Rapid health facility and community needs assessment; Hodeida ...

Rapid health facility and community
needs assessment; Hodeida, Yemen
Contents
1 Executive Summary ............................................................................................................ 2
2 Context and Background .................................................................................................... 4
3 Key Objectives: .................................................................................................................. 4
4 Methodology for the assessment ........................................................................................ 5
4.1 Sampling Frame and methods ...................................................................................... 5
4.2 Tools for data collection: ............................................................................................. 6
5 Key Findings and Results: .................................................................................................. 6
5.1 The Building blocks of Health Systems in Hodeida: ................................................... 6
5.1.1 Governance: .......................................................................................................... 6
5.1.2 Drugs, Equipment and infrastructure: .................................................................. 7
5.1.3 HMIS .................................................................................................................... 8
5.1.4 HR ......................................................................................................................... 9
5.1.5 Health Financing ................................................................................................. 10
5.1.6 Service Delivery ................................................................................................. 10
5.2 Community needs Assessment .................................................................................. 11
6 Conclusions and Recommendations ................................................................................. 12
7 Annexes ............................................................................................................................ 14
7.1 Annex-I; Map of Hodeidah and Merlin’s Intervention districts ................................ 14
7.2 Appendix-II; Catchment Areas and populations ........................................................ 15
7.3 Health Facilities assessed ........................................................................................... 16
7.4 Key Contacts, Hodeida .............................................................................................. 17
7.5 Health Facility Assessment template ......................................................................... 19

1 Executive Summary
Background: To scope out the feasibility and modalities of Merlin’s proposed
nutrition/health intervention is Hodeida, a rapid field assessment was conducted by
technical team comprising of Health Officer and Global supplies manager between 10 th and
22 nd of July 2012. The approach involved conducting KPIs (Key Person Interview) with MoPH
and implementing agencies, visits to field sites (2 district hospitals and 10 Temporary health
facilities), observations, review of records and community FGDs (Focus Group Discussions).
Key Findings: The findings suggest that there are huge needs in 3 sectors; Nutrition, health
and WASH. Acute malnutrition in children < 5yrs is high and in line with findings of recent
Unicef survey (random unsystematic MUAC screening of 28 children found 6 MAM and 2
SAM cases). Lack of hygiene practices and clean drinking water is one of the key issues. The
epidemiological data and FGDs suggest that the key morbidities in community are Diarrhoea,
ARI and Malaria, with higher relative incidence rates in the children 90%
patients leave health facilities without drugs and there is acute shortage of essential
equipment and WASH facilities. All these factors convert to poor utilization of services; OPD
utilization rate of 0.2/person/year which is far below SPHERE standards of
1consultation/person/year. This situation is worsened by weak HMIS, loose HR structure,
inadequate supportive supervision, lack of continued medical education and corruption.
Conclusions and recommendations: The needs in community justify Merlin’s approach of an
integrated nutrition, health and WASH programme. It is feasible to set up stabilization
centres at district level hospitals of Az Zaidiah and Al Marawah, however OTP sites need to
be supported by Mobile Health and Nutrition teams, with community level outreach services
2

through CHWs. MoPH is quite forthcoming to Merlin; working with them, building technical
and infrastructural capacity complemented by community buy in and social mobilization will
be imperative for successful programme implementation. Key programmatic challenges
could be (but not limited to); recruitment and retention of quality staff especially at SCs,
coordination with OTP level health workers and social mobilization. Strategically, it is
extremely important that Merlin establishes presence on the ground at the earliest, initiates
preparations office hire, staff recruitment, logistical etc and maintains relations with the key
stakeholders.
3

