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SYPHILIS 854 Does this facility do any syphilis testing on site, i.e., YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 in the facility? NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 859 855 Do you use syphilis rapid diagnostic test to YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 diagnose syphilis at this service site? NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 857 856 May I see a sample syphilis rapid diagnostic test (RDT) OBSERVED, AT LEAST 1 VALID. . . . . . . . . . . . . . . . . 1 kit? OBSERVED, NONE VALID. . . . . . . . . . . . . . . . . . . . . 2 REPORTED AVAILABLE, NOT SEEN. . . . . . . . . . . . 3 CHECK TO SEE IF AT LEAST ONE IS VALID NONE AVAILABLE TODAY. . . . . . . . . . . . . . . . . . . . . 4 857 Other than syphilis RDT, does this facility conduct YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 any other syphilis testing in the facility? NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 859 858 Please tell me if: (a) (b) (c ) a) Any of the following syphilis test or test TEST ARE ALL ITEMS FOR TEST IS THE ITEM IN equipment is used in this facility, CONDUCTED AVAILABLE? WORKING ORDER? b) All items needed for the test are available, and Yes No REPORTED NOT YES NO DON'T c) Equipment is in working order OBSERVED NOT SEEN AVAILABLE KNOW 01 VDRL 1 b 2 1 2 3 02 02 PCR for STIs (CTN) 1 b 2 1 2 3 03 03 Rotator or shaker 1 c 2 c 3 1 2 3 04 04 Rapid plasma reagin test (RPR) 1 b 2 1 2 3 05 05 05 Treponema Pallidum Hemaglutination 1 b 2 1 2 3 Assay (TPHA) 859 859 CHLAMYDIA 859 Does this facility do any chlamydia testing on site, i.e., YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 in the facility? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 861 860* Please tell me if: (a) (b) a) Any of the following chlamydia test, TEST ARE ALL ITEMS FOR TEST test equipment, or stain is used CONDUCTED AVAILABLE? in the facility; b) All items needed for the test are Yes No REPORTED NOT available, and OBSERVED NOT SEEN AVAILABLE 01* Geimsa stain / Gram stain / Wright's stain 1 b 2 1 2 3 02 02* PCR for CHLAMYDIA 1 b 2 1 2 3 861 254 • Appendix C
861 Does this facility do any TB tests on site? YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 865 862 Please tell me IF: (a) (b) (c ) a) Any of the following TB tests EQUIPMENT/ EQUIPMENT/ALL ITEMS FOR TEST IS THE ITEM IN or equipment is used in the facility TEST USED AVAILABLE? WORKING ORDER? b) All items needed for the test are NORMALLY available Yes No REPORTED AVAILABLE YES NO DON'T c) Equipment is functioning OBSERVED NOT SEEN NOT TODAY KNOW 01 Ziehl-Neelson test for AFB 1 2 05 TUBERCULOSIS 02 Carbol-Fuchsin 1 b 2 1 2 3 03 03 Sulphuric Acid (20 - 25% concentration) 1 b 2 1 2 3 or Acid Alcohol 04 04 Methylene Blue 1 b 2 1 2 3 05 05 Fluorescence Microscope (FM) - LED 1 b 2 1 c 2 c 3 1 2 8 06 06 06 Culture / growth medium for Mycobacterium 1 b 2 1 2 3 Tuberculosis (e.g., MGIT 960) 07 07 Biosafety hood / cabinet 1 b 2 1 2 3 08 08 Auramine stain for Fluorescence Microscope 1 b 2 1 2 3 ASK ONLY IF (05) YES AND AVAILABE 863 (OBSERVED OR REPORTED NOT SEEN) 863* Is Gene Expert services available at this facility? YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 865 863A What type of service is it? MOBILE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 STATIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 864* May I see a sample TB rapid diagnostic test (RDT) kit OBSERVED, AT LEAST 1 VALID. . . . . . . . . . . . . . . . . 1 for Gene Expert? OBSERVED, NONE VALID. . . . . . . . . . . . . . . . . . . . . 2 CHECK TO SEE IF AT LEAST ONE IS VALID REPORTED AVAILABLE, NOT SEEN. . . . . . . . . . . . 3 NONE AVAILABLE TODAY . . . . . . . . . . . . . . . . . . . . . 4 865 Do you maintain any sputum containers at this service YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 site for collecting sputum specimen? NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 867 866* May I see a sample sputum container? OBSERVED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 REPORTED, NOT SEEN. . . . . . . . . . . . . . . . . . . . . . . 3 NONE AVAILABLE TODAY . . . . . . . . . . . . . . . . . . . . . 4 867 Does this laboratory send sputum outside the YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 facility for TB testing? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 DON'T KNOW. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 870 868 Do you maintain records of result of YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 sputum tests conducted elsewhere? NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 870 869 May I see the record or register? OBSERVED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 REPORTED, NOT SEEN. . . . . . . . . . . . . . . . . . . . . . . 