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118 Did the provider tell you anything about bringing MORE MEDICINES . . . . . . . . . . . . A [NAME] back to the health facility for follow-up or IF SYMPTOMS INCREASE OR non-emergency reasons? BECOME WORSE . . . . . . . . . . B FOLLOW-UP APPOINTMENT. . . . . C IF YES: VIT. A SUPPLEMENTATION. . . . . . . D LAB TEST RESULTS. . . . . . . . . . . E Why were you to return? CHILD ADMITTED. . . . . . . . . . . . . F ROUTINE IMMUNISATION . . . . . . G OTHER X (SPECIFY) NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . Y DON’T KNOW . . . . . . . . . . . . . . . . Z 394 • Appendix C
TREATMENT AND CARETAKER COMFORT LEVEL 119 Did the provider give or prescribe any YES, GAVE MEDS. . . . . . . . . . . . . . . 1 medicines for [NAME] to take at home? YES, GAVE PRESCRIPTION. . . . . . . 2 GAVE MEDS AND PRESCRIPTION. . . . . . . . . . . . . . . 3 NO . . . . . . . . . . . . . . . . . . . . . . . . . . 4 124 120 ASK TO SEE ALL MEDICATIONS THAT THE HAS ALL MEDS. . . . . . . . . . . . . . . . . . 1 CARETAKER RECEIVED AND ANY HAS SOME MEDS, SOME PRESCRIPTIONS THAT HAVE NOT YET BEEN UNFILLED PRESCRIPTIONS. . . . . 2 FILLED. NO MEDICATIONS SEEN, HAS PRESCRIPTIONS ONLY. . . . . . . . . 3 CIRCLE THE RESPONSE DESCRIBING THE MEDICATIONS AND PRESCRIPTIONS YOU SEE. 121 Did a provider at the facility explain to you how to YES. . . . . . . . . . . . . . . . . . . . . . . . . . . 1 give these medicines to [NAME] at home? NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 DON’T KNOW. . . . . . . . . . . . . . . . . . . 8 IF “2” OR “8” SUGGEST TO CLIENT TO GO BACK TO PROVIDER AT THE END OF THE INTERVIEW 122 Do you feel comfortable or confident that you YES. . . . . . . . . . . . . . . . . . . . . . . . . . . 1 know how much of each medication to give [NAME] NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 each day and for how many days to give it? DON’T KNOW. . . . . . . . . . . . . . . . . . . 8 IF “2” OR “8” SUGGEST TO CLIENT TO GO BACK TO PROVIDER AT THE END OF THE INTERVIEW 123 Has [NAME] been given a dose of any of these YES. . . . . . . . . . . . . . . . . . . . . . . . . . . 1 medications here at the facility already? NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 DON’T KNOW. . . . . . . . . . . . . . . . . . . 8 124 Did [NAME] receive an injection for treating YES, RECEIVED INJECTION. . . . . . . 1 the sickness here at the facility today? YES, RECEIVED PRESCRIPTION IF NO, CHECK PRESCRIPTIONS AND FOR INJECTION. . . . . . . . . . . . . 2 RECORD IF THERE IS A PRESCRIPTION FOR NO . . . . . . . . . . . . . . . . . . . . . . . . 3 AN INJECTION. DON’T KNOW . . . . . . . . . . . . . . . . 8 125 Did anyone at the health facility weigh [NAME] YES . . . . . . . . . . . . . . . . . . . . . . . . 1 today? NO . . . . . . . . . . . . . . . . . . . . . . . . . . 2 126 Did anyone talk to you today about [NAME]’s YES . . . . . . . . . . . . . . . . . . . . . . . . 1 weight and how [NAME] is growing? NO . . . . . . . . . . . . . . . . . . . . . . . . . . 2 127 Did any provider ask you today about the YES . . . . . . . . . . . . . . . . . . . . . . . . 1 types of foods and amounts that you normally NO . . . . . . . . . . . . . . . . . . . . . . . . . . 2 feed [NAME] when [NAME] is not sick? CANNOT REMEMBER . . . . . . . . 8 i.e. general nutrition care 127A Did any provider tell you today about the YES . . . . . . . . . . . . . . . . . . . . . . . . 1 types of foods and amounts that you normally NO . . . . . . . . . . . . . . . . . . . . . . . . . . 2 feed [NAME] when [NAME] is not sick? CANNOT REMEMBER . . . . . . . . 8 128 i.e. general nutrition care 127B What specifically were you told about nutrition VARIETIES OF NUTRITIOUS FOOD care/food to feed [NAME] when [NAME] is not sick? ITEMS NEED TO FEED. . . . . . . . . A TEXTURE OF FOOD. . . . . . . . . . . . . B FREQUENCY OF FEEDING. . . . . C HYGIENE DURING FEEDING. . . . . . D AMOUNT OF FEEDING. . . . . . . . . . . E OTHER X (SPECIFY) NO. . . . . . . . . . . . . . . . . . . . . . . . . . . . Y DON’T KNOW . . . . . . . . . . . . . . . . Z Appendix C • 395
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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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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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Page 377 and 378: 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 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
Page 427: 110 Has [HE/SHE] had watery and fre
Page 431 and 432: UNDERWEIGHT 136A Did the provider t
Page 435 and 436: Sample List for POST PARTUM WOMEN D
Page 437 and 438: Nepal Health Facility Survey - 2015
Page 439 and 440: 200. ACCESSING CARE AND DECISION MA
Page 441 and 442: S.N. Question/Information Coding Ca
Page 451 and 452: Nepal Health Facility Survey 2015 H
Page 453 and 454: 2.0 Composition, Training and Knowl
Page 455 and 456: 3.0 Participation Q.N. Questions Co
Page 457 and 458: Facility No.:____________________ T
Page 459 and 460: STAFF LISTING FORM: HEALTH WORKERS
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