2 Context and Background
The nutritional survey conducted by UNICEF and the Ministry of Health (MoPH) in late 2011
showed that GAM (Global Acute Malnutrition) rates in children under 5 years of age in Al-
Hodeida governorate were 31.7% which far exceeded the WHO emergency threshold of
15%. Merlin initially (beginning of 2012) planned to implement an integrated CMAM and
essential primary health care programme in Hais and Al Khokha districts of Al Hodeida.
However, Merlin managed to secure registration in Yemen only in May 2012. In discussion
with UNICEF and Nutrition sub cluster, new geographical areas of nutrition programme
intervention were agreed upon by the Merlin team comprising of Head of the region-Asia
and head of Safety and Security Merlin HQ. The new areas of intervention include 35
temporary health facilities (THF) in Al Marawah, AZ Zaidiah and Zabid districts of Al Hodeida
governorate, covering a catchment population of 151,731.
At the same time initial discussions were finalized with UNICEF for a potential PCA
(Programme Cooperation Agreement). The PCA would entail provision of nutritional
supplementation to the children

Yemen between 10 th and 22 nd July 2012. Besides identifying additional funding
opportunities, finalizing ongoing negotiations with UNICEF and WFP and establishing
working relationships with government ministries, WASH and health clusters and donor
agencies, the key objectives of the team were to:
To conduct a thorough health facility assessment (OTP and SC sites) and critical
health and/or nutrition needs in Hodeida governorate, Yemen.
To explore the feasibility and identify possible bottlenecks for the proposed CMAM
programme in Hodeida
To develop/revise and submit log frames, work plans and narrative reports for PCA
with UNICEF and WFP, Yemen.
4 Methodology for the assessment
The health facility assessment was conducted in due consultation with the MoPH Sana’a . A
letter of consent and support was obtained from MoPH which was also faxed to Hodeida
HQ. With the help of Nutrition Sub Cluster and Merlin’s Consultant Dr Reyad, meetings were
organized with the Director General and other senior officials of MoPH Hodeida. Objectives
of the assessment were shared with the MoPH Hodeida and Dr Fawwaz from MoPH Hodeida
was assigned to the assessment team for providing essential operational and logistical
support.
The key approach for this assessment included field visits to the health facilities and villages,
KPIs (Key persons Interviews) with MoPH, health facility staff and the community
leaders/tribesmen, Community FGDs (Focus Group Discussions), observation and review of
available records/data.
4.1 Sampling Frame and methods
Out of 35, a total of 12 health facilities (34%) were selected for this assessment. The
selection was non random and the decision was limited by the logistical challenges and time
5

constraints. However every possible measure was taken to make the sample size as
representative and as generalizable as possible. The key inclusion criteria’s that were
considered while selecting the sampled HFs were; the catchment population (smallest and
the largest) and the distance from district HQ (closest and farthest). Finally 10 THFs and 2
district level hospitals were assessed. Zabid hospital was visited but was not formally
assessed as it had already been assessed by the WHO for establishment of Stabilization
Centre.
4.2 Tools for data collection:
The health facility assessment data was collected using the template (See Annex.I)
developed through adaptation of existing formats including Merlin tool, WHO’s HeRAMS
tool, Save the children’s Health facility assessment tool. This was done keeping in mind the
pragmatic situation and data needs. All the data was collected real-time through spot
checks, review of records and KPIs. The data from all these forms was later manually entered
into the Ms Excel matrix and analysed. The data was double checked for errors and outliers.
Community needs assessment data was collected using community discussion record sheet,
with structured questions. Supplementary responses from the participants of FGDs were
collected in the additional space.
5 Key Findings and Results:
5.1 The Building blocks of Health Systems in Hodeida:
5.1.1 Governance:
The team at the MoPH level is very new lead by Dr Abdul Rahman Garallah the Director
General of Health Services who joined the office only couple of months ago. He seemed to
be extremely committed and forthcoming and assigned Dr Fawwaz, to accompany the
assessment team. The MoPH Hodeida team is dedicated and wants to improve the current
situation, but most of them have clinical backgrounds rather than public health. The MoPH
Hodeida does receive instructions from Sana’a however they have sufficient authority for
decision making at local level.
6

