URT Semi-Structured Interview for facility managers/in-charges FINAL 2 October 2014
COUNTRY NAME
DISTRICT
TOWN OR VILLAGE
YOUR NAME (Data Collector)
YOUR ORGANISATION (Data Collector)
DATE OF INTERVIEW / ______/______/______
DD MMYYYY
INTERVIEW CODE / |___|___|___|___|
CHECKLIST ADDITIONAL DATA TO BE RETRIEVED FROM THERESPONDENT*
Available Yes/No / Retrieved Yes/No
Facility/Hospital Annual Plan
Facility/Hospital Staffing Guidelines
*Indicate where additional data mentioned above and not yet retrieved can be obtained (i.e. contact person and details)
……………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………
INFORMED CONSENT FORM FOR KEY INFORMANT INTERVIEWS
Good morning/afternoon. I am a researcher and we are doing a study on the availability of health workers providing health care to women during pregnancy, labour and birth and to mothers and babies in the postnatal period. This study is part of a wider study which aims at describing the situation in eight different countries and is implemented by the Ministry of Health in collaboration with the United Nations Populations Fund, the World Health Organization, the World Bank, UNAIDS, and UNICEF.
Purpose of the study: The aim of this study is to gather information from healthcare managers and providers as part of understanding human resources for maternal and newborn care. We want to gather information regarding the training, deployment and work environment of health facility and hospital staff providing maternal and newborn health. Through this study we want to contribute to future policies on health workers for health care to mothers and children before, during and after birth. Therefore, we would be grateful if you could agree to share your thoughts and experience regarding this topic.
Discomfort and risk: The questions we will be asking about your ideas regarding the midwifery workforce as you interact with them. The study should not cause any harm to you or the community.
Duration of participation: Your participation is voluntary and your decision on whether you will participate or not in this study and the answers you will give will not have any influence on your position in the health system. Nevertheless if you feel uncomfortable with certain questions you can decide to not answer these and you can stop the interview at any moment in time.
Confidentiality: The interview will be confidential and your name will not appear in the report but will only be recorded on the consent form that will be keep locked and secure. We might wish to use some of your statements as confidential quotes and these will not be traceable to you personally. We will make notes and with your permission we wish to tape record the interview to make sure we record your answers right. After transcribing the interviews, these tapes will be destroyed.
Benefits and compensation: You will not gain personal benefit from participation in this study. The intention for this case study is to contribute towards further strengthening of the maternal and newborn workforce in your country.
Do you have any questions? (If yes, note the questions and answer)
Yes No
If you agree to participate we ask you to sign below:
“I have been given an opportunity to ask any questions I may have, and all such questions or inquiries have been answered to my satisfaction. I hereby consent to participate in this study”
I agree that my answers can be used as anonymous quotes: Yes No
Name: ------Signature:------
Date:------
- Background Characteristics
A1 / Gender / Male (1)
Female (2) / |___|
A2 / Age / Fill in full years / |___|___|
A3 / Facility level / District Hospital(1)
Health centre(2)
Dispensary(3)
Other, ………………………………………….(9) / |___|
A4 / Facility type / Government(1)
NGO/ FBO(2)
Other, ………………………………………….(9) / |___|
A5 / Function / Medical specialist(1)
Medical doctor (2)
Assistant Medical Officer(3)
Clinical Officer(4)
Assistant Clinical Officer(5)
Nursing Officer (degree level) (6)
Assistant Nursing Officer (diploma level)(7)
