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1. Information About Visit - ANTENATAL CARE NO. QUESTIONS CODING CLASSIFICATION GO TO READ TO CLIENT: Hello, I am_____________. As my colleague mentioned, we are representing New ERA. We are conducting a study of health facilities in <strong>Nepal</strong> in order to improve the services this facility offers and would like to ask you some questions about your experiences here today. Please know that whether you decide to allow this interview or not is completely voluntary and will not affect services you receive during any future visit. You may refuse to answer any question, and you may stop the interview at any time. Information from this interview may be provided to researchers for analyses, but neither your name nor the date of services will be on any shared information, so your identity will remain completely confidential. Do you have any questions for me? Do I have your permission to continue with the interview? Interviewer's signature (Indicates respondent's willingness to participate) 100 May I begin the interview now? AGREES . . . . . . . . . . . 1 CLIENT REFUSES . . . . . . . . . 2 END 101* RECORD THE TIME THE INTERVIEW STARTED. . . . . . . . . . . . . . USE 24 HOURS FORMAT . 2 0 1 DAY MONTH YEAR 102* Do you have a maternal & newborn health YES . . . . . . . . . . . . . . . . . . . . . . . 1 (MNH) card (HMIS 3.5) or any health card with NO, CARD KEPT WITH you today? FACILITY . . . . . . . . . . . . . . . . . 2 IF YES: ASK TO SEE THE CARD/BOOK. NO CARD/BOOK USED . . . . . 3 106 103* CHECK THE MNH CARD OR ANY HEALTH CARD YES, 1 TIME. . . . . . . . . . . . . . . . . . . 1 INDICATE WHETHER YES, 2 TIMES. . . . . . . . . . . . . . . . . . 2 THERE IS ANY NOTE OR RECORD OF THE YES, 3 OR MORE TIMES. . . . . . . . . 3 CLIENT HAVING RECEIVED TETANUS NO RECORD. . . . . . . . . . . . . . . . . . . 4 DIPHTERIA TOXOID. 104* HOW MANY WEEKS PREGNANT IS THE CLIENT, ACCORDING TO THE MNH CARD OR # OF WEEKS. . . . . . . . ANY CLIENT'S HEALTH CARD? NOT AVAILABLE. . . . . . . . . . . . . . . .95 106 Have you ever been pregnant, regardless of FIRST PREGNANCY. . . . . . . . . . . . . 1 the duration or outcome, or is this your first NOT FIRST PREGNANCY. . . . . . . . 2 pregnancy? 107 Is this your first antenatal visit at this facility for FIRST VISIT . . . . . . . . . . . . . . . . . . . 1 this pregnancy? SECOND VISIT . . . . . . . . . . . . . . . . 2 THIRD VISIT . . . . . . . . . . . . . . . . . . . 3 IF THIS IS NOT THE 1ST VISIT, ASK: FOURTH VISIT . . . . . . . . . . . . . . . . . 4 How many times have you visited this antenatal MORE THAN 4 VISITS . . . . . . . . . . . 5 clinic for this pregnancy? 342 • Appendix C
NO. QUESTIONS CODING CLASSIFICATION GO TO 108* During this visit (or previous visits) did a YES, THIS VISIT ONLY. . . . . . . . 1 provider give you iron pills, folic acid or iron with YES, THIS & PREVIOUS VISIT. . . . 2 folic acid? YES PREVIOUS VISIT ONLY. . . . 3 109 NO. . . . . . . . . . . . . . . . . . . . . . . 4 SHOW THE CLIENT AN IRON PILL, A DON’T KNOW. . . . . . . . . . . . . . 8 FOLIC-ACID PILL, OR A COMBINED PILL. 108A During this visit (or previous visits) did a YES, THIS VISIT ONLY. . . . . . . . 1 provider give you a prescription for iron pills, YES, THIS & PREVIOUS VISIT. . . . 2 folic acid or iron with folic acid? YES PREVIOUS VISIT ONLY. . . . 3 NO. . . . . . . . . . . . . . . . . . . . . . . 4 DON’T KNOW. . . . . . . . . . . . . . 8 114 109 During this visit (or previous visits) has a provider YES, THIS VISIT ONLY. . . . . . . . 1 explained to you how to take the iron pills? YES, THIS & PREVIOUS VISIT. . . . 2 YES PREVIOUS VISIT ONLY. . . . 3 NO. . . . . . . . . . . . . . . . . . . . . . . 4 DON’T KNOW. . . . . . . . . . . . . . 8 110* During this visit (or previous visits) did a provider YES, THIS VISIT ONLY. . . . . . . . 1 discuss with you the side effects of the iron YES, THIS & PREVIOUS VISIT. . . . 2 pill? YES PREVIOUS VISIT ONLY. . . . 