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Introduction: The benefit of super vision in Primary Health Centres is often not achieved in developing countries, including Nigeria. Traditionally, supervision emphasizes inspection of facilities without regard to facilitation. Supervisors blame individuals rather than look for root causes in deficient processes. For this reason, traditional supervision has tended not to 'empower' staff to engage in problem solving and/or in taking initiatives in improving service quality and access. There is need to change the focus of supervision from inspecting facilities and gathering service statistics to concentrating on performance of clinical tasks and resolution of problems. This paper aims to use supportive supervision to provide a framework for identifying and improving deficient supervision processes that negatively affect primary health care services in the communities. Materials and method: The information contained in this paper was based on work experience, interviews held with the 35 health workers in primary health centres, extensive literature reviewed on supervision and the reports from health centres. The study encouraged effective supervision by providing training that emphasized self-assessment, peer assessment, and others as vital components of supportive supervision. Result: The study identified several systemic problems plaguing effective supervision in primary health care centres. These problems were analysed as institutional and staff problems. They include lack of planning, training, defined priorities, shortage of resources (man, materials and finance), episodic visits by supervisors, lack of adherence to work ethics, poor interpersonal relationships between supervisors and supervisees and others. Among these problems identified, the most plaguing was lack of financial stability which resulted in poor motivation of staff as the majority of them, 33 (94.3%) complained of being owed two to three months salary arrears. Conclusion: Categorizing the problems that negatively influenced supervision helped the researchers to highlight best practices and the underlying mechanisms for sustainable supportive supervision that are capable of upgrading the technical and clinical skills of supervisors. [ABSTRACT FROM AUTHOR]