National Guidelines for Improving Quality of Care, Support ... - FHI 360

8b. Legal Protection 4 3 2 1 4 3 2 1 4 3 2 1
Child, Parent/Caregiver, Relative, Neighbor, Teacher, Family Friend,
Community Worker, Other ____________
Child, Parent/Caregiver, Relative,
Neighbor, Teacher, Family
Friend, Community Worker, Other
____________
Child, Parent/Caregiver,
Relative, Neighbor,
Teacher, Family Friend,
Community Worker, Other
_________
Source of Information:
(Circle all that apply)
Who provided services? (e.g. NGO, neighbor, teacher, church,or
other)
What was provided and to whom?
III. TYPES OF SUPPORT / SERVICES PROVIDED
(at present):
Food & nutrition support (such as supplemental foods)
a.
Shelter & other material support (such as house repair, clothes, bedding)
b.
Care (caregiver received training or support, child placed with family)
c.
Protection from abuse (education on abuse provided to child or caregiver)
d.
Legal support (birth certificate, legal services, succession plans prepared)
e.
Health care services (such as vaccinations, medicine, ARV, fees waived,
HIV/AIDS education, referrals)
f.
Psychosocial support (clubs, group support, individual counseling)
g.
Educational support (fees waived; provision of uniforms, school supplies,
tutorials, other)
h.
Livelihood support (vocational training, micro-finance opportunities for
family, etc)
i.
Other:
j.
Additional Actions Required and/or services needed:
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