Nurse (certificate level)(8)
MCH aid(9)
Other, ……………………………………….(99) / |___|___|
A6 / Years of work in this role / Fill in full years / |___|___|
A7 / Years of work at current facility / Fill in full years / |___|___|
A8 / Total years of work experience / Fill in full years / |___|___|
B. Staffing
The following questions are intended to better understand the number of number of staff positions in your facility/hospital. First we ask about the total number of positions and later we specifically what are the approved number of staff positions for this facility, the number of positions filled by employment in this facility and the number of positions filled by volunteers in this facility currently. Please count eachstaff member only once, on the basis of thehighest technical or professional qualification. / 1 Number of Approved positions at facility / 2 Number of Employed staff at facility / 3 Number of Volunteersat facilityB0a / Total number of staff at the facility / B0a.1 |___|___| / B0a.2 |___|___| / B0a.3 |___|___|
B0b / Do you have staff working part-time at this clinic
IF YES→ B0c
IF NO→ B1a / 1=yes 2=no / |___|
B0c / How many of your total employedstaff (answer B0a) work part-time? / |___|___|
B1a
B1b / Specialist Medical Doctor
Of the specialist medical doctors, how many are practitioners in obstetric and gynecological specialties? / B1a.1 |___|___| / B1a.2 |___|___| / B1a.3 |___|___|
B1b.1 |___|___| / B1b.2 |___|___| / B1b.3 |___|___|
B2 / Medical doctor / B2.1 |___|___| / B2.2 |___|___| / B2.3 |___|___|
B3 / Assistant Medical Officer / B3.1 |___|___| / B3.2 |___|___| / B3.3 |___|___|
B4 / Clinical Officer / B4.1 |___|___| / B4.2 |___|___| / B4.3 |___|___|
B5 / Assistant Clinical Officer / B5.1 |___|___| / B5.2 |___|___| / B5.3 |___|___|
B6 / Nursing Officer (degree level) / B6.1 |___|___| / B6.2 |___|___| / B6.3 |___|___|
B7 / Assistant Nursing Officer (diploma level) / B7.1 |___|___| / B7.2 |___|___| / B7.3 |___|___|
B8 / Nurse (certificate level) / B8.1 |___|___| / B8.2 |___|___| / B8.3 |___|___|
B9 / MCH aid / B9.1 |___|___| / B9.2 |___|___| / B9.3 |___|___|
B10 / Other staff involved in maternal and newborn health, specify
………………………………………………………. / B10.1 |___|___| / B10.2 |___|___| / B10.3 |___|___|
B11 / Other staff involved in maternal and newborn health, specify
………………………………………………………. / B11.1 |___|___| / B11.2 |___|___| / B11.3 |___|___|
B12 / Other staff involved in maternal and newborn health, specify
………………………………………………………. / B12.1 |___|___| / B12.2 |___|___| / B12.3 |___|___|
C. Service Provision
Information: In order to better understand the current provision of maternal and newborn services and essential interventions we have summarized these services and interventions and will ask you for each item which cadre/cadres of staff are providing this currently at your facility/hospital.
FAMILY PLANNING AND SEXUALLY TRANSMITTED INFECTIONS
C1 Family planning: Counselling and InformationC1a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C1b / Assistant medical officer MA / 1=yes 2=no / |___|
C1c / Clinical Officer / 1=yes 2=no / |___|
C1d / Assistant Clinical Officer / 1=yes 2=no / |___|
C1e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C1f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C1g / Nurse(certificate level) / 1=yes 2=no / |___|
C1h / MCH aid / 1=yes 2=no / |___|
C1i / Other:...... / 1=yes 2=no / |___|
C1j / Other:...... / 1=yes 2=no / |___|
C2 Family planning: Provision of all methods
C2a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C2b / Assistant medical officer / 1=yes 2=no / |___|
C2c / Clinical Officer / 1=yes 2=no / |___|
C2d / Assistant Clinical Officer / 1=yes 2=no / |___|
C2e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C2f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C2g / Nurse(certificate level) / 1=yes 2=no / |___|
C2h / MCH aid / 1=yes 2=no / |___|
C2i / Other:...... / 1=yes 2=no / |___|
C2j / Other: ...... / 1=yes 2=no / |___|