2 869A CHECK Q861 TB TEST DONE ON SITE TB TEST NOT DONE ON SITE (CODE 1 CIRCLE) (CODE 2 CIRCLE) 873A 870* Is there a system for quality control (either internal YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 or external) for the TB sputum smears assessed NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 873A in this laboratory? 871 Please tell me which type of Quality Control / Quality Assurance practice is followed by this facility INTERNAL QC / QA ONLY. . . . . . . . . . . . . . . . . . . . . . 1 EXTERNAL QC / QA ONLY. . . . . . . . . . . . . . . . . . . . . 2 INTERNAL & EXTERNAL QC / QA. . . . . . . . . . . . . . . .3 PROBE TO DETERMINE WHICH TYPE OF QUALTY SEND SLIDE FOR RE-READING. . . . . . . . . . . . 4 CONTROL IS USED OTHER (SPECIFY)________________________ 6 872* Are records maintained of the results from the quality YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 control (internal or external) procedures? NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 873A Appendix C • 255
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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
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Table 3.19 Average number of client
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and counseling of clients on at lea
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Table 3.20c Compliance with service
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Table 3.21b Provision of quality fa
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Table 3.22 Financial audit, disaste
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CHILD HEALTH SERVICES 4 Key Finding
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According to the 2011 Nepal Demogra
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Figure 4.3 Trends in early childhoo
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4.2.2 Vitamin A Supplementation The
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Table 4.4 Guidelines, trained staff
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Figure 4.6 Items for infection cont
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Figure 4.7 Availability of essentia
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Figure 4.8 Vaccine storage (N=816)
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Table 4.11.1 Assessments and examin
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4.4.1 Full Assessment IMCI/IMNCI Ge
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4.5 CLIENT OPINIONS Before leaving
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With regard to the topics of in-ser
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Service readiness. Section 5.3, inc
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Table 5.1 Availability of family pl
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Table 5.3.1 Family planning service
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Table 5.4.1 Methods of family plann
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5.3 SERVICE READINESS 5.3.1 Service
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Table 5.7 Items for infection contr
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Table 5.8.1 Client history and phys
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Privacy during a family planning co
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Table 5.10.1 Components of counseli
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Table 5.11.1 Feedback from family p
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5.6.2 Training Continual training f
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ANTENATAL CARE 6 Key Findings Abou
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Facilities providing ANC services i
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6.2). Fifty-three percent of the fa
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6.3.4 Medicines The national antena
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who are anemic. Only around 4 in 10
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Physical Examinations and Preventiv
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Table 6.8.2 Basic physical examinat
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Table 6.9.1 Content of antenatal ca
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Table 6.9a.1 Content of antenatal c
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Table 6.10.1 Content of antenatal c
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6.5.1 Client Knowledge Tables 6.11.
