HIV UNIT TO COMPLETE THIS FORM, ASK THE FACILITY MANAGER FOR PERMISSION TO REVIEW FACILITY REGISTERS IN THE PRENATAL, PEDIATRIC, AND HIV UNITS OF THE FACILITY. 205 I am interested in the data routinely collected in the YES 1 facility. For this section, I need to review some of NO, NOT AVAILABLE 2 301 the registers from this facility. Would it be possible NO, REFUSED 3 301 for me to do this? 206 RANDOMLY SELECT TWO PAGES OF A RECENT REGISTER. RECORD THE TOTAL NUMBER OF ENTRIES FOUND ON THE TWO RANDOMLY SELECTED PAGES. AN ENTRY IS DEFINED AS A ROW WITH A CLIENT’S NAME AND IDENTIFICATION RECORDED. RECORD THE INFORMATION AVAILABLE FOR EACH ENTRY IN THE REGISTER. IN ORDER TO COMPLETE THIS REVIEW IT MAY BE NECESSARY TO ALSO VISIT THE MALNUTRITION UNIT, WHERE THERAPEUTIC AND/OR SUPPLEMENTARY FOOD IS PROVIDED, TO ATTEMPT TO OBTAIN ANY INFORMATION WHICH IS NOT AVAILABLE IN REGISTERS. IF ANY OF THE IS NOT INCLUDED IN THE ACTUAL REGISTER, CROSS OUT THE ENTIRE COLUMN BELOW. IF THE ITEM IS IN THE REGISTER, BUT NO INFORMATION IS PROVIDED FOR THE PARTICULAR CLIENT, RECORD “NA” FOR “NOT AVAILABLE” IN THE SPACE PROVIDED. UNIQUE ID AGE AGE GENDER HEIGHT WEIGHT MUAC THERAPEUTIC OR (IN (IN 1= MALE (IN METERS) (IN KG) (IN CM) SUPPLEMENTARY MONTHS IF ≥ 5 2= FEMALE FOOD PROVIDED IF < 5 YEARS) 3= PREGNANT 1= YES YEARS) WOMAN 2= NO
HIV UNIT TO COMPLETE THIS FORM, ASK THE FACILITY MANAGER FOR PERMISSION TO REVIEW FACILITY REGISTERS IN THE PRENATAL, PEDIATRIC, AND HIV UNITS OF THE FACILITY. 205 I am interested in the data routinely collected in the facility. For this section, I need to review some of the registers from this facility. Would it be possible for me to do this? YES 1 NO, NOT AVAILABLE 2 NO, REFUSED 3 301 301 206 RANDOMLY SELECT TWO PAGES OF A RECENT REGISTER. RECORD THE TOTAL NUMBER OF ENTRIES FOUND ON THE TWO RANDOMLY SELECTED PAGES. AN ENTRY IS DEFINED AS A ROW WITH A CLIENT’S NAME AND IDENTIFICATION RECORDED. RECORD THE INFORMATION AVAILABLE FOR EACH ENTRY IN THE REGISTER. IN ORDER TO COMPLETE THIS REVIEW IT MAY BE NECESSARY TO ALSO VISIT THE MALNUTRITION UNIT, WHERE THERAPEUTIC AND/OR SUPPLEMENTARY FOOD IS PROVIDED, TO ATTEMPT TO OBTAIN ANY INFORMATION WHICH IS NOT AVAILABLE IN REGISTERS. IF ANY OF THE IS NOT INCLUDED IN THE ACTUAL REGISTER, CROSS OUT THE ENTIRE COLUMN BELOW. IF THE ITEM IS IN THE REGISTER, BUT NO INFORMATION IS PROVIDED FOR THE PARTICULAR CLIENT, RECORD “NA” FOR “NOT AVAILABLE” IN THE SPACE PROVIDED. UNIQUE ID AGE (IN MONTHS IF < 5 YEARS) AGE (IN IF ≥ 5 YEARS) GENDER 1= MALE 2= FEMALE 3= PREGNANT WOMAN HEIGHT (IN METERS) WEIGHT (IN KG) MUAC (IN CM) THERAPEUTIC OR SUPPLEMENTARY FOOD PROVIDED 1= YES 2= NO
spring_tool_evaluation_facility_level_nutrition_assessment.docx