Professional Documents
Culture Documents
Tool No. (2) : Comments Available? Service No Yes
Tool No. (2) : Comments Available? Service No Yes
(2) Primary care assessment instrument (checklist) for the primary care health center infrastructure Checklist to describe the PHC sit/facility infrastructure: Health Center NO. () Health Center Name:.. Health Center Type:. Section (A) 1/ Check the following conditions Conditions general surrounding Building furniture Kitchen storage of food water supplies bathrooms Good Acceptable Bad
2/ What equipment is available and which of the following are functioning Equipments stethoscope thermometer microscope vaccination kit weight scale Number working number not working
Service Patient Monitoring by PHC physician Basic Diagnostic Tests Screenings Immunization Services Prenatal Care Emergency Care Chronic Disease Care Reproductive Health Services Education and Community Support
available? yes no
Comments
Referrals to Specialists
Section (B)
4/ Which of the following activities are currently available in this primary care center?
Activity Yes No Comment and describe what type of medical equipment available
Community Outreach Well Child Care Immunization Services Womens Services Adolescent Health Adult Services Chronic Disease Management Tracking & Follow-Up Pharmacy Services Home Visits Preventive Health Services Management Information System Diagnostic Lab Radiology
Yes Activity No Comment and describe what type of medical equipment available
Midwifery support Alternative Therapy (Acupuncture, Massage, Sauna, Reflexology) Preventive Dental Services Mental Health Services Referrals to Specialists Quality Assurance Clinical Practice Guidelines Residency Training Nurse Education Phone Triage Patient & Family Education Urgent Care Emergency Care Health Education Microbiology lab Physical Therapy In Service/Clinical Training
6/ what is the overall quality of services provided with this health center? Above standard Of standard quality Below standard Very bad