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Table 5.10.1 Components of counseling and discussions during consultations for all female family planning clients Among all female family planning clients whose consultations were observed, the percentages whose consultation included the indicated components and the indicated discussions, by facility type, <strong>Nepal</strong> Health Facility Survey 2015 Components of consultation Zonal and above hospitals District-level hospitals Facility type Private hospitals PHCCs HPs UHCs National average Privacy and confidentiality Visual privacy assured 75.8 60.0 80.6 61.1 41.8 42.1 47.8 Auditory privacy assured 69.8 46.4 67.8 54.9 34.8 27.1 39.9 Confidentiality assured 4.3 8.1 3.9 7.7 7.7 1.7 7.3 All three counseling conditions on privacy and confidentiality met 1 3.6 7.4 3.9 6.5 6.2 1.7 6.0 Discussion related to STIs and condoms Use of condoms to prevent STIs 0.0 0.8 0.0 0.0 0.1 0.0 0.1 Use of condoms as dual method 2 0.0 0.8 0.0 0.9 1.5 0.0 1.2 Any discussion related to STIs 3 0.0 0.8 0.0 0.9 1.6 0.0 1.3 Concerns, side effects, and individual client cards Concerns about methods discussed 4 31.4 35.8 30.2 36.5 31.6 32.4 32.4 Side effects discussed 5 20.2 26.3 30.2 25.8 22.3 26.9 23.2 Individual client card reviewed during consultation 54.8 74.5 46.8 74.8 66.1 54.2 66.3 Individual client card written on after consultation 94.4 92.5 91.5 91.9 80.6 79.3 83.6 Visual aid and return visit Visual aids were used during consultation 10.9 4.9 6.6 10.0 5.0 3.7 5.8 Return visit discussed 37.3 64.1 48.2 67.6 61.2 85.3 61.6 Number of observed female FP clients 36 62 17 81 542 29 768 1 Visual and auditory privacy and confidentiality assured during consultation 2 Use of condoms to prevent both pregnancy and sexually transmitted infections (STIs) 3 Discussed risks of STIs, using condoms to prevent STIs, or using condoms as dual method 4 Provider asked client about concerns with family planning method. 5 Method-specific side effect discussed with client, if client was provided or prescribed a method 110 • Family Planning Services
Table 5.10.2 Components of counseling and discussions during consultations for all female family planning clients Among all female family planning clients whose consultations were observed, the percentages whose consultation included the indicated components and the indicated discussions, by background characteristics, <strong>Nepal</strong> Health Facility Survey 2015 Managing authority Ecological region Earthquakeaffected Components of consultation Public Private Mountain Hill Terai districts (14) National average Privacy and confidentiality Visual privacy assured 47.0 80.6 63.7 48.2 43.5 51.2 47.8 Auditory privacy assured 39.3 67.8 54.1 39.0 37.7 38.0 39.9 Confidentiality assured 7.3 3.9 3.8 9.4 5.5 8.8 7.3 All three counseling conditions on privacy and confidentiality met 1 6.0 3.9 1.3 7.6 5.1 7.4 6.0 Discussion related to STIs and condoms Use of condoms to prevent STIs 0.1 0.0 0.0 0.1 0.2 0.0 0.1 Use of condoms as dual method 2 1.2 0.0 1.4 1.0 1.4 0.6 1.2 Any discussion related to STIs 3 1.3 0.0 1.4 1.0 1.6 0.6 1.3 Concerns, side effects, and individual client cards Concerns about methods discussed 4 32.5 30.2 28.9 31.3 34.7 25.3 32.4 Side effects discussed 5 23.1 30.2 21.5 24.2 22.5 19.6 23.2 Individual client card reviewed during consultation 66.7 46.8 58.4 64.5 70.3 56.4 66.3 Individual client card written on after consultation 83.4 91.5 90.5 78.2 88.5 78.8 83.6 Visual aid and return visit Visual aids were used during consultation 5.8 6.6 9.8 4.4 6.6 3.7 5.8 Return visit discussed 61.9 48.2 76.5 60.1 59.9 65.4 61.6 Number of observed female FP clients 751 17 74 380 313 239 768 1 Visual and auditory privacy and confidentiality assured during consultation 2 Use of condoms to prevent both pregnancy and sexually transmitted infections (STIs) 3 Discussed risks of STIs, using condoms to prevent STIs, or using condoms as dual method 4 Provider asked client about concerns with family planning method. 5 Method-specific side effect discussed with client, if client was provided or prescribed a method 5.5 CLIENT OPINION AND KNOWLEDGE 5.5.1 Major Problems After their consultations were observed, all family planning clients were interviewed about issues commonly related to client satisfaction. The exit interviews also probed clients’ opinions of the services they had received that day. Clients were asked to rate whether specific issues posed a major problem, a minor problem, or no problem at all for them during the visit. Few clients complained about the family planning services they received on the day of the visit (Tables 5.11.1 and 5.11.2). The most common complaints—waiting time, amount of explanation of method, number of hours the facility is open, and cleanliness of the facility—were cited by only 3 to 4 percent of clients. Family Planning Services • 111
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Nepal Health Facility Survey 2015 F
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This report presents findings of th
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3 FACILITY-LEVEL INFRASTRUCTURE, RE
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7 DELIVERY AND NEWBORN CARE .......
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TABLES AND FIGURES 1 OVERVIEW OF TH