C3 Prevent and manage Sexually Transmitted illnesses including Mother-to-Child Transmission of HIV and syphilis:Counselling and health information (with BCC materials)
C3a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C3b / Assistant medical officer / 1=yes 2=no / |___|
C3c / Clinical Officer / 1=yes 2=no / |___|
C3d / Assistant Clinical Officer / 1=yes 2=no / |___|
C3e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C3f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C3g / Nurse(certificate level) / 1=yes 2=no / |___|
C3h / MCH aid / 1=yes 2=no / |___|
C3i / Other:...... / 1=yes 2=no / |___|
C3j / Other:...... / 1=yes 2=no / |___|
C4 Prevent and manage Sexually Transmitted illnesses including Mother-to-Child Transmission of HIV and syphilis:Diagnosis and/or treatment (includes activities during pregnancy)
C4a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C4b / Assistant medical officer / 1=yes 2=no / |___|
C4c / Clinical Officer / 1=yes 2=no / |___|
C4d / Assistant Clinical Officer / 1=yes 2=no / |___|
C4e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C4f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C4g / Nurse(certificate level) / 1=yes 2=no / |___|
C4h / MCH aid / 1=yes 2=no / |___|
C4i / Other:...... / 1=yes 2=no / |___|
C4j / Other:...... / 1=yes 2=no / |___|
PREGNANCY AND ANTENATAL CARE
C5 Management of unintended pregnancy:Provision of post abortion (miscarriage) careusing Manual Vacuum Aspiration (MVA)C5a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C5b / Assistant medical officer / 1=yes 2=no / |___|
C5c / Clinical Officer / 1=yes 2=no / |___|
C5d / Assistant Clinical Officer / 1=yes 2=no / |___|
C5e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C5f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C5g / Nurse(certificate level) / 1=yes 2=no / |___|
C5h / MCH aid / 1=yes 2=no / |___|
C5i / Other:...... / 1=yes 2=no / |___|
C5j / Other:...... / 1=yes 2=no / |___|
C6 Management of unintended pregnancy:Provision of post abortion (miscarriage) careusing other methods than MVA
C6a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C6b / Assistant medical officer / 1=yes 2=no / |___|
C6c / Clinical Officer / 1=yes 2=no / |___|
C6d / Assistant Clinical Officer / 1=yes 2=no / |___|
C6e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C6f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C6g / Nurse(certificate level) / 1=yes 2=no / |___|
C6h / MCH aid / 1=yes 2=no / |___|
C6i / Other:...... / 1=yes 2=no / |___|
C6j / Other:...... / 1=yes 2=no / |___|
C7 Appropriate antenatal care package: Medical history and screening for maternal illnesses
C7a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C7b / Assistant medical officer / 1=yes 2=no / |___|
C7c / Clinical Officer / 1=yes 2=no / |___|
C7d / Assistant Clinical Officer / 1=yes 2=no / |___|
C7e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C7f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C7g / Nurse(certificate level) / 1=yes 2=no / |___|
C7h / MCH aid / 1=yes 2=no / |___|
C7i / Other:...... / 1=yes 2=no / |___|
C7j / Other:...... / 1=yes 2=no / |___|
C8 Appropriate antenatal care package: Screening for hypertensive disorders of pregnancy
C8a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C8b / Assistant medical officer / 1=yes 2=no / |___|
C8c / Clinical Officer / 1=yes 2=no / |___|
C8d / Assistant Clinical Officer / 1=yes 2=no / |___|
C8e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C8f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C8g / Nurse(certificate level) / 1=yes 2=no / |___|
C8h / MCH aid / 1=yes 2=no / |___|
C8i / Other:...... / 1=yes 2=no / |___|
C8j / Other:...... / 1=yes 2=no / |___|
C9 Appropriate antenatal care package: Provision of iron and/or folic acid to prevent maternal anaemia
C9a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C9b / Assistant medical officer / 1=yes 2=no / |___|
C9c / Clinical Officer / 1=yes 2=no / |___|
C9d / Assistant Clinical Officer / 1=yes 2=no / |___|
