Type of facility / General Hospital / General Hospital / Provincial Hospital / Provincial Hospital / Provincial Hospital / Provincial Hospital
1. Approximate population served by this health care facility / 70000 / 80000 / 3000 / 55000 / 25000 / 40000
2. Number of beds / 21-50 / 21-50 / 21-50 / 11-20 / 21-50 / 21-50
3. Number of admissions in one year / >5000 / 1001-2000 / 201-300 / 501-700 / 401-500 / 1001-2000
4. Number of outpatients in one year / >5000 / >5000 / 600 / >5000 / >5000 / >5000
5. Number of functioning operating rooms (major & minor) / 2 / 2 / 0 / 1 / 1 / 1
6. Number of patients at this facility requiring major & minor surgical procedures per year / >5000 / 1001-2000 / 101-200 / 21-50 / 101-200 / 81-100
7. Number of children at this facility requiring surgical procedures per year / 2001-5000 / 500 - 1000 / 51-80 / 51-80 / 21-50 / 5-10
8. Number of patients referred for surgical intervention to a higher level facility per year / 21-50 / 20-30 / 101-200 / 21-50 / 81-100 / 21-50
9. Distance (in km) the average patient travel to get to health facility for surgical services / 5-10 / 5-10 / 5-10 / 11-20 / 11-20 / 21-50
10. Distance average patient travel to access surgical services (if not provided) / 21-50 / 0 / 101-200 / 101-200 / 81-100 / 201-300
11. Avaliability of oxygen cylinder or concentrator supply with mask and tubing / AT / AT / ST / AT / AT / ST
12. Avaliability of running water / AT / AT / AT / AT / AT / ST
13. Avaliability of an electricity source/operational power generator / AT / AT / AT / ST / ST / ST
14. Avaliability of a functioning anesthesia machine / AT / AT / NA / NA / ST / AT
15. Avaliability of medical records / AT / AT / AT / NA / ST / AT
16. Avaliability of an area designated for Emergency care / AT / ST / NA / AT / ST / AT
17. Avaliability of an area designated for Postoperative care / AT / AT / NA / AT / ST / NA
18. Avaliability of management guidelines available for Emergency care / AT / NA / NA / AT / NA / NA
19. Avaliability of management guidelines available for Surgery / AT / NA / NA / AT / NA / NA
20. Avaliability of management guidelines available for Anesthesia / AT / ST / NA / AT / NA / NA
21. Avaliability of management guidelines available for Pain Relief / ST / ST / NA / AT / NA / NA
22. Avaliability of a blood bank available at the facility / AT / ST / NA / AT / ST / NA
23. Avaliability of a facility to test hemoglobin & urine / AT / ST / AT / AT / ST / AS
24. Avaliability of a functioning X-ray machine / AT / AT / NA / NA / ST / NA
25. Avaliability of a functioning pulse oximeter / AT / AT / NA / AT / ST / AS
Total available all the time / 14 (93.3%) / 8 (53.3%) / 4 (26.7%) / 12 (80%) / 2 (13.3%) / 3 (20%)
Annex 1. WHO EESC Tool Results - Infrastructure
Key: AT (all the time); ST (sometimes); NA (not available)
Province / Sanma / Shefa / Torba / Malampa / Penama / TafeaType of facility / General Hospital / General Hospital / Provincial Hospital / Provincial Hospital / Provincial Hospital / Provincial Hospital
26. Surgeons (qualified) / 1 / 2 / 0 / 0 / 0 / 0
27. Anesthesiologist physicians (qualified) / 1 / 1 / 0 / 0 / 0 / 0
28. Obstetricians/Gynecologists (qualified) / 1 / 2 / 0 / 0 / 0 / 0
29. General doctors providing surgery (including obstetrics) / 1 / 0 / 0 / 1 / 0 / 1
30. General doctors providing anesthesia / 0 / 0 / 0 / 0 / 0 / 1
31. Nurses/Clinical officers providing anesthesia / 4 / 3 / 0 / 0 / 0 / 2
32. Clinical officers providing surgery (including obstetrics) / 0 / 2 / 0 / 0 / 1 / 2
33. Paramedics/Midwives providing surgery (including obstetrics) / 14 / 5 / 3 / 3 / 3 / 4
Annex 2. WHO EESC Tool Results – Human Resources
Location / Sanma / Shefa / Torba / Malampa / Penama / TafeaType of facility / General Hospital / General Hospital / Provincial Hospital / Provincial Hospital / Provincial Hospital / Provincial Hospital
Y/N / Refer? / Y/N / Refer? / Y/N / Refer? / Y/N / Refer? / Y/N / Refer? / Y/N / Refer?
