IPPF Quality of Care — Preparing for Assessment

Companion Guide_Humanitarian

Version 1

2.

1. Site Observation

Instructions:  The checklists are organized by area of the SDP. Proceed from one area to the next, using the Companion Guide to complete each checklist. The following indicators require that you talk with the staff responsible for the area and are marked in grey:
1.6.3 - 1.6.6
1.7.2

1.1: Entrance/waiting area/toilets

  1. 1.1.1

    Signage is clear *

    OBSERVE: Signage is clear

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 1.1.2

    General maintenance *

    OBSERVE: SDP meets safety standards. Toilet and hand washing facilities are functional.

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  3. 1.1.3

    Adequate light *

    OBSERVE: Overhead lighting is bright enough

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  4. 1.1.4

    Accessible for persons with disabilities *

    OBSERVE: Toilet facilities, sinks, entrance, and exit are wheelchair-accessible

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  5. 1.1.5

    SDP has age-appropriate information, education and communication (IEC) materials available for youth *

    OBSERVE: IEC materials for youth are on display and accessible to clients

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  6. 1.1.6

    Condoms are accessible *

    OBSERVE: Condoms should be available and easily accessible in discreet locations in the SDP.

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

1.2: Registration

  1. 1.2.1

    Privacy and confidentiality are maintained during client registration *

    OBSERVE: Auditory privacy is maintained when client is registering

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 1.2.2

    Confidentiality of record keeping *

    OBSERVE: Files are stored in a locked cabinet or digitally on a password-protected device

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

1.3: Triage area

  1. 1.3.1

    Audio and visual privacy ensured in triage area *

    OBSERVE: Triage area has audio and visual privacy

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

1.4: Consultation rooms

  1. 1.4.1

    Audio and visual privacy ensured in consultation room *

    OBSERVE: Consultation room has audio and visual privacy

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 1.4.2

    Privacy is secured before information is exchanged between clients and service providers *

    OBSERVE: Only necessary people are in the consultation rooms during client counselling and physical examinations

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  3. 1.4.3

    IEC materials are available *

    OBSERVE IEC MATERIALS: Check for SRH, Contraception, STIs/HIV prevention, and Comprehensive abortion services

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

1.5: Procedure rooms

  1. 1.5.1

    Audio and visual privacy ensured in procedure room *

    OBSERVE: Procedure room has audio and visual privacy

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 1.5.2

    Adequate handwashing facilities *

    OBSERVE: Handwashing facilities with soap available where healthcare is provided

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

1.6: Instrument processing

  1. 1.6.1

    The SDP has guidelines for infection prevention and control displayed *

    OBSERVE: Infection prevention guidelines are displayed in the instrument processing room

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 1.6.2

    SDP has adequate personal protective equipment for infection prevention *

    OBSERVE: SDP has at least 1 heavy duty gloves, plastic aprons, rubber boots, and protective shields/goggles

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  3. 1.6.3

    There is a functional committee or person responsible for infection prevention and control *

    ASK STAFF: Is there someone trained and responsible?

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  4. 1.6.4

    Decontamination of instruments performed according to standards *

    ASK STAFF: Check 0.5% chlorine preparation, 10 min soaking time, and 3-bucket rinse technique

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  5. 1.6.5

    Cleaning of instruments and equipment performed according to guidelines *

    ASK STAFF: Cleans with brush under soapy water, checks for biological matter, rinses, and dries

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  6. 1.6.6

    Sterilization process performed according to standards *

    ASK STAFF: Autoclave timing/temp or chemical immersion rules followed with a validation monitor system

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

1.7: Waste management

  1. 1.7.1

    Waste is segregated and stored in clearly labeled containers *

    OBSERVE: Bins lined and labeled (general, infectious, sharps)

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 1.7.2

    Infection prevention practices during handling waste performed according to standards *

    ASK STAFF: PPE worn, no reuse/uncapping of sharps, bins max 3/4 full

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  3. 1.7.3

    Waste storage methods do not harm public health or environment *

    OBSERVE: Storage is locked, clean, organized, pest-protected, public-protected, and shaded

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  4. 1.7.4

    SDP has on-site or off-site final waste disposal mechanism *

    VERIFY: Presence of landfill/incinerator on-site or 2nd party contract off-site

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

1.8: Commodities

  1. 1.8.1

    Emergency and Humanitarian process management *

    ASK LOGISTICS: SOP/supply chain manual for emergency preparedness available

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 1.8.2

    Commodity security for range of contraceptive methods *

    OBSERVE STOCK: 5 contraceptive methods consistently available over past 3 months

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  3. 1.8.3

    Emergency contraception is available *

    OBSERVE STOCK: Emergency contraception in stock

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
3.