C9e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C9f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C9g / Nurse(certificate level) / 1=yes 2=no / |___|
C9h / MCH aid / 1=yes 2=no / |___|
C9i / Other:...... / 1=yes 2=no / |___|
C9j / Other:...... / 1=yes 2=no / |___|
C10 Appropriate antenatal care package: Tetanus immunization
C10a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C10b / Assistant medical officer / 1=yes 2=no / |___|
C10c / Clinical Officer / 1=yes 2=no / |___|
C10d / Assistant Clinical Officer / 1=yes 2=no / |___|
C10e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C10f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C10g / Nurse(certificate level) / 1=yes 2=no / |___|
C10h / MCH aid / 1=yes 2=no / |___|
C10i / Other:...... / 1=yes 2=no / |___|
C10j / Other:...... / 1=yes 2=no / |___|
C11 Appropriate antenatal care package: Counselling on birth and emergency preparedness
C11a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C11b / Assistant medical officer / 1=yes 2=no / |___|
C11c / Clinical Officer / 1=yes 2=no / |___|
C11d / Assistant Clinical Officer / 1=yes 2=no / |___|
C11e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C11f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C11g / Nurse(certificate level) / 1=yes 2=no / |___|
C11h / MCH aid / 1=yes 2=no / |___|
C11i / Other:...... / 1=yes 2=no / |___|
C11j / Other:...... / 1=yes 2=no / |___|
C12 Appropriate antenatal care package: Counselling HIV & AIDS
C12a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C12b / Assistant medical officer / 1=yes 2=no / |___|
C12c / Clinical Officer / 1=yes 2=no / |___|
C12d / Assistant Clinical Officer / 1=yes 2=no / |___|
C12e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C12f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C12g / Nurse(certificate level) / 1=yes 2=no / |___|
C12h / MCH aid / 1=yes 2=no / |___|
C12i / Other:...... / 1=yes 2=no / |___|
C12j / Other:...... / 1=yes 2=no / |___|
C13 Appropriate antenatal care package: Screening and Provision of antiretroviral drugs (ARV) for HIV
C13a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C13b / Assistant medical officer / 1=yes 2=no / |___|
C13c / Clinical Officer / 1=yes 2=no / |___|
C13d / Assistant Clinical Officer / 1=yes 2=no / |___|
C13e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C13f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C13g / Nurse(certificate level) / 1=yes 2=no / |___|
C13h / MCH aid / 1=yes 2=no / |___|
C13i / Other:...... / 1=yes 2=no / |___|
C13j / Other:...... / 1=yes 2=no / |___|
C14 Appropriate antenatal care package: Prevent and manage malaria with insecticide treated nets and/or antimalarial medicine
C14a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C14b / Assistant medical officer / 1=yes 2=no / |___|
C14c / Clinical Officer / 1=yes 2=no / |___|
C14d / Assistant Clinical Officer / 1=yes 2=no / |___|
C14e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C14f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C14g / Nurse(certificate level) / 1=yes 2=no / |___|
C14h / MCH aid / 1=yes 2=no / |___|
C14i / Other:...... / 1=yes 2=no / |___|
C14j / Other:...... / 1=yes 2=no / |___|
C15 Appropriate antenatal care package: Reduce malpresentation at term with External Cephalic Version (ECV)
C15a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C15b / Assistant medical officer / 1=yes 2=no / |___|
C15c / Clinical Officer / 1=yes 2=no / |___|
C15d / Assistant Clinical Officer / 1=yes 2=no / |___|
C15e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C15f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C15g / Nurse(certificate level) / 1=yes 2=no / |___|
C15h / MCH aid / 1=yes 2=no / |___|
C15i / Other:...... / 1=yes 2=no / |___|
C15j / Other:...... / 1=yes 2=no / |___|
C16 Appropriate antenatal care package: Prevention of pre-eclampsia with calcium of low-dosage aspirin
C16a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C16b / Assistant medical officer / 1=yes 2=no / |___|
C16c / Clinical Officer / 1=yes 2=no / |___|