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Table 6.12.2 Feedback from antenata
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With regard to supervision of ANC p
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Table 6.16 Guidelines, trained staf
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DELIVERY AND NEWBORN CARE 7 Key Fin
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A quarter of facilities that offer
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Table 7.3.2 Medicines and commoditi
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than facilities in the hill (75 per
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Considering the signal functions se
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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 9.2 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
Page 237 and 238: MALARIA 11 Key Findings Half of Ne
Page 239 and 240: years, ACT stocks at health facilit
Page 241 and 242: Table 11.2 Availability of malaria
Page 243 and 244: 11.4.2 Treatment Readiness to Treat
Page 245 and 246: REFERENCES Bhandari, G. P., M. R. A
Page 247 and 248: National Centre for AIDS and STD Co
Page 249: 2016 - 2021 NHSS RF INDICATORS MATR
Page 252 and 253: 7 8 Radhika Bogati Nisha Khadka Sad
Page 255 and 256: QUESTIONNAIRES Appendix C Appendix
Page 257 and 258: NEPAL HEALTH FACILITY SURVEY - 2015
Page 259 and 260: FACILITY IDENTIFICATION 001 NAME OF
Page 261 and 262: FIND THE MANAGER, THE PERSON IN-CHA
Page 263 and 264: SECTION 2: GENERAL FILTER QUESTIONS
Page 265 and 266: SOURCE OF WATER 330 What is the mos
Page 267 and 268: 360* Does this facility have any ro
Page 269 and 270: SECTION 4: STAFFING - MANAGEMENT -
Page 271 and 272: 420X CHECK Q006 FACILITY TYPE IS FA
Page 273 and 274: HMIS FIND THE PERSON RESPONSIBLE FO
Page 275 and 276: SECTION 5: PROCESSING OF INSTRUMENT
Page 277 and 278: 602 CHECK Q600 FACILITY-BASED WASTE
Page 279 and 280: SECTION 7: BASIC SUPPLIES - CLIENT
Page 281 and 282: SECTION 8: DIAGNOSTICS 800 CHECK Q1
Page 283 and 284: 811* Please tell me if: (a) (b) (c
Page 285 and 286: 830 Does this facility do any blood
Page 287: 847C* Does this facility do any tes
Page 291 and 292: SECTION 9: MEDICINES AND COMMODITIE
Page 293 and 294: MEDICINES FOR NON-COMMUNICABLE DISE
Page 295 and 296: MATERNAL AND CHILD HEALTH 906* Are
Page 297 and 298: SECTION 9.2: CONTRACEPTIVE COMMODIT
Page 299 and 300: SECTION 9.3: ANTI-TB DRUGS 930 CHEC
Page 301 and 302: 944* Are any of the following Fusio
Page 303 and 304: 1006* ASK YOUR RESPONDENT TO SHOW Y
Page 305 and 306: SECTION 11: CHILD GROWTH MONITORING
Page 307 and 308: 1210 I would like to know if the fo
Page 309 and 310: SECTION 13: FAMILY PLANNING 1300 CH
Page 311 and 312: EQUIPMENT AND SUPPLIES 1314* I woul
Page 313 and 314: INFECTION CONTROL 1350 ASSESS THE R
Page 315 and 316: 1407* As part of ANC services, plea
Page 317 and 318: INFECTION CONTROL 1450 ASSESS THE R
Page 319 and 320: 1509* Do you have the national guid
Page 321 and 322: SECTION 16: DELIVERY AND NEWBORN CA
Page 323 and 324: EQUIPMENT AND SUPPLIES FOR ROUTINE
Page 325 and 326: PMTCT DURING LABOR AND DELIVERY 162
Page 327 and 328: SECTION 17: MALARIA 1700 CHECK Q102
Page 329 and 330: SECTION 18: SEXUALLY TRANSMITTED IN
Page 331 and 332: 1851 INFECTION CONTROL AND CONDITIO
Page 333 and 334: 1910 CHECK Q1902 AND Q1908 NO TB DI
Page 335 and 336: SECTION 20: HIV TESTING AND COUNSEL
Page 337 and 338: 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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NEPAL HEALTH FACILITY SURVEY - 2015
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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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