In Rwanda, a team of external supervisors in each of 39 district hospitals conduct supervision visits to HCs in that district.25 The external supervisors are part of a district health management team. They work within the health management information system and have explicit supervisory functions. A supervisor is usually responsible for supervision within a certain domain such as HIV and TB, laboratory services, maternal and child care, general outpatient clinic services, etc. Depending on the number of HCs under a district hospital, this may in some districts require supervisors to work full time with supervision, including daily field visits sometimes to distant HCs. The size of a supervision team varies according to the number of HCs supervised under the hospital, ranging from as low as 4 to as many as 23 HCs. Anecdotally, supervisors are typically clinically experienced nurses with a higher nursing degree (a so-called A1 or A0 degree) and rarely trained specifically in facilitation of learning or interpersonal communication.