2. Interview with Responsible Staff

2.1: General

  1. 2.1.1

    SDP has a well-functioning triage system *

    ASK MANAGER: Severe patients seen within 15 minutes of arrival

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 2.1.2

    SDP follows protocols on occupational post-exposure reporting, management, and follow-up *

    ASK STAFF: Protocol for injury recording, blood exposure, and PEP referral exists

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  3. 2.1.3

    SDP has staff or volunteers who can speak the prevalent local languages *

    ASK STAFF: Staff/volunteers speak local language

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

2.2: Information and service provision

  1. 2.2.1

    SDP offers SRH information, services and other related services for people with diverse SOGIESC *

    ASK STAFF: Manager describes inclusive information/services for diverse SOGIESC

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 2.2.2

    Standard tools used for contraceptive counseling *

    ASK MANAGER: Uses standard tools like BCS+ cards or WHO MEC criteria

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  3. 2.2.3

    SDP provides postabortion care services or referrals *

    ASK MANAGER: Provides postabortion care services or has functioning referrals

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  4. 2.2.4

    SDP provides medical or surgical abortion services or referrals *

    ASK MANAGER: Provides abortion services or has functioning referrals

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  5. 2.2.5

    SDP provides gender-inclusive and age-appropriate information about the availability of abortion and postabortion care services *

    ASK MANAGER: Inclusive and age-appropriate info available

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  6. 2.2.6

    SDP provides information on pregnancy and childbirth and newborn danger signs and where to seek emergency care *

    ASK MANAGER: Maternal/newborn danger sign info available

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  7. 2.2.7

    SDP has a protocol for prevention and treatment of post-partum haemorrhage *

    ASK MANAGER: Protocol exists and uterotonics are actively available

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  8. 2.2.8

    Consent for procedures is documented for all clients *

    ASK MANAGER: Review 10 records to verify written/verbal consent documentation

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

2.3: Staff and provider training

  1. 2.3.1

    Service providers providing basic EmONC received training in the past 12 months *

    ASK MANAGER: EmONC training completed within 12 months

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 2.3.2

    Service providers providing contraception received training in the past 12 months *

    ASK MANAGER: Contraception training completed within 12 months

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  3. 2.3.3

    Service providers providing abortion received training in the past 12 months *

    ASK MANAGER: Abortion training completed within 12 months

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  4. 2.3.4

    Service providers received training on sexual and gender-based violence and clinical management of rape in the past 12 months *

    ASK MANAGER: SGBV/Rape management training completed within 12 months

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

2.4: Client referrals

  1. 2.4.1

    SDP has an up-to-date referral directory for survivors of violence *

    ASK MANAGER: Directory updated within past 6 months

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 2.4.2

    SDP has an up-to-date referral directory for abortion services *

    ASK MANAGER: Directory updated within past 6 months

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  3. 2.4.3

    SDP has a referral pathway SOP established for clients needing abortion care (if abortion services not offered) *

    ASK MANAGER: Referral pathway SOP exists

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  4. 2.4.4

    SDP has an up-to-date referral directory for comprehensive EmONC services *

    ASK MANAGER: Directory updated within past 6 months

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  5. 2.4.5

    SDP has a referral pathway SOP established for clients needing emergency transfer *

    ASK MANAGER: SOP exists and transfers possible 24/7

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

2.5: Client information systems

  1. 2.5.1

    Client information recorded or updated regularly *

    ASK STAFF: Recorded daily in master register and updated after every visit

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 2.5.2

    Client records stored by unique ID *

    ASK STAFF: Records have a unique ID and are stored systematically by ID rather than name

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

2.6: Quality monitoring

  1. 2.6.1

    SDP compiles routine service data as a performance report on a regular basis *

    ASK MANAGER: Performance report compiled at least monthly

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 2.6.2

    SDP uses data to guide decision-making and programming *

    ASK MANAGER: Monthly reviews of statistics take place to facilitate decisions

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

2.7: Client engagement

  1. 2.7.1

    Community meetings are conducted to obtain feedback *

    ASK MANAGER: At least one meeting per quarter (protracted crisis) or per month (acute crisis)

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 2.7.2

    Client exit interviews are done at the SDP to get client feedback *

    ASK STAFF: Conducted at least every 2-3 years with at least 10 clients

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  3. 2.7.3

    Client feedback mechanism is in place *

    ASK STAFF: Suggestion box or multiple formats (SMS, online, phone) to ensure accessibility

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  4. 2.7.4

    Client feedback is routinely reviewed and used to improve services *

    ASK STAFF: Feedback routinely used to improve access and quality

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
4.