5.1.1.1 Supportive Supervision:
None of the assessed health facility was ever visited by a district or Hodeida level official
during past 2 months and 62% of the HFs were visited more than one year ago. Most of the
visits by the officials were during the mass polio vaccination campaigns or other health
camps. There seem to be no structured mechanism or framework for monitoring the field
level activities.
5.1.2 Drugs, Equipment and infrastructure:
Drugs are supplied from Sana’a, and as per the DG health, the drug supply is quite irregular
and only twice a year. Essential drugs in very limited quantity are supplied to Hodeida HQ
and same goes down to the health facilities. There is acute shortage of drugs and nearly
three fourth (72%) health facilities suggested that >90% of the patients are turned back
without provision of prescribed drugs. An effective drug management system and cold chain
was also found lacking; expired (dated) anti-malarial drugs, condoms and vaccine was found
at the assessed health facilities. It however could not be ascertained whether these were
distributed/administered to the beneficiaries.
Nearly 62% of the health facilities had shortage of essential medical equipment (e.g
thermometer, tongue depressor, weighing scale etc) for the services being provided. The
overall upkeep/storage of drugs and equipment was poor (dusty, broken, unsterilized
equipment, drugs stored at high temperatures). There were also instances when delivery kits
supplied by Unicef/MoH few years ago remained packed and unused till date.
Only 50% of health facilities assessed had any access to electricity. None of the health
facilities assessed had incinerators or safe waste disposal mechanisms. 3 of the 12 has
running water, but without quality control or chlorination facilities, and only 1 offered
drinking water for patients.
District hospital buildings have patient waiting areas and an adequate number of rooms (10)
for health services including OPD, FP, EPI, ANC, nutrition, delivery and laboratory. There are
14 beds available for emergency use. However not all of the rooms or beds were being
7

utilized, including a minor OT in Az Zaidiah. The condition of the buildings was reasonable
but some of the areas needed major repairs e.g. big cracks in the wall of pharmacy, missing
electricity fittings, and tiles falling off the walls in Az Zaidiah hospital. The electricity cuts are
up to 14 hrs per day and both hospitals had working generators (100KV and 2KV). The waste
disposal mechanisms were not being followed; syringes and needles were disposed off right
in front of Az Zaidiah hospital. The toilets were available but very dirty. Running water was
available from overhead tanks but was never chlorinated or tested for quality in the past one
year. There were no drinking water facilities for the patients visiting the hospitals. Even the
SAM children eating plumpy nut in the hospitals were not provided with drinking water as
per CMAM protocols.
Temporary health facilities 70% of assessed THFs were being run from 1-2 rooms in the
house of health workers, 10% from a room in another government building (school) and 20%
only existed on paper (as there was no space/room allocated to these facilities). None of the
8 THFs in Al Marawah allocated to Merlin were functional on the ground. According to the
District health manager of Al Marawah it is really hard to find rooms for THFs in these
villages. As per him, the health workers are deployed for these THFs but only visit the areas
for carrying out EPI activities. He had no answer when asked; ‘what do the health workers do
on the other days’ 1 This feedback has been shared with DG health and he assured that all 8
health facilities would be put in place before Merlin starts interventions’ in Al Marawah (it
seems unlikely though and may need a follow up).
There are no WASH (drinking water and toilets) facilities available at temporary health
facilities unless health workers let the beneficiaries use their own toilets. 50% of the HFs
used personal gensets (probably out of the money earned through private consultations).
5.1.3 HMIS
There are specific reporting formats, registers and protocols for reporting of the health
information but the consistency and reliability of data is questionable. The assessment team
1 The assessment team approached Sheikh of village Al-Shaibah who was very forthcoming (but had never been
approached by MoH) and promised to provide a room and all possible help to set up the THF.
8

