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Adolescent Sexual and Reproductive Health Toolkit for - UNFPA

Adolescent Sexual and Reproductive Health Toolkit for - UNFPA

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t Continued<br />

Skill<br />

Clients<br />

1 2 3 4 5<br />

Total<br />

Score<br />

Action Step<br />

Date of visit(s) --><br />

Skills Used<br />

Ensured sufficient supplies of<br />

condoms <strong>and</strong> FP methods be<strong>for</strong>e<br />

client encounter<br />

Asked probing open-ended questions<br />

Gave the client the chance to<br />

ask questions<br />

Addressed the client’s<br />

questions appropriately<br />

Made appropriate referrals to other<br />

sectors or health facility <strong>for</strong> additional<br />

support or treatment, as appropriate<br />

Adhered to st<strong>and</strong>ard precautions<br />

Wrap-up<br />

Reminded the client of the importance of<br />

subsequent visits by the adolescent<br />

trained in CBD<br />

Thanked the client <strong>for</strong> his/her time<br />

Completed the client’s record card<br />

Competed the appropriate data<br />

collection <strong>for</strong>ms<br />

<strong>Adolescent</strong>'s Remarks<br />

______________________________________________________________________________________________________________<br />

______________________________________________________________________________________________________________<br />

______________________________________________________________________________________________________________<br />

Supervisor’s Remarks<br />

______________________________________________________________________________________________________________<br />

______________________________________________________________________________________________________________<br />

______________________________________________________________________________________________________________<br />

Community-Based Distribution <strong>and</strong> Peer Education Tools<br />

85

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