3. Provider Observation

3.1: General service provision

  1. 3.1.1

    SDP meets general service provision requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

3.2: Contraception service provision

  1. 3.2.1

    SDP meets general contraceptive service provision requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 3.2.2

    SDP meets oral contraception service provision requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  3. 3.2.3

    SDP meets emergency contraception service provision requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  4. 3.2.4

    SDP meets injectable contraception service provision requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  5. 3.2.5

    SDP meets self-injectable (DMPA-SC) contraception service provision requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  6. 3.2.6

    SDP meets IUD insertion service provision requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  7. 3.2.7

    SDP meets IUD removal service provision requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  8. 3.2.8

    SDP meets implant insertion service provision requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  9. 3.2.9

    SDP meets implant removal service provision requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

3.3: Comprehensive abortion care service provision

  1. 3.3.1

    SDP meets general comprehensive abortion care provision requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 3.3.2

    SDP meets harm reduction model requirements (severely legally restricted contexts only) *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  3. 3.3.3

    SDP meets surgical abortion service provision requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  4. 3.3.4

    SDP meets medical abortion service provision requirements, including for self-managed abortion *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  5. 3.3.5

    SDP meets immediate postabortion care and follow-up service provision requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  6. 3.3.6

    SDP meets post-abortion contraception service provision requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

3.4: Sexually transmitted infection (STI) and HIV/AIDS service provision

  1. 3.4.1

    SDP meets STI and HIV/AIDS service provision requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

3.5: Obstetrics service provision

  1. 3.5.1

    SDP meets prenatal care requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  2. 3.5.2

    SDP meets labor and delivery requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
  3. 3.5.3

    SDP meets postnatal care requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)

3.6: Sexual and gender-based violence service provision

  1. 3.6.1

    SDP meets SGBV service provision requirements *

    REVIEW COMPETENCY: All providers assessed scored at least 80%

    • Sufficient
    • Insufficient
    • Not observed
    • Not Applicable (N/A)
5.

3.1: General Service Provision

Per provider

Complete as many sections as possible through direct observation. If no clients are available for observation, please simulate the client-provider interaction and indicate whether the observation is with a client or a simulation using the dropdown box under each provider's name. The assessor should use the MA's SOPs to aid in completion of the observation. After the observation, give the provider feedback on criteria that were marked "Insufficient".

3.1.1 General service provision

  1. Greets clients and treats them with kindness, dignity and respect *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  2. Gives the client the choice to meet alone (without partner or carer) *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  3. Only required clinical staff are present, unless requested by the client *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  4. Asks client about her current or prior experience with family planning methods *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  5. Applies no unnecessary medical or administrative restrictions to exclude youth or other clients services *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  6. Does not impose a third party authorization requirement, unless required to do so by law *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  7. Provides information on other relevant SRH services *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  8. Uses language the client understands *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  9. Does not coerce/pressure clients (services are voluntary, respect rights) *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  10. If client reports reproductive coercion, provider sensitively inquires about the type of reproductive coercion they are experiencing and adapts counseling to help the client find the contraceptive or abortion method that will work best for them (e.g., using contraception or abortion covertly if needed). *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  11. If a client reports intimate partner violence provider responds supportively and offers referral to violence support services. *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A
6.

3.2: Contraceptive Service Provision

Per provider

3.2.4 INJECTABLE CONTRACEPTIVES

  1. Describes characteristics of available Injectables (NET-EN, DMPA IM or DMPA-SC) *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment. It contributes to the provider’s own score; a provider passes this service at ≥80%. That pass/fail decides whether the roll-up indicator (3.x) is marked Sufficient or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  2. Explains possible side effects including changes in bleeding *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment. It contributes to the provider’s own score; a provider passes this service at ≥80%. That pass/fail decides whether the roll-up indicator (3.x) is marked Sufficient or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  3. Verifies the correct vial, dosage, and expiration date before administration *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  4. Performs proper hand hygiene *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  5. Provide injection according to SOP and/or manufacturer guidelines *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  6. Explains when the client should return for next dose or for warning signs *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