got different information on different occasions regarding coverage of health services and
the epidemiological data, while reports did not match the data in registers on couple of
occasions. No coverage charts except EPI were displayed in the health facilities but the
presented EPI data was often ambiguous e.g. DPT-3 coverage > DPT-1 coverage. The health
management information system is mostly paper based and only computerised at MoPH
Hodeida level for transmission to Sana’a. However, most importantly this data is not
analysed or used for monitoring and appropriate corrective actions.
5.1.4 HR
The human resources for health in Hodeida varied in qualifications, technical skills and
contract agreements. The district level hospitals had reasonable number of health service
providers (range 15 to 21); both hospitals had at least 1 doctor, 2 to 4 nurses and 6-9 midwives
but no specialists. 90% 2 of the temporary health facilities had one health worker but
their qualifications varied from nurse, nurse technician and health guide to doctor assistant.
None of the facilities assessed had a specialist or MD on staff. Only one third of health
facilities had midwives available - though the district level facilities had several on staff, the
majority of rural health facilities have no midwives available.
The health staff in 75% of the THFs was officially employed by the MoPH however remaining
25% THFs were being run by ‘Voluntary health workers’, who did not have any contract with
MoPH but hoped to get it someday. These ‘voluntary’ health workers received some drugs
(Amoxicillin and Anti malarial), vaccine, OCPs and RDTs for malaria from MoPH (district
level). They maintained the health records on OPD, EPI, Malaria and family planning in MoPH
supplied registers and submitted monthly reports to the District health office on prescribed
formats. All of these voluntary health workers charged the beneficiaries for their services
and personal drugs. As per them, they provided the Govt. supplied drugs free of charge
(however this could not be verified).
2 1 health facility in Zabid had 3 workers; 2 hired locally by the government health worker who had flourishing
private practice
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The commitment and technical skills of the health officials and workers were inadequate.
The salary of government staff is quite low; while a doctor receives approx. US$ 250 per
month, a THF level health worker receives US$ 100-120. This is one of the key issues leading
to poor motivation in the health workforce and an underlying reason for private practice (at
least they say so). The level of skills in the health workers was low and there was a clear lack
of continued medical education. Only 50% of the health workers received any training during
past 1 year. The trainings received were on EPI and nutrition only.
5.1.5 Health Financing
The assessment team could not undertake major deliberations on this topic given the
sensitivities around it. However health financing was immensely poor at central and
governorate levels. As per DG health they have to charge user fees in order to sustain the
services at health facilities. On the other hand an expat doctor working in one of the
assessed hospitals told that, ‘funds received by hospital don’t actually trickle down into the
essential drugs and equipment’.
5.1.6 Service Delivery
Both the district level hospitals provided OPD, Family planning, ANC/PNC/delivery, nutrition
(UNICEF supported OTP – screening and provision of plumpy-nut), EPI and lab services.
However the services are only provided between 8 am to 1pm. All the services (including
general OPD and lab tests) are paid and price lists are displayed at the entrance. Only Az
Zaidiah hospital had a paediatric ward, which worked till 1pm and afterwards emergency
patients were referred to Hodeida. Al Marawah had no paediatric ward but the district
health manager’s office on 1 st floor had enough space to establish the stabilization centre 3 .
All the catchment population of 100% assessed health facilities live within 2 hours walking
distance from the health facilities. 87% 4 of the temporary health facilities provided OPD and
EPI services, 50% provided Family planning and 25% skilled birth attendance. However the
3 Dr Reyad (Merlin Consultant) said he could arrange for necessary permissions to obtain the space
4 All except Al Marawah THFs
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annual OPD utilization rates for the assessed health facilities were low; range 0.1-0.7 5 and
total 0.2 per person per year. This is far below the SPHERE standards of 1 consultation per
person per year in a stable rural and dispersed population. According to the THF records, the
SBA coverage for the catchment population was also quite low - 11%. The reported EPI
coverage was 95% (range 64% - 340%) however this could not be verified in the field.
The official working hours for all the health facilities are 8 am to 1pm. However 80% of the
health workers (government employed or Voluntary) in functional THFs provided charged
services beyond 1 pm; govt supplied drugs, (if any) were free. One of the THF worker had
flourishing practice and he even locally hired a mid wife (@ $100 per month) to provide
wider range of services including deliveries and lab facilities. Even senior MoPH staff
engaged in post working hour’s private practice which is legal in Yemen.
5.2 Community needs Assessment
This was not one of the major components of assessment but information was gathered
wherever feasible. The focus group discussions and KPIs suggested that there are huge
nutrition (between 30 – 90% of families reported extreme food shortages), health and WASH
needs in the community. There are acute food shortages as communities have less means to
purchase the commodities. Women headed households are the most vulnerable, and 80%
are reportedly unable to meet their daily food needs. In a random non-systematic MUAC
screening (quick and dirty) of 28 children from different villages of the 3 districts, the
assessment team found 2 SAM and 6 MAM cases. This gives a GAM rate of 28% which is
similar to MoPH UNICEF Nutritional survey findings.
The key health needs included prevention and treatment of diarrhoeal disease, acute
respiratory infections and malaria. The children and women are most vulnerable to these
diseases. Communities expressed a need for provision of Maternal and child health services
closer to their villages, as well as midwives and skilled birth attendance in rural health
facilities.. The epidemiological data (2011) provided by MoPH suggest that the top 3
5 Higher utilization rates in HFs with very low catchment population e.g Deer Ali HF in Az Zaidiah with
catchment population of 1425 had utilization of 0.7 but Al Badwa with 10,625 had rate of 0.2 consultations per
person /year
11

