participation, self criticism and working out solutions together.

Clinic supervisors must be able to work effectively within evolving district structures and be able to report changes in management and policy back to clinic staff. Such report back is essential for staff motivation and team building.

They also need to work intersectorally. For example, the clinic supervisor must work collaboratively with doctors, PHC nurses and programme coordinators to coordinate and rationalise training. This job can be facilitated through the development of training task teams which has been done in some districts. Supervisors must work closely with programme coordinators not only in planning and implementing training programmes, but collecting and disseminating information on new policies and guidelines as well.

Supervisors also need to liaise with others such as the district health information officer regarding statistics and data routinely collected at the clinic level. For example, the current development of new daily clinic registers (tick registers) requires that all clinic staff receive adequate training in their use. Staff should also be challenged to see what this health information says about their community and the services they provide. Also, clinic supervisors must work closely with district drug coordinators to improve the management of drugs, the use of essential drugs lists and rational drug prescribing.

Finally, supervisors themselves will require periodic training and updates to keep abreast of the many rapid changes in health care.