Foreit 1984.

Methods	Study design: Cluster RCT Duration of study: April to December 1981, with observation until April 1982 Unit of allocation: Region (6 intervention, 6 control) Method of allocation: Random allocation of matched pairs of regions to the intervention and control groups based on the health characteristics of health posts Unit of analysis: Supervisees (140 intervention, 138 control). Supervisors (6 intervention, 6 control) Sampling: Not stated
Participants	Country: Brazil Income classification: Upper‐middle income Geographical scope: State in north east Brazil Rural/urban: Urban and rural Setting: Health facility (hospitals, clinics) and community (private homes, schools, community centres, town halls and rural villages) Supervisees: Non‐professional community‐based distribution workers Supervisors: Not stated Patients/clients: Recipients of family planning commodities
Interventions	Stated purpose: Deliver supplies, collect data, problem solving, visiting physicians and political leaders, giving family planning talks, home visits Description intervention: Quarterly supervisory visits plus supplementary visits to deal with emergencies and improve staff performance Control: Routine supervision (monthly supervisory visits) Training: None Frequency of supervisory visits: Quarterly (intervention group), monthly (control group) Co‐interventions: Feedback forms and daily logs introduced in both intervention and control groups
Outcomes	Primary outcomes: Supervisor performance: days worked per month, days in the field, total visits made, lectures given, home visits made and contact with local leaders Secondary outcomes: Staff performance: new clients, revisits and staff turnover Time points when outcomes measured: 9 month period up to December 1981 and 10 month period up to April 1982
Notes	Funding: Not stated
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Method of randomisation not stated."One member of each pair was randomly assigned to the experimental group and the other to the control"
Allocation concealment (selection bias)	Low risk	Allocation performed at the start of the study
Blinding (performance bias and detection bias) All outcomes	High risk	Primary outcomes are not objective. Outcome measures based on daily logs by participants.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Data not available to assess follow‐up
Selective reporting (reporting bias)	Low risk	All outcome variables reported on
Other bias	Unclear risk	Funding of study not stated
Baseline outcome measurements similar?	Unclear risk	No baseline outcome measurements provided
Baseline characteristics similar?	Unclear risk	No details of supervisor or supervisee characteristics provided, only details of the areas: "The regions were also geographically equivalent as possible, so the results of the experiment would not be influenced by such factors as migration or physical conditions encountered by the supervisors. The experiment area was some what larger, more populous, and less urban than the control area. There were, however, no systematic differences within pairs on these variables."
Protection against contamination?	Low risk	“....the results of the experiment would not be influenced by such factors as migration or physical conditions encountered by the supervisors”