morbidities in Hodeida include Respiratory infections (27.8%), Diarrhoea and Gastroenteritis
(10.4%) and Malaria (9.1%). However children

drinking water and hygiene sanitation practices) which are further aggravated due to
poverty, lack of awareness and health seeking behaviour, geographical distances and
user fees at point of service delivery.
2. Health systems are weak in all of the 6 areas; Weak HMIS, acute shortage of drugs
and equipment, poor infrastructure, loosely structured and technically weak health
workforce, inadequate range and coverage of essential health services are largely the
result of weak governance, lack of commitment, corruption and inadequate health
financing.
3. Merlin’s approach of an integrated nutrition, health and WASH programme is
justified and needs based. If certain components are left unfunded, Merlin should
seek additional opportunities
4. MoPH officials at Hodeida level are quite forthcoming and have in principal agreed to
provide all necessary support to Merlin’s programme. It will be imperative to work
with/through them but also keep MoPH officials from Sana’a level in loop. It will be
most productive to engage and build the capacity of staff at HF and community
levels.
5. It is feasible to set up stabilization centres at district level hospitals of Az Zaidiah and
Al Marawah but will need lot additional logistical and operational efforts during start
up / initial phase. Merlin will need to hire its own staff for SCs, and paediatric ward
would need to be established in Al Marawah; 1 st floor in main building would be ideal
6. OTP sites need to be supported by Mobile Health and Nutrition teams, with
community level outreach services through CHWs. While a top up incentive (which is
OK with MoPH) and capacity building of the THF workers will leverage support for
MHNTs, the free distribution of essential drugs and equipment provided by Merlin
will need to be monitored through setting up of Village health committees.
7. Key programmatic challenges could be (but not limited to); recruitment and
retention of quality staff especially at SCs, minimizing corruption, coordination with
OTP level health workers and social mobilization.
8. Strategically, it is extremely important that Merlin establishes presence on the
ground at the earliest (before end of Ramadan), and maintains relations with key
stakeholders before more of areas allocated to Merlin are overtaken by other
agencies (e.g Zabid SC taken over by WHO in July).
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7 Annexes
7.1 Annex-I; Map of Hodeidah and Merlin’s Intervention districts
Figure 2: Map of Al Hodeidah, Yemen showing 3 districts of Intervention (Source Nutrition Cluster Yemen, 2012)
14

