MONITORING & EVALUATION TOOL FOR SHAPE COMMUNITY EDUCATORS

BHS AREA: ______________________________________________________________________

SHAPE COMMUNITY EDUCATOR: ____________________________________________________
DATE & TIME CONDUCTED: _________________________________________________________

AREAS ASSESSMENT OBSERVATIONS/ OTHER

–YES– | – NO – RECOMMENDATIONS REMARKS
1. SIGNAGE
(VISIBILITY OF POSTERS).
2. SCHEDULE
(SCHEDULE FOR
CONDUCTING COMMUNITY
AWARENESS & EDUCATION).
3. AVAILABILITY
OF HIV HEALTH
SERVICE
(EDUCATION & REFERRAL).
4. IEC MATERIALS
(AVAILABILITY OF PROVIDED
PRINTOUTS TO BE
CONVERTED AS FLIP CHARTS/
ANY AVAILABLE IEC FLIP
CHART IN THE BHS).
5. LOGBOOK
(FOR COMMUNITY MEMBERS
REACHED & REFERRED).

AREAS ASSESSMENT OBSERVATIONS/ OTHER

–YES– | – NO – RECOMMENDATION REMARKS
S
6. FOCAL PERSON
 (DESIGNATED PERSON WHO
CAN ACCESS THE MATERIALS
AND LOGBOOK).
7. SAFE SPACES
(DESIGNATED ROOM OR ANY
SAFE SPACE THAT IS WELL-LIT
AND VENTILATED TO BE ABLE
TO CONDUCT COMMUNITY
EDUCATION).
8. COMMODITIES
(CONDOMS, LUBRICANTS, AND
OTHER AVAILABLE IEC
MATERIALS).
9. AREAS FOR
IMPROVEMENT
(NEEDED REINFORCEMENT OR
ANY ADDITIONAL SESSIONS TO
BE CONDUCTED FOR
IMPROVEMENT OF COMMUNITY
EDUCATOR).
10. COMMUNITY
(ABLE TO REACH THE TARGET
KEY POPULATION
[MSM,TG,YKP] IN PROVIDING
AWARENESS TO ANY
COMMUNITY MEMBER ABOUT
THE EXISTENCE &
AVAILABILITY OF A SHAPE
COMMUNITY EDUCATOR IN THE
BHS).
BHS SHAPE COMMUNITY EDUCATOR: EVALUATOR:

_________________________________ _________________________________

MONITORING & EVALUATION TOOL FOR COMMUNITY RESPONDENTS

BHS AREA: ______________________________________________________________________

COMMUNITY RESPONDENT: ________________________ GENDER IDENTITY: ___________
DATE & TIME CONDUCTED: _________________________________________________________

AREAS ASSESSMENT OBSERVATIONS/ OTHER

–YES– | – NO – RECOMMENDATIONS REMARK
 1. AWARENESS
(AWARENESS OF ANY COMMUNITY
MEMBER FROM THE TARGET
POPULATION [MSM,TG,YKP] ABOUT THE
EXISTENCE & AVAILABILITY OF A SHAPE
COMMUNITY EDUCATOR IN THE BHS).

2. SERVICE
AVAILABILITY
(ABLE TO REACH OUT OR AVAIL THE
SERVICES OFFERED FOR HIV, AIDS & TB).

3. COMMUNITY
CENTER AWARENESS
(ABLE TO GET AWARENESS OF THE
REFERRAL SYSTEM ESPECIALLY TO ORO
PIA COMMUNITY CENTER BY KAGAY-AN
PLUS INC. AND OTHER FACILITIES TO
AVAIL THE DIFFERENTIATED SERVICES).

4. EDUCATION
(ABLE TO GET ADEQUATE INFORMATION
AND PROPER EDUCATION ABOUT HIV101,
TB, SOGIESC, ETC.).

5. RECOMMENDATIONS
(ASK RESPONDENT FOR ANY
RECOMMENDATIONS AND OR
OBSERVATION FROM THE FACILITY).

COMMUNITY RESPONDENT: EVALUATOR:

_________________________________ _________________________________