A. General Health Facility Information To be answered by the health facility manager or his/her appointee(s). Circle the coding corresponding to the correct/observed response. Observe and verify records accordingly. NO. QUESTION FILTERS A01 Level of health facility National Hospital 1 Regional Hospital 2 General Hospital 3 A02 Health facility ownership Government 1 Private not for profit (PNFP) 2 Private for profit (PFP) 3 A03 Does the health facility offer nutrition Yes 1 services? No 2 A04 Does the health facility have a Yes (Skip to A08) 1 designated nutritionist? No 2 A05 Does the health facility have a person Yes 1 in charge of nutrition? No (Skip to A08) 2 A06 What is the cadre of the person in charge of nutrition services in the Cadre (specify)----------------------------------- health facility? A07 Has the person in charge of nutrition Yes 1 services received any in-service training No 2 in nutrition in the past two years? A08 Does the health facility have an Yes 1 established quality improvement (QI) No (Skip to A13) 2 team? A09 What is the composition of the health Facility manager 1 facility QI team? (Tick all that apply) Heads of department/units 2 Nutritionists 3 CSO representative 4 Community representative 5 Other (specify)…………… 6 A10 Does the health facility have a QI work Yes 1 plan and budget? (Verify) No 2 A11 Is the QI team functional (i.e., meets Yes 1 monthly and minutes are available)? No 2 A12 Does the health facility leadership Yes 1 actively participate in the monthly QI No 2 meetings? A13 Does the health facility have a Yes 1 continuous professional development No (Skip to A15) 2 (CPD)/continuous medical education (CME) schedule? A14 Are nutrition topics included in the Yes 1 CPD/CME schedule? No 2 A15 Is nutrition integrated in the health Yes 1 facility work plan and budget? No 2
A. General Health Facility Information To be answered by the health facility manager or his/her appointee(s). Circle the coding corresponding to the correct/observed response. Observe and verify records accordingly. A01 Level of health facility National Hospital Regional Hospital General Hospital 1 2 3 A02 Health facility ownership Government Private not for profit (PNFP) Private for profit (PFP) 1 2 3 A03 Does the health facility offer nutrition services? Yes No 1 2 A04 Does the health facility have a designated nutritionist? Yes (Skip to A08) No 1 2 A05 Does the health facility have a person in charge of nutrition? Yes No (Skip to A08) 1 2 A06 What is the cadre of the person in charge of nutrition services in the health facility? Cadre (specify)----------------------------------- A07 Has the person in charge of nutrition services received any in-service training in nutrition in the past two years? Yes No 1 2 A08 Does the health facility have an established quality improvement (QI) team? Yes No (Skip to A13) 1 2 A09 What is the composition of the health facility QI team? (Tick all that apply) Facility manager Heads of department/units Nutritionists CSO representative Community representative Other (specify)…………… 1 2 3 4 5 6 A10 Does the health facility have a QI work plan and budget? (Verify) Yes No 1 2 A11 Is the QI team functional (i.e., meets monthly and minutes are available)? Yes No 1 2 A12 Does the health facility leadership actively participate in the monthly QI meetings? Yes No 1 2 A13 Does the health facility have a continuous professional development (CPD)/continuous medical education (CME) schedule? Yes No (Skip to A15) 1 2 A14 Are nutrition topics included in the CPD/CME schedule? Yes No 1 2 A15 Is nutrition integrated in the health facility work plan and budget? Yes No 1 2 NO. QUESTION FILTERS
Uganda-NSD-Tool-Hospitals-Sep2015.docx