3.2.5 SELF-INJECTABLE CONTRACEPTIVES

  1. Describes characteristics of available Injectables (NET-EN, DMPA IM or DMPA-SC) *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  2. Explains possible side effects including changes in bleeding *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  3. Explains and shows the client how to self-inject *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  4. Observes the client self-inject *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  5. Discusses a plan for storage and disposal *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  6. Offers printed information for the client to guide on how to use *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  7. Explains when the client should administer next dose or for warning signs *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

3.2.6 IUD INSERTION

  1. Describes characteristics of available IUDs (copper or levonorgestrel) *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  2. Explains possible side effects, rare complications and danger signs *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  3. Explains the step-by-step process of insertion, using models or illustrations *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  4. Inserts IUD according to SOP and/or manufacturer guidelines *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

3.2.7 IUD REMOVAL

  1. Removes IUD according to SOP and/or manufacturer guidelines *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

3.2.8 IMPLANT INSERTION

  1. Describes characteristics of available choices of implants (e.g. 1-rod vs 2-rod) *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  2. Explains side effects and rare complications *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  3. Inserts implants according to SOP and/or manufacturer guidelines *

    Observed behaviour (Technical Competency Checklist). NOT scored toward the SDP assessment score. It contributes to the provider’s own score; a provider passes this service at ≥80% of applicable criteria. That pass/fail decides whether the roll-up indicator is Sufficient (all providers ≥80%) or Insufficient. Field: Radio · DEFAULT_ASSESSMENT_ANSWERS · Required · Comment on · Scoring OFF.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

3.2.9 IMPLANT REMOVAL

  1. Removes implant according to SOP and/or manufacturer guidelines *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A
7.

3.3: Comprehensive Abortion Care Service Provision

Per provider

The Technical Competency Checklist will be used to complete provider observations. Clinical assessors should have skills matched to the service being observed (e.g., the assessor must be trained in dilatation and evacuation (D&E) to observe and assess technical competency for a D&E procedure). Identify at least one provider to assess per service offered at the SDP. The form provides space to complete technical competency checklists for up to four providers per service.

Instructions: Do not enter assessment data on this tab. This sheet will auto-populate based on your entries in the Technical Competency Checklist (following tabs), which is used to complete the provider observation. Please note that the "N/A" column on this tab is populated using the applicability information entered on the "Instructions_Prov Obs" tab. For additional information about the benchmarks for "Sufficient", please review the Companion Guide.

3.3.1 General CAC Service Provision Principles

  1. Confirm pregnancy if the client unsure *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  2. Determine gestational age (first day of LMP alone or in combination with physical exam or ultrasound) *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  3. Provides information and counselling free from coercion *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  4. Provides information about abortion and post-abortion options available to the fullest extent of the law *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  5. Explains the post-abortion or abortion care services available (surgical, medical and self-care) *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  6. Supports client to make an informed choice of method (surgical, medical, self-care) *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  7. Explains the process comprehensively *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  8. Offers information on postabortion contraceptive options *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  9. Refers to antenatal care any client who decides to continue the pregnancy *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

3.3.2 Harm reduction model for severely restricted legal contexts

  1. Counselling and information provided on the safest methods of abortion self-care (i.e. misoprostol) *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  2. Post-abortion care (managment of complications, provision of contraception, other SRH services) is provided *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

3.3.3 Surgical Abortion or Surgical management for PAC or CAC including incomplete abortion

  1. Ensures that the client has been appropriately counseled and consented for the procedure *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  2. Informs the client about what will happen before it happens and what she can expect to feel *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  3. Follows SOP for sedation and analgesia - See CCCG Chapter 5, page 189 Appendix 1: How to administer a paracervical block *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  4. Follows SOP for MVA - See CCCG Chapter 5, page 190 Appendix 2: How to perform vacuum aspiration *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  5. Follows SOP for dilatation and evacuation (D&E) - See CCCG Chapter 5, page 191-192: Appendix 3: How to perform dilatation and evacuation *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  6. Provides discharge instructions including signs of complications, follow-up visit, what to do in the event of an emergency *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

3.3.4 Medical Abortion or Medical management for PAC- including incomplete abortion and abortion self-care

  1. Ensures that the client has been appropriately counseled and consented for the procedure *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  2. Follows SOP for medical abortion in-clinic or for home care (CCCGs Chapter 5, 3.2) *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  3. Provides information on how to take the medication(s) correctly *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  4. Provide correct dosage and regimen of either misoprostol + mifepristone OR misoprostol alone *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  5. Gives choice of taking the medication at facility or at home (either all doses or second dose) *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  6. Provides information including signs of complications including ongoing pregnancy, follow-up visit, and where to access help if necessary *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  7. Offers pain medication *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  8. Offers post-abortion follow-up (in clinic or remote ) *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