C16d / Assistant Clinical Officer / 1=yes 2=no / |___|
C16e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C16f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C16g / Nurse(certificate level) / 1=yes 2=no / |___|
C16h / MCH aid / 1=yes 2=no / |___|
C16i / Other:...... / 1=yes 2=no / |___|
C16j / Other:...... / 1=yes 2=no / |___|
C17 Appropriate antenatal care package: Treatment of severe hypertension in Pregnancy (with for example; Methyldopa, Hydralazine, Nifedipine)
C17a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C17b / Assistant medical officer / 1=yes 2=no / |___|
C17c / Clinical Officer / 1=yes 2=no / |___|
C17d / Assistant Clinical Officer / 1=yes 2=no / |___|
C17e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C17f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C17g / Nurse(certificate level) / 1=yes 2=no / |___|
C17h / MCH aid / 1=yes 2=no / |___|
C17i / Other:...... / 1=yes 2=no / |___|
C17j / Other:...... / 1=yes 2=no / |___|
C18 Appropriate antenatal care package: Treatment of eclampsia: with administration of parental (injection) of Magnesium Sulphate or other drugs
C18a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C18b / Assistant medical officer / 1=yes 2=no / |___|
C18c / Clinical Officer / 1=yes 2=no / |___|
C18d / Assistant Clinical Officer / 1=yes 2=no / |___|
C18e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C18f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C18g / Nurse(certificate level) / 1=yes 2=no / |___|
C18h / MCH aid / 1=yes 2=no / |___|
C18i / Other:...... / 1=yes 2=no / |___|
C18j / Other:...... / 1=yes 2=no / |___|
Labour and delivery
C19 Attending and managing normal labour and birthC19a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C19b / Assistant medical officer / 1=yes 2=no / |___|
C19c / Clinical Officer / 1=yes 2=no / |___|
C19d / Assistant Clinical Officer / 1=yes 2=no / |___|
C19e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C19f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C19g / Nurse(certificate level) / 1=yes 2=no / |___|
C19h / MCH aid / 1=yes 2=no / |___|
C19i / Other:...... / 1=yes 2=no / |___|
C19j / Other:...... / 1=yes 2=no / |___|
C20 Induction of labour to manage in cases of pre-labour rupture of membranes at term
C20a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C20b / Assistant medical officer / 1=yes 2=no / |___|
C20c / Clinical Officer / 1=yes 2=no / |___|
C20d / Assistant Clinical Officer / 1=yes 2=no / |___|
C20e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C20f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C20g / Nurse(certificate level) / 1=yes 2=no / |___|
C20h / MCH aid / 1=yes 2=no / |___|
C20i / Other:...... / 1=yes 2=no / |___|
C20j / Other:...... / 1=yes 2=no / |___|
C21 Corticosteroids to prevent respiratory distress syndrome in newborns
C21a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C21b / Assistant medical officer / 1=yes 2=no / |___|
C21c / Clinical Officer / 1=yes 2=no / |___|
C21d / Assistant Clinical Officer / 1=yes 2=no / |___|
C21e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C21f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C21g / Nurse(certificate level) / 1=yes 2=no / |___|
C21h / MCH aid / 1=yes 2=no / |___|
C21i / Other:...... / 1=yes 2=no / |___|
C21j / Other:...... / 1=yes 2=no / |___|
C22 Prevention of postpartum haemorrhage(Active Management of PPH or prophylactic uterotonics by injection)
C22a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C22b / Assistant medical officer / 1=yes 2=no / |___|
C22c / Clinical Officer / 1=yes 2=no / |___|
C22d / Assistant Clinical Officer / 1=yes 2=no / |___|
C22e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C22f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C22g / Nurse(certificate level) / 1=yes 2=no / |___|
C22h / MCH aid / 1=yes 2=no / |___|
C22i / Other:...... / 1=yes 2=no / |___|
C22j / Other:...... / 1=yes 2=no / |___|
C23 Treatment of Postpartum Hemorrhage with drugs and/or uterine massage and/or IV fluids