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Figure 4.3 Trends in early childhoo
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Table 7.12 Postpartum exit delivery
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PREFACE T his is the first comprehe
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ACKNOWLEDGMENTS T he 2015 Nepal Hea
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LIST OF CONTRIBUTORS Chapter 1 Ram
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GDP HA HDC HFOMC HIV HLD HMIS HP HT
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VDC VDRL WHO village development co
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Eighty-five percent of facilities o
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Five percent of all facilities offe
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xxxii • Map of Nepal
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According to the 2013 Global Burden
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1.2.3 Nepal Health Sector Program T
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1.3 THE HEALTH CARE SYSTEM 1.3.1 Ov
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Figure 1.2 Health service delivery
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prepared on an incremental basis ac
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METHODOLOGY 2 2.1 OVERVIEW T he 201
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Health Facility Operation and Manag
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Assess the computer programs (CAPI
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Data Sorting, Editing, and Entry at
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Table 2.2 Results of facility conta
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Table 2.4 Distribution of providers
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2.5.3 Sample for Observations and E
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Table 2.8 Distribution of observed
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FACILITY-LEVEL INFRASTRUCTURE, RESO
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Table 3.1 Availability of specific
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Figure 3.1 Availability of basic cl
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Overall, around three fourths of pr
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3.3.3 Standard Precautions for Infe
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PHCCs, HPs, or UHCs had all of the
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Table 3.6 Capacity for processing e
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Table 3.7.2 Laboratory diagnostic c
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normal delivery services are consid
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Overall, 37 percent of health facil
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3.4.2 Supportive Management for Pro
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Supportive Management Practices A f
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Table 3.13 HMIS status: HMIS report
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Table 3.15 Storage practice for med
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types, PHCCs (78 percent) were leas
Page 93 and 94: Table 3.19 Average number of client
Page 95 and 96: and counseling of clients on at lea
Page 97 and 98: Table 3.20c Compliance with service
Page 99 and 100: Table 3.21b Provision of quality fa
Page 101 and 102: Table 3.22 Financial audit, disaste
Page 103 and 104: CHILD HEALTH SERVICES 4 Key Finding
Page 105 and 106: According to the 2011 Nepal Demogra
Page 107 and 108: Figure 4.3 Trends in early childhoo
Page 109: 4.2.2 Vitamin A Supplementation The
Page 112 and 113: Table 4.4 Guidelines, trained staff
Page 114 and 115: Figure 4.6 Items for infection cont
Page 116 and 117: Figure 4.7 Availability of essentia
Page 118 and 119: Figure 4.8 Vaccine storage (N=816)
Page 120 and 121: Table 4.11.1 Assessments and examin
Page 122 and 123: 4.4.1 Full Assessment IMCI/IMNCI Ge
Page 124 and 125: 4.5 CLIENT OPINIONS Before leaving
Page 126 and 127: With regard to the topics of in-ser
Page 128 and 129: Service readiness. Section 5.3, inc
Page 130 and 131: Table 5.1 Availability of family pl
Page 132 and 133: Table 5.3.1 Family planning service
Page 134 and 135: Table 5.4.1 Methods of family plann
Page 136 and 137: 5.3 SERVICE READINESS 5.3.1 Service
Page 138 and 139: Table 5.7 Items for infection contr
Page 140 and 141: Table 5.8.1 Client history and phys
Page 142 and 143: Privacy during a family planning co
Page 146 and 147: Table 5.11.1 Feedback from family p
Page 148 and 149: 5.6.2 Training Continual training f
Page 151 and 152: ANTENATAL CARE 6 Key Findings Abou
Page 153 and 154: Facilities providing ANC services i
Page 155 and 156: 6.2). Fifty-three percent of the fa
Page 157 and 158: 6.3.4 Medicines The national antena
Page 159 and 160: who are anemic. Only around 4 in 10
Page 161 and 162: Physical Examinations and Preventiv
Page 163 and 164: Table 6.8.2 Basic physical examinat
Page 165 and 166: Table 6.9.1 Content of antenatal ca
Page 167 and 168: Table 6.9a.1 Content of antenatal c
Page 169 and 170: Table 6.10.1 Content of antenatal c
