Neonatal sepsis:_________ How many newborns have been E17 referred or admitted in this facility Low birth weight/preterm:________ for the following conditions in the last 30 days? Birth asphyxia:_________________ Yes...................................1 Have you heard of newborn deaths E18 No..........2 SKIP TO E20 in this setting? Do not know .......99 SKIP TO E20 (If yes) How many deaths in the last E19 Number: ______________ 3 months? INSTRUCTIONS: this section, I will ask questions about abortion and post-abortion “In care.”
E17 How many newborns have been referred or admitted in this facility for the following conditions in the last 30 days? Neonatal sepsis:_________ Low birth weight/preterm:________ Birth asphyxia:_________________ E18 Have you heard of newborn deaths in this setting? Yes...................................1 No..........2 SKIP TO E20 Do not know .......99 SKIP TO E20 E19 (If yes) How many deaths in the last 3 months? Number: ______________ INSTRUCTIONS: “In this section, I will ask questions about abortion and post-abortion care.”
5a.-Health-Facility-Assessment-Tool.docx