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SECTION 14: ANTENATAL CARE 1400 CHECK Q102.05 ANC SERVICES NOT ANC SERVICES AVAILABLE IN FACILITY AVAILABLE IN FACILITY NEXT SECTION OR SERVICE SITE ASK TO BE SHOWN THE LOCATION IN THE FACILITY WHERE ANTENATAL CARE SERVICES ARE PROVIDED. FIND THE PERSON MOST KNOWLEDGEABLE ABOUT ANTENATAL CARE SERVICES IN THE FACILITY. INTRODUCE YOURSELF, EXPLAIN THE PURPOSE OF THE SURVEY AND ASK THE FOLLOWING QUESTIONS. 1401 How many days in a month are antenatal care services offered at this facility? 1401A USE A 4-WEEK MONTH TO CALCULATE # OF DAYS How many days in a month are ANC-specific outreach clinic conducted from this facility? USE A 4-WEEK MONTH TO CALCULATE # OF DAYS NUMBER OF DAYS/MONTH NUMBER OF DAYS/MONTH 1402* Do ANC providers provide any of the following services to pregnant women as part of routine ANC? 01 IRON SUPPLEMENTATION 02 FOLIC ACID SUPPLEMENTATION 04 TETANUS DIPTHERIA VACCINATION 05* ALBENDAZOLE YES 1 1 1 1 NO 2 2 2 2 06* MISOPROSTOL 1 2 1403* CHECK Q1402.04 Td VACCINATION Td VACCINATION PROVIDED NOT PROVIDED 1406 1403A How many days in a month is Td vaccination provided through outreach from this facility? USE A 4-WEEK MONTH TO CALCULATE # OF DAYS NUMBER OF DAYS/MONTH 1404* Is tetanus diptheria vaccination available on all days YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1406 that ANC services are available in this facility? NOT ALL ANC DAYS. . . . . . . . . . . . . . . . . . . . 2 1405* How many days in a month are tetanus diptheria (Td) vaccination services available at this facility? DAYS PER MONTH . . . . . . . . . . . . . . . . USE A 4-WEEK MONTH TO CALCULATE # OF DAYS LESS OFTEN THAN ONCE/MONTH. . . . . . . 00 1406* Do ANC providers in this facility provide any of the following tests from this site to pregnant women / clients as part of ANC? IF YES, ASK TO SEE THE TEST KIT OR EQUIPMENT. IF TEST NOT DONE IN ANC, PROBE TO DETERMINE IF THE TEST IS DONE ELSEWHERE IN THE FACILITY (A) OBSERVED AVAILABLE AT LEAST ONE VALID AVAILABL E NONE VALID REPORETED AVAILABLE NOT SEEN (B) NOT OBSERVED NONE AVAILABLE TODAY NO, NEVER AVAILABLE AVAILABLE ELSEWHERE IN FACILITY CHECK TO SEE IF AT LEAST ONE TEST KIT OF EACH TEST IS VALID/UNEXPIRED 02 URINE PROTEIN TEST 1 2 3 4 5 6 03 URINE GLUCOSE TEST 1 2 3 04* HEMOGLOBIN TEST 1 2 3 4 5 6 4 5 6 05 SYPHILIS RAPID DIAGNOSTIC TEST 1 2 3 4 5 6 06* BLOOD GLUCOSE TEST 1 2 3 4 5 6 07* BLOOD GROUPING 1 2 3 4 5 6 08* URINE PREGNANCY TEST 1 2 3 4 5 6 1406A* Please tell me if any of the following HIV rapid diagnostic test (RDT) kits are available at this services site today. I would like to see them. CHECK TO SEE IF AT LEAST ONE IS VALID (NOT EXPIRED) (A) OBSERVED (B) NOT OBSERVED AVAILABLE REPORTED NOT DK / NO, AT LEAST AVAILABLE AVAILABLE AVAILABLE NEVER ONE VALID NONE VALID NOT SEEN TODAY AVAILABLE 01 DETERMINE 1 2 3 4 5 02 UNIGOLD 1 2 3 4 5 03 STATPACK 1 2 3 4 5 04 TRIDOT 1 2 3 4 5 05 OTHER (SPECIFY) ________________________________ 1 2 3 4 5 280 • Appendix C
1407* As part of ANC services, please tell me if providers in this facility provide the following services to ANC clients YES NO 01 COUNSELING ON RECOMMENDED MINIMUM OF 4 ANC VISITS FOR EACH PREGNANCY 1 2 02 COUNSELING ON BIRTH PREPAREDNESS OR PREPARATION FOR DELIVERY 1 2 03 COUNSELING ABOUT FAMILY PLANNING 1 2 04 COUNSELING ABOUT HIV/AIDS 1 2 05* COUNSELING ABOUT USE OF LLIN TO PREVENT MOSQUITO BITES AND MALARIA 1 2 06 COUNSELING ABOUT BREASTFEEDING 1 2 07 COUNSELING ABOUT NEWBORN CARE 1 2 08 COUNSELING ON POSTNATAL CARE VISITS 1 2 1408 Do ANC providers in this facility diagnose and treat suspected STIs, DIAGNOSE AND TREAT STIs. . . . . . . . . . . . . . . . . . .. . . . 1 or are suspected STI clients referred to another provider DIAGNOSE BUT REFER ELSEWHERE FOR TREATMENT2 or location for diagnosis and treatment? REFER ELSEWHERE IN FACILITY FOR DIAG & TREATM3 REFER OUTSIDE FACILITY FOR DIAG & TREATMENT. . 4 NO DIAGNOSIS / TREATMENT / REFERRAL. . . . . . . . . . . 