Page 171 and 172: 6.5.1 Client Knowledge Tables 6.11.
Page 173 and 174: Table 6.12.2 Feedback from antenata
Page 175 and 176: With regard to supervision of ANC p
Page 177 and 178: Table 6.16 Guidelines, trained staf
Page 179 and 180: DELIVERY AND NEWBORN CARE 7 Key Fin
Page 181: A quarter of facilities that offer
Page 184 and 185: Table 7.2 Guidelines, trained staff
Page 186 and 187: Table 7.3.2 Medicines and commoditi
Page 188 and 189: than facilities in the hill (75 per
Page 190 and 191: Considering the signal functions se
Page 193 and 194: Table 7.6 presents the proportion o
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7.6 BASIC MANAGEMENT AND ADMINISTRA
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Table 7.10 Training for providers o
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Table 7.12 Postpartum exit delivery
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Table 7.13.2 Postpartum check/advic
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new infections have dropped to belo
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Table 8.1 Availability of HIV testi
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had waste receptacles. Half of the
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176 • HIV/AIDS and Sexually Trans
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Good record-keeping systems to trac
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premature babies, and stillborn bir
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To be considered ready to provide S
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Chronic respiratory diseases. Secti
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Table 9.1 Guidelines, trained staff
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Table 9.2 Diagnostic capacity and e
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Figure 9.3 Items to support quality
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have spacers for inhalers. The latt
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Figure 9.6 Medicines and commoditie
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Although the number of TB cases and
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Only one-third of facilities in Nep
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terai (13 percent) regions. Similar
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MALARIA 11 Key Findings Half of Ne
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years, ACT stocks at health facilit
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Table 11.2 Availability of malaria
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11.4.2 Treatment Readiness to Treat
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REFERENCES Bhandari, G. P., M. R. A
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National Centre for AIDS and STD Co
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2016 - 2021 NHSS RF INDICATORS MATR
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7 8 Radhika Bogati Nisha Khadka Sad
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QUESTIONNAIRES Appendix C Appendix
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NEPAL HEALTH FACILITY SURVEY - 2015
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FACILITY IDENTIFICATION 001 NAME OF
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FIND THE MANAGER, THE PERSON IN-CHA
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SECTION 2: GENERAL FILTER QUESTIONS
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SOURCE OF WATER 330 What is the mos
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360* Does this facility have any ro
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SECTION 4: STAFFING - MANAGEMENT -
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420X CHECK Q006 FACILITY TYPE IS FA
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HMIS FIND THE PERSON RESPONSIBLE FO
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SECTION 5: PROCESSING OF INSTRUMENT
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602 CHECK Q600 FACILITY-BASED WASTE
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SECTION 7: BASIC SUPPLIES - CLIENT
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SECTION 8: DIAGNOSTICS 800 CHECK Q1
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811* Please tell me if: (a) (b) (c
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830 Does this facility do any blood
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847C* Does this facility do any tes
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861 Does this facility do any TB te
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SECTION 9: MEDICINES AND COMMODITIE
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MEDICINES FOR NON-COMMUNICABLE DISE
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MATERNAL AND CHILD HEALTH 906* Are
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SECTION 9.2: CONTRACEPTIVE COMMODIT
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SECTION 9.3: ANTI-TB DRUGS 930 CHEC
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944* Are any of the following Fusio
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1006* ASK YOUR RESPONDENT TO SHOW Y
