Annex 7: Service Protocol Reference Guides Minimum Package of Activities No Name MPA Service Description Primary Data Collection Secondary Data Collection Tools Tools New outpatient consultation Any new curative care visit during the Curative Care Register Original prescription for 1 past month drugs dispensed kept at the pharmacy which includes cost of drugs. Drugs register and stock cards conform. 2 New outpatient consultation of During the past month, indigents who Indigent outpatient register Proceedings indigent an indigent patient have been consulted as an outpatients. committee Indigents are locally identified. Maximum Community Client of 5% of all new curative consultations Satisfaction Survey: during the previous month. questionnaire application 3 Minor Surgery Any new minor surgical intervention Minor Surgery Register Original prescription for during the past month. Minor Surgery drugs and medical defined as (i) Suture; (ii) incision and consumables dispensed kept drainage; (iii) minor excisions. at the pharmacy which includes cost of drugs/consumables. Drugs register and stock cards conform. 4 Referred patient arrived at the Counter-referral slip available at the Original of counter-referral Copy of the counter-referral General Hospital Health Center. Fully filled in by the MD. slip available at the Health slip available at the General The number of valid counter-referral slips Center. Hospital. Referred patient is counted. registered in the outpatient’s department register. 5 Completely Vaccinated Child Child less than 12 months old which has Vaccination Register Under-five card with received all vaccines according to the vaccination records, held by
Annex 7: Service Protocol Reference Guides Minimum Package of Activities No Name MPA Service Description Primary Data Collection Tools Secondary Data Collection Tools 1 New outpatient consultation Any new curative care visit during the past month Curative Care Register Original prescription for drugs dispensed kept at the pharmacy which includes cost of drugs. Drugs register and stock cards conform. 2 New outpatient consultation of an indigent patient During the past month, indigents who have been consulted as an outpatients. Indigents are locally identified. Maximum of 5% of all new curative consultations during the previous month. Indigent outpatient register Proceedings indigent committee Community Client Satisfaction Survey: questionnaire application 3 Minor Surgery Any new minor surgical intervention during the past month. Minor Surgery defined as (i) Suture; (ii) incision and drainage; (iii) minor excisions. Minor Surgery Register Original prescription for drugs and medical consumables dispensed kept at the pharmacy which includes cost of drugs/consumables. Drugs register and stock cards conform. 4 Referred patient arrived at the General Hospital Counter-referral slip available at the Health Center. Fully filled in by the MD. The number of valid counter-referral slips is counted. Original of counter-referral slip available at the Health Center. Copy of the counter-referral slip available at the General Hospital. Referred patient registered in the outpatient’s department register. 5 Completely Vaccinated Child Child less than 12 months old which has received all vaccines according to the Vaccination Register Under-five card with vaccination records, held by