5 1408A Do ANC providers in this facility diagnose and treat suspected HIV, DIAGNOSE AND TREAT HIV. . . . . . . . . . . . . . . . . . . . . . . . 1 or are suspected HIV clients referred to another provider DIAGNOSE BUT REFER ELSEWHERE FOR TREATMENT2 or location for diagnosis and treatment? REFER ELSEWHERE IN FACILITY FOR DIAG & TREATM3 REFER OUTSIDE FACILITY FOR DIAG & TREATMENT. . 4 NO DIAGNOSIS / TREATMENT / REFERRAL. . . . . . . . . . . 5 1409* Do you have the RH clinical protocal for medical officers, staff nurses, YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 ANM in this service area today? NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1411 1410* May I see this guidelines? OBSERVED. . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1415 REPORTED NOT SEEN. . . . . . . . . . . . . . . . . . . 2 ACCEPTABLE IF PART OF OTHER GUIDELINES 1411* Do you have any other ANC guidelines like Maternity guideline/National YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 medical standard volume III in this service area today (OTHERS) ? NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1415 1412* May I see these guidelines? OBSERVED. . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 REPORTED NOT SEEN. . . . . . . . . . . . . . . . . . . 2 1415* Do you have IEC/BCC materials like danger sign posters, BPB YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 flip charts,ANC/PNC job aids, pamphlets for client education on NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1417 subjects related to pregnancy or antenatal care available in this service area today? 1416 May I see the visual aids for client education? OBSERVED. . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 REPORTED NOT SEEN. . . . . . . . . . . . . . . . . . 2 1417* Are any individual client cards or records for ANC and PNC YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 clients maintained at this service site? NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1419 (Maternal and Newborn Health Card (HMIS 3.5)) (Maternal and Newborn Health Service Register (HMIS 3.6)) (Any other client's health card) 1418 May I see a blank copy of the following client records, cards or registers? OBSERVED REPORTED NOT NOT SEEN AVAILABLE 01 Maternal and Newborn Health Card (HMIS 3.5) 1 2 3 02* Maternal and Newborn Health Service Register (HMIS 3.6) 1 2 3 03 Any other client's health card 1 2 3 1419 Does this facility have a system whereby YES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 observation or parameters for ANC clients NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1421 are routinely carried out before the consultation? IF YES, ASK TO SEE THE PLACE WHERE THESE ACTIVITIES TAKE PLACE. Appendix C • 281
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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
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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
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 and 288: 847C* Does this facility do any tes
Page 289 and 290: 861 Does this facility do any TB te
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: INFECTION CONTROL 1350 ASSESS THE R
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
Page 339 and 340: SECTION 22: HIV CARE AND SUPPORT 22
Page 341 and 342: BASIC SUPPLIES AND EQUIPMENT 2330 A
Page 343 and 344: SECTION 24: MINOR SURGICAL SERVICES
Page 345 and 346: SECTION 25: CESAREAN DELIVERY 2500
Page 347 and 348: SECTION 27: BLOOD TRANSFUSION SERVI
Page 349 and 350: SECTION 30: GENERAL FACILITY LEVEL
Page 351 and 352: NEPAL HEALTH FACILITY SURVEY - 2015
Page 353 and 354: 201* CHECK [Q103] FOR PROVIDER OCCU
Page 355 and 356: 4. FAMILY PLANNING SERVICES 400 In
Page 357 and 358: DELIVERY SERVICES 506 In your curre
Page 359 and 360: 7. DIAGNOSTIC SERVICES 700 In your
Page 361 and 362: 808 Among the various things relate
Page 363 and 364: 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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