3.3.5 Immediate Post Abortion Care and Follow up

  1. Provider follows-post operative SOPs *

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  2. Informs what to expect in the coming days, when they can resume normal activity including sexual intercourse *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  3. Informs on signs of complications including ongoing pregnancy, and where to access help if necessary *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  4. Offers follow-up visit (in clinic or remote) *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

3.3.6 Contraceptive counselling for post-abortion clients

  1. Ensure client understands that acceptance of a contraceptive method is not a precondition for abortion *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  2. For clients who choose to adopt contraception, provide it at the time of abortion (according to medical eligibility) *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  3. Contraceptive method is provided as per SOP *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A
8.

3.4: STI and HIV/AIDS Service Provision

Per provider

3.4.1 STI and HIV/AIDS Service Provision

  1. Determines diagnosis consistent with syndromic or etiological (i.e. testing) diagnosis *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  2. Prescribes the appropriate antimicrobial treatment according to national protocols or follows WHO guidelines *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  3. Providers follows HIV standard operating procedures (SOP) including delivery of ARVs to continue treatment for people who were enrolled in antiretroviral therapy prior to the emergency, delivery of cotrimoxazole to all HIV patients as prophylaxis. *

    Providers follows HIV standard operating procedures (SOP) including delivery of ARVs to continue treatment for people who were enrolled in antiretroviral therapy prior to the emergency, delivery of cotrimoxazole to all HIV patients as prophylaxis.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  4. Providers follows PMTCT standard operating procedures (SOP) and/or referral pathway. *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A
9.

3.5: Obstetrics Service Provision

Per provider

3.5.1 Prenatal client care (all prenatal clients)

  1. Assess (screen) for risk factors for high-risk pregnancy and refer appropriately for high level care *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  2. Measures blood pressure *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  3. Conducts panel of tests depending on availability in the context (1. regular measurement of blood pressure, weight and presence of proteinuria 2. HIV, syphilis testing at 12 weeks) *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  4. Counseling on birth preparedness and complications readiness, danger signs in pregnancy and early facility delivery *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  5. Conducts additional investigations/interventions as indicated (setting or risk factors) *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  6. Discusses/ offers options for postnatal contraception *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

3.5.2 Labor and delivery

  1. For all health centers (Basic EmONC): Providers follow BEmONC SOP including all SEVEN signal functions of basic EmONC: parenteral administration of antibiotics, parenteral anticonvulsants, parenteral uterotonics, manual removal of the placenta, removal of retained products of conception, assisted vaginal delivery, and neonatal resuscitation with a bag and mask AND referral pathway (established for clients needing emergency transfer 24/7) *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  2. For all referal hospitals if applies (Comprehensive EmONC) Providers follows BEmONC SOP including all SEVEN signal functions of basic EmONC PLUS: a. Perform surgery (e.g., caesarean section). b. Perform safe blood transfusion, observing universal infection prevention precautions c. Essential Newborn Care + (Space for newborn resuscitation in labour ward, Provide newborn resuscitation & continue to manage newborns with respiratory distress and Establish Kangaroo Mother Care) AND referral pathway (established for clients needing emergency transfer 24/7) *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

3.5.3 Postnatal client care (all postnatal clients)

  1. Observes client and baby with post-natal care for 24 hours after birth, observing for any warning signs *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  2. Assessed for vaginal bleeding, uterine contraction, fundal height, temperature, and heart rate (pulse) during the first 24 hours after birth *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A

  3. Follow-up postnatal visits include: physical healing and function, breastfeeding, emotional well-being, and counselling on nutrition, hygeine and sex *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A
10.

3.6: Sexual and Gender-based Violence Service Provision

Per provider

3.6.1 SGBV service provision

  1. Follows SGBV standard operating procedures (SOP) including clinical care management, LIVES approach, forensic and referral pathway *

    Observed behaviour from the Technical Competency Checklist. Mark Sufficient if the provider performs this correctly, Insufficient if not. Use “Not observed” only when the service is available but could not be observed, and “N/A” only when the service is not available. Each criterion counts toward the provider’s score for this service; a provider passes at ≥80%. After the observation, give the provider feedback on criteria marked “Insufficient”.

    • Sufficient
    • Insufficient
    • Not Observed
    • N/A
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