3 NO. . . . . . . . . . . . . . . . . . . . . . . 4 DON’T KNOW. . . . . . . . . . . . . . 8 111 Please tell me any side effects of the iron pill that NAUSEA . . . . . . . . . . . . . . . . . . . A you know of. BLACK STOOLS . . . . . . . . . . . . B CONSTIPATION . . . . . . . . . . . . C PROBE: ANY OTHER? OTHER_____________________ X DON’T KNOW . . . . . . . . . . . . . . Z 114 During this visit (or a previous visit) did a provider YES, THIS VISIT ONLY. . . . . . . . 1 advice you to use mosquito net that has been YES, THIS & PREVIOUS VISIT. . . . 2 treated with an insecticide? YES PREVIOUS VISIT ONLY. . . . 3 NO. . . . . . . . . . . . . . . . . . . . . . . 4 DON’T KNOW. . . . . . . . . . . . . . 8 115* During this visit (or a previous visit) did a provider YES, THIS VISIT ONLY. . . . . . . . 1 offer you a mosquito net that has been treated YES, THIS & PREVIOUS VISIT. . . . 2 with an insecticide free of charge? YES PREVIOUS VISIT ONLY. . . . 3 NO. . . . . . . . . . . . . . . . . . . . . . . 4 DON’T KNOW. . . . . . . . . . . . . . 8 117 During this visit (or previous visits) has a provider YES, THIS VISIT ONLY. . . . . . . . 1 talked to you about nutrition or what is good for YES, THIS & PREVIOUS VISIT. . . . 2 you to be eating during your pregnancy? YES PREVIOUS VISIT ONLY. . . . 3 NO. . . . . . . . . . . . . . . . . . . . . . . 4 DON’T KNOW. . . . . . . . . . . . . . 8 118* Please tell me any signs of complications or VAGINAL BLEEDING. . . . . . . . . A danger signs of pregnancy that you know of. FEVER. . . . . . . . . . . . . . . . . . . . B I am referring to anything that could be an SWOLLEN FACE OR HAND indication of a problem or complication with the OR EXTREMITIES . . . . . . . . . . . . C pregancy, or anything that could negatively affect TIREDNESS OR the pregnancy. BREATHLESSNESS. . . . . . . . . D HEADACHE OR BLURRED VISION. . . . . . . . . . E SEIZURES/CONVULSIONS. . . . . . . F CIRCLE ALL RESPONSES CLIENT MENTIONS. REDUCED OR ABSENCE YOU MAY PROBE WITHOUT USING SPECIFIC OF FETAL MOVEMENT. . . . . . G ANSWERS GIVEN ON RIGHT LOWER ABDOMINAL PAIN H (E.G., "ANYTHING ELSE?") OTHER. . . . . . . . . . . . . . . . . . . . X DON’T KNOW ANY. . . . . . . . . . Z 120 Appendix C • 343
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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
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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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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
Page 365 and 366: Sample List for ANTENATAL CARE Obse
Page 367 and 368: NEPAL HEALTH FACILITY SURVEY - 2015
Page 369 and 370: NO. QUESTION / OBSERVATIONS CODES F
Page 371 and 372: NO. QUESTION / OBSERVATIONS ROUTINE
Page 373 and 374: NO. QUESTION / OBSERVATIONS DANGER
Page 375: NEPAL HEALTH FACILITY SURVEY - 2015
Page 379 and 380: NO. QUESTIONS CODING CLASSIFICATION
Page 381 and 382: 205 What is the total amount you pa
Page 383 and 384: Sample List for FAMILY PLANNING Obs
Page 385 and 386: Sample List for FAMILY PLANNING Obs
Page 387 and 388: Nepal Health Facility Survey 2015 O
Page 389 and 390: NO. QUESTIONS / OBSERVATIONS CLIENT
Page 391 and 392: NO. QUESTIONS / OBSERVATIONS FOR Q1
Page 393 and 394: NO. QUESTIONS / OBSERVATIONS CODES
Page 399 and 400: NO. QUESTIONS / OBSERVATIONS 9. IMP
Page 403 and 404: Nepal Health Facility Survey 2015 F
Page 409 and 410: 205 What is the total amount you pa
Page 411 and 412: Sample List for SICK CHILD Observat
Page 413 and 414: Sample List for SICK CHILD Observat
Page 415 and 416: Nepal Health Facility Survey-2015 O
Page 417 and 418: NO. 5. PROVIDER INTERACTION WITH CA
Page 425 and 426: 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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205 What is the total amount you pa
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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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