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SECTION 11: CHILD GROWTH MONITORING
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1210 I would like to know if the fo
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SECTION 13: FAMILY PLANNING 1300 CH
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EQUIPMENT AND SUPPLIES 1314* I woul
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INFECTION CONTROL 1350 ASSESS THE R
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1407* As part of ANC services, plea
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INFECTION CONTROL 1450 ASSESS THE R
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1509* Do you have the national guid
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SECTION 16: DELIVERY AND NEWBORN CA
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EQUIPMENT AND SUPPLIES FOR ROUTINE
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PMTCT DURING LABOR AND DELIVERY 162
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SECTION 17: MALARIA 1700 CHECK Q102
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SECTION 18: SEXUALLY TRANSMITTED IN
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1851 INFECTION CONTROL AND CONDITIO
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1910 CHECK Q1902 AND Q1908 NO TB DI
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SECTION 20: HIV TESTING AND COUNSEL
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SECTION 21: HIV TREATMENT 2100 CHEC
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SECTION 22: HIV CARE AND SUPPORT 22
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BASIC SUPPLIES AND EQUIPMENT 2330 A
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SECTION 24: MINOR SURGICAL SERVICES
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SECTION 25: CESAREAN DELIVERY 2500
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SECTION 27: BLOOD TRANSFUSION SERVI
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SECTION 30: GENERAL FACILITY LEVEL
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201* CHECK [Q103] FOR PROVIDER OCCU
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4. FAMILY PLANNING SERVICES 400 In
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DELIVERY SERVICES 506 In your curre
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7. DIAGNOSTIC SERVICES 700 In your
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808 Among the various things relate
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Sample List for ANTENATAL CARE Obse
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Sample List for ANTENATAL CARE Obse
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NO. QUESTION / OBSERVATIONS CODES F
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NO. QUESTION / OBSERVATIONS ROUTINE
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NO. QUESTION / OBSERVATIONS DANGER
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NO. QUESTIONS CODING CLASSIFICATION
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205 What is the total amount you pa
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Sample List for FAMILY PLANNING Obs
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Sample List for FAMILY PLANNING Obs
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Nepal Health Facility Survey 2015 O
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NO. QUESTIONS / OBSERVATIONS CLIENT
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NO. QUESTIONS / OBSERVATIONS FOR Q1
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NO. QUESTIONS / OBSERVATIONS CODES
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NO. QUESTIONS / OBSERVATIONS 9. IMP
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Nepal Health Facility Survey 2015 F
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Sample List for SICK CHILD Observat
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Sample List for SICK CHILD Observat
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Nepal Health Facility Survey-2015 O
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NO. 5. PROVIDER INTERACTION WITH CA
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Nepal Health Facility Survey-2015 S
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110 Has [HE/SHE] had watery and fre
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TREATMENT AND CARETAKER COMFORT LEV
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UNDERWEIGHT 136A Did the provider t
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Sample List for POST PARTUM WOMEN D
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Nepal Health Facility Survey - 2015
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200. ACCESSING CARE AND DECISION MA
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S.N. Question/Information Coding Ca
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Nepal Health Facility Survey 2015 H
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2.0 Composition, Training and Knowl
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3.0 Participation Q.N. Questions Co
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Facility No.:____________________ T
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STAFF LISTING FORM: HEALTH WORKERS
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