Are laboratory services used for initiation and monitoring of No Yes ⓪ ② psychotropic medication? No Yes Are the following available at or near the health facility: ⓪ ② 3.1.Complete blood count No Yes ⓪ ② 3.2.Liver function test No Yes ⓪ ② 3.3.Thyroid function test No Yes ⓪ ② blood sugar test No Yes ⓪ ② 3.5.Toxicology screening test (urine test) No Yes ⓪ ② 3.6.Creatine clearance test (BUN) No Yes ⓪ ② No Yes 3.7.Serum Lithium Level ⓪ ② 3. Average Score ( ) (= sum of all scored divided by total # of items scored) Notes and Recommendations: 4. Staff Training Indicators How many Was this training Training What % of this staff Staff hours of training followed by conducted was trained? was provided? supervision? None (0%) ⓪ GPs Some (1-50%) No Yes ① ⓪ ② Most (>50%) ② Prior to IMC None (0%) ⓪ training, the Nurses Some (1-50%) No Yes following staff ① ⓪ ② Most (>50%) received ② MH None (0%) ⓪ training by Midwifes Some (1-50%) No Yes ① ⓪ ② (agency/entity): Most (>50%) ② None (0%) ⓪ MH priority CHW Some (1-50%) No Yes ① ⓪ ② conditions Most (>50%) ② covered: None (0%) ⓪ Some (1-50%) No Yes ① ⓪ ② Most (>50%) ② 4. Average Score 4a ( ) 4b ( ) (= sum of all scored items divided by total # of items scored) Notes and Recommendations: 5. Staff Skills Indicators At least one health care provider in the clinic is trained in… Assessment and management of mental disorders*
Are laboratory services used for initiation and monitoring of psychotropic medication? ⓪ No ② Yes Are the following available at or near the health facility: ⓪ No ② Yes 3.1.Complete blood count ⓪ No ② Yes 3.2.Liver function test ⓪ No ② Yes 3.3.Thyroid function test ⓪ No ② Yes blood sugar test ⓪ No ② Yes 3.5.Toxicology screening test (urine test) ⓪ No ② Yes 3.6.Creatine clearance test (BUN) ⓪ No ② Yes 3.7.Serum Lithium Level ⓪ No ② Yes 3. Average Score (= sum of all scored divided by total # of items scored) ( ) Notes and Recommendations: 4. Staff Training Indicators Training conducted Staff What % of this staff was trained? How many hours of training was provided? Was this training followed by supervision? Prior to IMC training, the following staff received MH training by (agency/entity): MH priority conditions covered: GPs ⓪ None (0%) ① Some (1-50%) ② Most (>50%) ⓪ No ② Yes Nurses ⓪ None (0%) ① Some (1-50%) ② Most (>50%) ⓪ No ② Yes Midwifes ⓪ None (0%) ① Some (1-50%) ② Most (>50%) ⓪ No ② Yes CHW ⓪ None (0%) ① Some (1-50%) ② Most (>50%) ⓪ No ② Yes ⓪ None (0%) ① Some (1-50%) ② Most (>50%) ⓪ No ② Yes 4. Average Score (= sum of all scored items divided by total # of items scored) 4a ( ) 4b ( ) Notes and Recommendations: 5. Staff Skills Indicators At least one health care provider in the clinic is trained in… Assessment and management of mental disorders*