7.2 Appendix-II; Catchment Areas and populations

7.3 Health Facilities assessed
S.
No.
District Facility Distance from
HQ (hrs by
Car)
Distance
from Dist.
HQ (hr.min)
Key Informants Designation Phone
1 Az Zaidiah Az Zaidiah hospital 0.50 0.00 Dr Abdul Wahab M.O Medical officer
__________
Mohd. A Gilan Matron
737126179
2 Az Zaidiah Al Rabat THF 1.10 0.20 Yahya Ali Health worker 733526585
3 Az Zaidiah Deer Al Wagih THF 1.30 0.40 Issa Hadi Haggagi Volunteer (Diploma 736575002
Nursing)
4 Az Zaidiah Burkhul THF 2.00 1.00 Yusuf Abdullah Yusuf Volunteer (Doctor
711891366
Assistant)
5 Az Zaidiah Deer Ali THF 1.00 0.10 Kasim Abdullah Ali Volunteer (Nurse Male) 770101764
6 Zabid Al-Badwa THF 1.00 0.10 Futeini Yahya
Saida Abdulla Siddique
Health worker
Hired volunteer
777350276
736218819
7 Zabid AL Tawelah THF 2.00 0.45 Nasher Hussein Mahi Health Worker 733524133
Daoud Ismail Ali
8 Zabid Al Habeel THF 2.00 0.50 Abid Abdullah Nurse 734021321
9 Zabid Al Fadel THF 1.45 0.35 Samira hamid Health Worker 735757361
10 Al Marawah Al Marawah
Health Centre
0.25 0.00 Ahmed Shaibah
Abdul Qayei
11 Al Marawah Mahal Omer THF 1.00 0.30 Ahmed Shaibah
Abdul Qayei
12 Al Marawah Al Shaibah THF 1.10 0.45 Ahmed Shaibah
Abdul Qayei
District Health Manager,
Manager Health Centre
District Health Manager,
Manager Health Centre
District Health Manager,
Manager Health Centre
777311633
771129489
777311633
771129489
777311633
771129489
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7.4 Key Contacts, Hodeida
Agency/Organization Name Position E:mail Tel #
Government
Hodeida Governorate
Local Council
Governor’s Office
Chairman
Health office Aabdulrahman Garallah DG of Health office Gar_psych@yahoo.com 777202996
Health office Dr. Ahmed Zabarah Deputy DG health 771341766
Dr Fawaz Al Kajlani Health Care Service dr.fawaz777@gmail.com 777383426
Dr Abdulwahab Al Faquih Assistant manager 7772245672
Dr Yassir Shahar
International Cooperation
777245100
manager
Dr Ali Shuaib PHC Manager alishuiab2008@yahoo.com 777269060
Yahya Gunaid Health Education 777176230
Local NGOs
Abo mosa NGO Mr. Abdoh Ali Mnsoob DG Abo mosa NGO Alashary5@gmail.com 777715690
CSSW Mr.Faisal Al-ghushaimi Coordinator falghoshaimi@gmail.com 777215126,712045807
WES group Mrs. Fatima Jelan Manager wesgroup_w@hotmail.com 733886029
WES group Mr. Hatem Musleh Executive Director wesgroup_w@hotmail.com 777189462,733314284
Me for my country Ms.Shawqeah Al-absi General manager Mem.hod@gmail.com 733570210
Future NGO Dr. Mohamed Taleb General manager moust360@yahoo.com 777310092
Future NGO Mr. Abdoh Yassen moust360@yahoo.com 733574754
YFCA Mrs .Asia Shaibani 733870655
YFCA Ms.Takia Ali Fakirah 771571166,73520608
YWU Mariam Omar Al-haj WYU_hod@yahoo.com
777743971
khammash26@yahoo.com
YWU Amat Al-rahman Ahmed amtalrhman2009@gmail.com 777544511
ROPHD Abdoh Mohamed al-khewani Coordinator Abdua43@gmail.com 700696946,773047465
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International NGOs
OXFAM Tinka Lydia Project manager LTinka@oxfam.org.uk 735177753
OXFAM Apollo Arora Emergency food sec.& aarora@oxfam.org.uk 734982777
livelihood coordinator
OXFAM Ms. Eva Niederberger HSP PHP ENiederberger@oxfam.org.uk 736801054
Save the Children Dr Mariam 711103331
Save the Children Ms. Alem Greiling Nutrition specialist AGreiling@mena.savethechildren.se 735201534
Save the Children Dr.Shihab Ibrahim Programme Officer sibraheem@mena.savethechildren.se 736444928
Islamic relief Mr.Hashem Awnallah Country Director hashem.awnallah@iryemen.org 772388880
Global sports partners Mr. Kevin Graham General manager GSPYEMEN@pobox.com
733118176
kevinbgraham@pobox.com
GIZ-SFS Mr. Parta Advisor sfsyemen@yahoo.com 777187450
SOUL Ms Nadden Noor Al-hebshi Team leader n_noor@soul-yemen.org 711138383
IRD Dr.Sue Ellis Country Director sellis@irdglobal.org 736845226
IRD Mr.Hunter Price Program Officer hprice@ird-dc.org 733137615
IRD Mr. Basam Al-absi Consultant alabsibassam@gmail.com 735400500
Vision hope Ms.Ypie de Wolf Project Director Disaster ypie.dewolf@vision-hope.org 733199474
Response
Vision hope Mr. Matthias Leibbrand Chief Executive Officer matthias.leibbrand@vision-hope.org 733712036
United Nations Organisations
WFP Ms.Ami Nagamune Program officer ami.nagamune@wfp.org 736777834
WFP Ms. Amani Al –Manakhi Programme assistant Amani.AlManakhi@wfp.org 736777827
UNICEF Dr. Rasha Al-ardi Health and Nutrition Officer ralardi@unicef.org 712223014
UNICEF Salaam Education/WASH 712223494
UNICEF Dr. Khaled Al-shaibani Field officer Hodeidah kalshaibani@unicef.org 711684553
UNOCHA Abdirahman Mohamed Humanitarian Affairs Officer Mohamed142@un.org 712222817
UNDSS El Saeed Karara Field Security Coordinator elsaid.karara@undss.org 712222466
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7.5 Health Facility Assessment template
Health Facility Assessment Form
QES No.: ______ Date: ______/________/______ Governorate: _____________________
District: _______________ Village Name: ___________________ Coord.: X ________Y ________
Distance from State HQ (by car): ___ hr_____min
Distance from District HQ (by hour/car): ___hr_____min
Name of Interviewer: ________________________
Name, Designation and Contact no of Key Informant:______________________________________________
*****************************************************************************************
GENERAL INFORMATION
1. Estimated Population of the catchment area served by this HF:
Total Population ______ or HH _______ No. of villages:_________
2. Type of Health Facilities: Health Center (Bedded) ____ (# beds) PHC Unit
Health Center (No bed) Dispensary
Dressing Others: ________
3. Which is/are the organization/s supporting this Health Facility: ____________________________
______________________________________________________________________________________
4. Was the building constructed by: MOH when ________________
NGO _______when ________________
Other _______when ________________
(specify the type of construction, e.g. brick, tent, etc.) ________________________________________
5. How many rooms and for which services they are available
Room Diameter Doors Windows paint Comment on equipments absent Other
comments