34. Resuscitation / Y / N / Y / N / N / YS / Y / N / N / YS / Y / N
35. Cricothyroidotomy/Tracheostomy / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
36. Chest tube insertion / Y / N / Y / N / N / YS / N / YS / N / YS / Y / N
37. Removal of foreign body / Y / N / Y / N / N / YS / N / YS / N / YS / Y / N
38. Acute burn management / Y / N / Y / N / N / YS / N / YS / N / YS / Y / N
39. Incision & drainage of abscess / Y / N / Y / N / Y / N / Y / N / N / YS / Y / N
40. Suturing / Y / N / Y / N / N / YS / Y / N / N / YS / Y / N
41. Wound debridement / Y / N / Y / N / N / YS / N / YS / Y / N / Y / N
42. Caesarean section / Y / N / Y / N / Y / YS / N / YS / N / YS / Y / N
43. Dilatation & curettage/vacuum extraction / Y / N / Y / N / N / YS / N / YS / Y / N / Y / N
44. Obstetric fistula repair / N / YS / N / YS / N / YS / N / YS / N / YS / N / YS
45. Tubal ligation/vasectomy / Y / N / Y / N / N / YS / Y / N / N / YS / Y / N
46. Biopsy / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
47. Appendectomy / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
48. Hernia repair / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
49. Hydrocelectomy / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
50. Cystostomy / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
51. Urethral stricture dilatation / N / YS / Y / N / N / YS / N / YS / N / YS / N / YS
52. Laparotomy / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
53. Male circumcision / Y / N / Y / N / Y / N / Y / N / Y / N / Y / N
54. Neonatal surgery / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
55. Cleft lip repair / N / YS / Y / N / N / YS / N / YS / N / YS / N / YS
56. Clubfoot repair / Y / N / Y / N / N / YS / Y / N / N / YS / N / YS
57. Contracture release/skin grafting / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
58. Closed treatment of fracture / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
59. Treatment of open fracture / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
60. Joint dislocation treatment / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
61. Drainage of osteomyelitis/septic arthritis / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
62. Amputation / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
63. Cataract surgery / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
64. Regional anesthesia blocks / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
65. Spinal anesthesia / Y / N / Y / N / N / YS / N / YS / N / YS / Y / N
66. Ketamine intravenous anesthesia / Y / N / Y / N / N / YS / N / YS / N / YS / Y / N
67. General anesthesia inhalational / Y / N / Y / N / N / YS / N / YS / N / YS / N / YS
Total number of interventions able to be performed / 31 (91.2%) / 33 (97%) / 3 (8.8%) / 6 (17.6%) / 3 (8.8%) / 13 (38.2%)
Number of Bellwether procedures (of 3) / 3 / 2 / 0 / 0 / 0 / 0
Annex 3. WHO EESC Tool Results - Interventions
Key: Y (yes); N (no); YS (yes refer because of lack of skill)
Location / Sanma / Shefa / Torba / Malampa / Penama / TafeaType of facility / General Hospital / General Hospital / Provincial Hospital / Provincial Hospital / Provincial Hospital / Provincial Hospital
