Appendix B: Blank Forms (Suitable for photocopying) Health Facility General Checklist A Human Resources & Facility Management B Pharmacy, Dispensary & Storeroom C Drugs & Supplies D Laboratory & Diagnostic Services E Equipment F Communicable Disease Control & Infection Prevention G Medical Records, Confidentiality & Referral H1.1 Ante Natal Care H1.2/3 Labor, Delivery, Postpartum & Newborn Care H2 Reproductive Health H3 Child Health H4 Communicable Diseases H6 Emergency Care H7 SGBV I Infrastructure Supervision Schedule form Attendance form Overseeing Supervisors Checklist Performance Appraisal
Appendix B: Blank Forms (Suitable for photocopying) A B C D E F G H1.1 H1.2/3 H2 H3 H4 H6 H7 I Health Facility General Checklist Human Resources & Facility Management Pharmacy, Dispensary & Storeroom Drugs & Supplies Laboratory & Diagnostic Services Equipment Communicable Disease Control & Infection Prevention Medical Records, Confidentiality & Referral Ante Natal Care Labor, Delivery, Postpartum & Newborn Care Reproductive Health Child Health Communicable Diseases Emergency Care SGBV Infrastructure Supervision Schedule form Attendance form Overseeing Supervisors Checklist Performance Appraisal
DMSS%20Supervision%20Manual%20FINAL%2030AUG09.docx