Plan of the Health facility (with the actual distribution of the services)
6. Electricity Connection Available: Yes No Average duration of load shedding/Day: _______hrs
Alternative source of electricity: Genset Solar Inverter Other_____________ None
7. Is there a functional incinerator available Yes No
Are there adequate mechanisms for safe disposal of Medical Waste Yes No
8. Is water available at this HF Yes No IF NOT, SKIP TO No. 8
If yes, is there a network system Yes No
If not, where is the water from:
Town network system
Protected well
Unprotected well
Other source
_____________________________
If not from a network system, where is the water stored: ________________________
Is the water chlorinated and tested for residual chlorine Chlorinated Y/N
Tested Y/N
9. Are latrines available Yes No
If yes, how many: ___________and in which condition: good fair bad
Separate for Males and Females Yes No
10. Is this Health Facility serving: IDP only IDP & Residents Residents only
HEALTH SERVICE AND MANPOWER
11. No. of Health Staff present at the HF:
Staff
Doctor
Doctor
Pharmaci
Nurse
Laboratory
Nutrition
Watsan
Mid
Health
CHW
Other
Specialist
General
st
Technician
Staff
Officer
Wife
visitor
National
International
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12. Health Facilities type of services provided:
Type of services
OPD
Availability
Y / N
Any comments on functionality,
Numbers/coverage for past month
IPD Beds
Male
Female
SMALL THEATRE
PHARMACY
LABORATORY
(Essential
Drugs)
ANC
PNC/FP
EOC/Delivery
>5 Child HC
SFC
TFC
NUTRITION
CTC
VIT. A
GMP
EPI/cold chain
ORT
OTHER (specify)
13. Is an OPD SERVICE provided Yes No If Yes, Please fill the following table:
No. Description Available Qty Functioning Not Functioning Remarks
1 Stethoscope
2 Sphygmomanometer
3 Thermometer
4 Torch
5 Tongue Depressor
6 Foetoscope
7 Paracheck
8 Table
9 Chair
14. Is an IPD SERVICE provided Yes No If Yes, Please fill the following table:
21