Capital Outlays
68. Resuscitator bag valve & mask (adult) / FA / AS / AS / AS / AS / AS
69. Resuscitator bag valve & mask (pediatric) / FA / AS / AS / AS / AS / AS
70. Stethoscope / FA / FA / FA / AS / AS / FA
71. Suction pump (manual or electric) with catheter / FA / FA / AT / AS / AS / FA
72. Blood pressure measuring equipment / FA / AS / AT / FA / AS / AS
73. Thermometer / FA / AS / FA / FA / AS / AS
74. Scalpel with blades / FA / FA / AT / FA / AS / AT
75. Retractor / FA / FA / AS / AT / AS / AT
76. Scissors / FA / FA / FA / FA / AS / FA
77. Oropharyngeal airway (adult size) / FA / FA / AS / AS / AS / FA
78. Oropharyngeal airway (pediatric size) / FA / FA / AS / AS / AS / FA
79. Forceps, artery / FA / FA / AT / AS / AS / FA
80. Gloves (sterile) / FA / FA / AS / AS / AS / FA
81. Gloves (examination) / FA / FA / AT / FA / AS / FA
82. Needle holder / FA / FA / AT / FA / FA / FA
83. Sterilizer / FA / FA / AS / AS / AS / FA
84. Vaginal speculum / FA / FA / AS / AS / AS / FA
85. Nasogastric tubes / FA / FA / AS / AS / AS / FA
86. Light source (lamp & flash light) / FA / FA / FA / AS / AS / AS
87. Intravenous fluid infusion set / FA / FA / FA / AS / AS / FA
88. Intravenous cannulas/scalp vein infusion set / FA / FA / AS / AS / AS / FA
89. Syringes with needles (disposable) / FA / FA / FA / AS / AS / FA
90. Sharps disposal container / FA / FA / AS / AS / AS / FA
91. Tourniquet / AS / FA / AS / AS / AS / FA
92. Needles & sutures / FA / FA / FA / AS / AS / FA
93. Splints for arm, leg / FA / FA / AT / AS / FA / FA
94. Urinary catheters (Foleys disposable) / FA / FA / FA / AS / AS / FA
95. Waste disposal container / FA / FA / FA / AS / AS / FA
96. Face masks / FA / FA / AS / AS / AS / FA
97. Eye protection / FA / AS / AS / AS / AS
98. Protective gowns/aprons / FA / FA / AS / FA / AS / AS
99. Soap / FA / FA / FA / FA / FA / FA
Supplementary equipment for use by skilled health professionals
100. Magill forceps (adult) / AS / FA / NA / AS / AB / AB
101. Magill forceps (pediatric) / AS / FA / AB / AS / AB / AB
102. Endotracheal tubes (adult) / FA / FA / NA / AS / AB / AS
103. Endotracheal tubes (pediatric) / FA / FA / AB / AS / AB / AS
104. IV infusor bags / FA / FA / NA / AS / AB / AB
105. Chest tubes insertion equipment / FA / FA / NA / AS / AB / AB
106. Laryngoscope Macintosh blades with bulbs & batteries (adult) / FA / FA / AS / AS / AS / AS
107. Laryngoscope Macintosh blades with bulbs & batteries (pediatric) / FA / FA / AS / AS / AS / AS
108. Cricothyroidotomy set / AB / FA / AB / FA / AB / AB
Total number of supplies (capital outlay) fully available / 31 (96.9%) / 28 (87.5%) / 10 (31.25%) / 8 (25%) / 3 (9.4%) / 23 (71.9%)
Total number of supplies (supplementary) fully available / 6 (66.7%) / 9 (100%) / 0 / 0 / 0 / 0
Annex 4. WHO EESC Tool Results - Emergency & Essential Surgical Care Equipment and Supplies
Key: FA (fully available for all patients all the time); AS (available with frequent shortages or difficulties); AB (absent); blank (no data)