C23a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C23b / Assistant medical officer / 1=yes 2=no / |___|
C23c / Clinical Officer / 1=yes 2=no / |___|
C23d / Assistant Clinical Officer / 1=yes 2=no / |___|
C23e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C23f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C23g / Nurse(certificate level) / 1=yes 2=no / |___|
C23h / MCH aid / 1=yes 2=no / |___|
C23i / Other:...... / 1=yes 2=no / |___|
C23j / Other:...... / 1=yes 2=no / |___|
C24Treatment of Postpartum Hemorrhage with blood transfusion and\or surgical facilities
C24a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C24b / Assistant medical officer / 1=yes 2=no / |___|
C24c / Clinical Officer / 1=yes 2=no / |___|
C24d / Assistant Clinical Officer / 1=yes 2=no / |___|
C24e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C24f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C24g / Nurse(certificate level) / 1=yes 2=no / |___|
C24h / MCH aid / 1=yes 2=no / |___|
C24i / Other:...... / 1=yes 2=no / |___|
C24j / Other:...... / 1=yes 2=no / |___|
C25 Performing assisted vaginal delivery (with forceps or vacuum extractor) manual removal of the placenta
C25a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C25b / Assistant medical officer / 1=yes 2=no / |___|
C25c / Clinical Officer / 1=yes 2=no / |___|
C25d / Assistant Clinical Officer / 1=yes 2=no / |___|
C25e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C25f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C25g / Nurse(certificate level) / 1=yes 2=no / |___|
C25h / MCH aid / 1=yes 2=no / |___|
C25i / Other:...... / 1=yes 2=no / |___|
C25j / Other:...... / 1=yes 2=no / |___|
C26 Performing assisted vaginal delivery (with forceps or vacuum extractor)
C26a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C26b / Assistant medical officer / 1=yes 2=no / |___|
C26c / Clinical Officer / 1=yes 2=no / |___|
C26d / Assistant Clinical Officer / 1=yes 2=no / |___|
C26e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C26f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C26g / Nurse(certificate level) / 1=yes 2=no / |___|
C26h / MCH aid / 1=yes 2=no / |___|
C26i / Other:...... / 1=yes 2=no / |___|
C26j / Other:...... / 1=yes 2=no / |___|
C27 Performing Caesarean Section for maternal or foetal indication
C27a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C27b / Assistant medical officer / 1=yes 2=no / |___|
C27c / Clinical Officer / 1=yes 2=no / |___|
C27d / Assistant Clinical Officer / 1=yes 2=no / |___|
C27e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C27f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C27g / Nurse(certificate level) / 1=yes 2=no / |___|
C27h / MCH aid / 1=yes 2=no / |___|
C27i / Other:...... / 1=yes 2=no / |___|
C27j / Other:...... / 1=yes 2=no / |___|
Postnatal (mother and newborn)
C28 General health check includinghealth information/education and nutritional adviceC28a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C28b / Assistant medical officer / 1=yes 2=no / |___|
C28c / Clinical Officer / 1=yes 2=no / |___|
C28d / Assistant Clinical Officer / 1=yes 2=no / |___|
C28e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C28f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C28g / Nurse(certificate level) / 1=yes 2=no / |___|
C28h / MCH aid / 1=yes 2=no / |___|
C28i / Other:...... / 1=yes 2=no / |___|
C28j / Other:...... / 1=yes 2=no / |___|
Postnatal (mother)
C29 Detecting and managing postpartum sepsis (infection)C29a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C29b / Assistant medical officer / 1=yes 2=no / |___|
C29c / Clinical Officer / 1=yes 2=no / |___|
C29d / Assistant Clinical Officer / 1=yes 2=no / |___|
C29e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C29f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C29g / Nurse(certificate level) / 1=yes 2=no / |___|
C29h / MCH aid / 1=yes 2=no / |___|
C29i / Other:...... / 1=yes 2=no / |___|
