CLINIC SUPERVISOR'S MANUAL - Management Sciences for Health

SECTION 3: SUPERVISOR’S SUPPORT LISTS
QUARTERLY SUPERVISOR’S SUPPORT CHECKLIST
[�] Tick the appropriate box
QUALITY OF SERVICES No Action to be taken Clin Sup
Of 10 infants reach age 1 # fully immunized
Of 10 women reach delivery # ANC visit 3/ more
Of 10 STD’s treated # syndromic Rx
Of 10 diarrhoea # only ORS
Of 10 TB # regular Rx last month
Of 10 # nutrition chart used to advise
Clin = Clinic
Sup = Supervisor
SUPERVISOR’S SUPPORT LISTS – NOTES
ACTIONS TO BE TAKEN BY SUPERVISOR
ACTIONS TO BE TAKEN BY CLINIC
Supervisor Signature Clinic Nurse Date
OTHER COMMENTS/NOTES
12 Clinic Supervisor’s Manual