No. Description Available Qty
1 Bed (male)
2 Bed (female)
3 Drip Holder
4 Safety Box
15. Is a LABORATORY SERVICE provided Yes No If Yes, Please fill the following table:
No. Description Available Qty Functioning Not Functioning Remarks
1 Microscope
2 Manual centrifuge
3 Slides
4 Reagent Gemsa Stain
5 Safety box
16. Are CHILD HEALTH/NUTRITION SERVICES provided Yes No If Yes, Please fill the following
table:
No. Description Available Qty Functioning Not Functioning Remarks
1 Weighing/height Scales
2 Oxygen Concentrator
3 Timer
4 Thermometer
5 Nebulizer
6 GM card
7 Vaccination card
16a. Is there adequate and appropriate space for storage of Nutrition commodities Yes No
17. Is a REPRODUCTIVE HEALTH SERVICE provided Yes No If Yes, Please fill the following table:
No. Description Available Qty Functioning Not Functioning Remarks
1 Stethoscope
2 Sphygmomanometer
3 Thermometer
4 Weighing Scale
5 Foetoscope
6 Antenatal Care Card
7 Poster on FP
8 Poster on FP, HIV/AIDS/STI
9 Poster on Obstetric Risk Factors
10 Anaemia Management Guide
11 Table
12 Chair
18. Are Contraceptive available Yes No
If yes, can you list which methods:
__________________________________
__________________________________
__________________________________
19. Is a DELIVERY SERVICE provided Yes No If Yes, Please fill the following table:
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No. Description Available Qty
1 Delivery kit
2 Bed
3 Drip Holder
4 Safety Box
20. Is an ORT CORNER available Yes No If Yes, Please fill the following table:
No. Description Available Qty Remarks
1 Aluminium Jug
2 Cups & Spoon
3 Nasogastric Tube
4 Explanation Table
5 Chair
6 ORT Poster
21. Is EPI SERVICE provided Yes No If NO, Skip the following questions
22. Do you know about VACCINATION TARGET and STRATEGY
No DESCRIPTION TARGET % WHEN WHERE # of Children
Vaccinated*
1 Fix Centre
2 Outreach
3 Mobile Team
23. Please fill the following table:
(*refer to previous month: _____________)
No. Description Available Qty Functioning Not Functioning Remarks
1 Solar Vaccine Refrigerator
2 Vaccine Carrier
3 Cold Chain Monitoring
4 Vaccine Vial Monitoring
5 Vaccination Card
6 Vaccination register
7 Safety Box
8 Table
9 Chair
VACCINES:
10 - BCG Available Qty Vaccine Stock Outs (in Past 3 months) Period (From to)
11 - PENTA
12 - OPV
13 - MEASLES
14 - TT
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