C29j / Other:...... / 1=yes 2=no / |___|
C 30 Screen and initiate or continue antiretroviral therapy for HIV
C30a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C30b / Assistant medical officer / 1=yes 2=no / |___|
C30c / Clinical Officer / 1=yes 2=no / |___|
C30d / Assistant Clinical Officer / 1=yes 2=no / |___|
C30e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C30f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C30g / Nurse(certificate level) / 1=yes 2=no / |___|
C30h / MCH aid / 1=yes 2=no / |___|
C30i / Other:...... / 1=yes 2=no / |___|
C30j / Other:...... / 1=yes 2=no / |___|
Postnatal (newborn)
C 31 Immediate drying, warming, skin to skin, delayed bathingC31a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C31b / Assistant medical officer / 1=yes 2=no / |___|
C31c / Clinical Officer / 1=yes 2=no / |___|
C31d / Assistant Clinical Officer / 1=yes 2=no / |___|
C31e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C31f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C31g / Nurse(certificate level) / 1=yes 2=no / |___|
C31h / MCH aid / 1=yes 2=no / |___|
C31i / Other:...... / 1=yes 2=no / |___|
C31j / Other:...... / 1=yes 2=no / |___|
C 32 Neonatal resuscitation with bag and mask
C32a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C32b / Assistant medical officer / 1=yes 2=no / |___|
C32c / Clinical Officer / 1=yes 2=no / |___|
C32d / Assistant Clinical Officer / 1=yes 2=no / |___|
C32e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C32f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C32g / Nurse(certificate level) / 1=yes 2=no / |___|
C32h / MCH aid / 1=yes 2=no / |___|
C32i / Other:...... / 1=yes 2=no / |___|
C32j / Other:...... / 1=yes 2=no / |___|
C 33 Immediate Hygienic cord and skin care
C33a / Medical specialist/Medical doctor / 1=yes 2=no / __|
C33b / Assistant medical officer / 1=yes 2=no / |___|
C33c / Clinical Officer / 1=yes 2=no / |___|
C33d / Assistant Clinical Officer / 1=yes 2=no / |___|
C33e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C33f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C33g / Nurse(certificate level) / 1=yes 2=no / |___|
C33h / MCH aid / 1=yes 2=no / |___|
C33i / Other:...... / 1=yes 2=no / |___|
C33j / Other:...... / 1=yes 2=no / |___|
C 34 Initiation of exclusive breastfeeding (within first hour) care
C34a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C34b / Assistant medical officer / 1=yes 2=no / |___|
C34c / Clinical Officer / 1=yes 2=no / |___|
C34d / Assistant Clinical Officer / 1=yes 2=no / |___|
C34e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C34f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C34g / Nurse(certificate level) / 1=yes 2=no / |___|
C34h / MCH aid / 1=yes 2=no / |___|
C34i / Other:...... / 1=yes 2=no / |___|
C34j / Other:...... / 1=yes 2=no / |___|
C 35Case management of neonatal sepsis, meningitis and pneumonia
C35a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C35b / Assistant medical officer / 1=yes 2=no / |___|
C35c / Clinical Officer / 1=yes 2=no / |___|
C35d / Assistant Clinical Officer / 1=yes 2=no / |___|
C35e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C35f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C35g / Nurse(certificate level) / 1=yes 2=no / |___|
C35h / MCH aid / 1=yes 2=no / |___|
C35i / Other:...... / 1=yes 2=no / |___|
C35j / Other:...... / 1=yes 2=no / |___|
C 36 Case management of neonatal sepsis, meningitis and pneumonia
C36a / Medical specialist/Medical doctor / 1=yes 2=no / |___|
C36b / Assistant medical officer / 1=yes 2=no / |___|
C36c / Clinical Officer / 1=yes 2=no / |___|
C36d / Assistant Clinical Officer / 1=yes 2=no / |___|
C36e / Nursing Officer (degree level) / 1=yes 2=no / |___|
C36f / Assistant Nursing Officer (diploma level) / 1=yes 2=no / |___|
C36g / Nurse(certificate level) / 1=yes 2=no / |___|
C36h / MCH aid / 1=yes 2=no / |___|
C36i / Other:...... / 1=yes 2=no / |___|
C36j / Other:...... / 1=yes 2=no / |___|
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