APPENDIX-B: Community Profile Community Health Services Assessment & Mapping of Community level Health Workers Community Profile – County: __________________________ District: ___________________________ Facility: _____________________________ Community Details Services in Community No. Mass No. Growth No. CHDC CHC MCH Vital of CHDC Diarrhea-CCM CHV of Malaria-CCM FP CHC Within functional of drug Population ARI-CCM functional CBD-FP WASH Awareness pumps Hand DOTS CLTS registration Established Awareness Established No. Present? HP Monitoring Meeting Community Meeting distribution 5km pumps latrines hand
APPENDIX-B: Community Profile Community Health Services Assessment & Mapping of Community level Health Workers – Community Profile County: __________________________ District: ___________________________ Facility: _____________________________ Community Details Services in Community No. Community Population Within 5km No. of Hand pumps No. of functional hand pumps No. of functional latrines CHC Established CHC Meeting CHDC Established CHDC Meeting CHV Present? Diarrhea-CCM ARI-CCM Malaria-CCM CBD-FP DOTS WASH HP Growth Monitoring FP Awareness Mass drug distribution CLTS MCH Awareness Vital registration