The VHWs will be trained, supervised and provided basic commodities as per MOH guidelines. VHWs will conduct community mapping and sensitization in an effort to achieve inclusive maternal and child care (See annex 11). Community mapping will provide more comprehensive information about the population served by the VHWs who are linked to a particular health centre, with age and gender breakdowns, reproductive health histories, the actual number of pregnancies, newborn children and provides information about chronic diseases such as TB and HIV/AIDS. At the same time community mapping will require the support from community leaders to receive cooperation from the community and will re-emphasize the relevance of VHWs and therefore contribute to their self-esteem. The main duties of VHWs are: Community mapping (collecting vital statistics). See Annex 11 for the format for community mapping Continued tracing of community members who are in need of reproductive health services as well as TB, HIV/AIDS services (quarterly follow-up format, also in Annex 11) Basic health promotion and provision of basic curative health services in line with the policies Timely referral to health centre/hospital Reporting to health centre and attending or being represented (by other VHWs serving the same village) during monthly meetings at the HC To facilitate the cooperation, monitoring and payments of the VHWs attached to one health centre (ideally VHWs serve 20 households), the VHWs should preferably select one or more persons who could interact with the health centre on their behalf and could become a member in the HCC. At the health centre one of the health workers, for example Nursing Assistant will be assigned to be the focal point for the VHWs. Village Health Workers also associate with village health committees, who may play a relevant role at the village level. The VHW performance will be monitored quarterly by the health centre’s Focal Point (a health worker assigned by the nurse in charge to work with the VHWs). Depending on their performance in increasing the uptake of MNH/TB/HIV/AIDS services at the health centre the VHWs will be entitled to receive part of the PBF benefits earned by the health centre on a quarterly basis. The method for sharing the PBF benefits will be decided upon by the VHWs. (Memorandum of Understanding between health centre and VHW is in Annex 12). Figure 2 below reflects the institutional arrangements as described above.
Table 3. Implementation Plan for the PBF Project (February 2013 to June 2014) Activity Responsible Entity Timeline Costs (USD Costs (LSL) (Exchange rate 9.2) Comments Recruit PBF consultant to provide technical support in the evaluation of the PPTA proposals. MOH Procurement and MOH PBF Unit February 2013 7100 65320 Two staff members from IT Unit went for web enabled application study tour in Burundi from the 4th to the 7th June 2013 MOH IT UNIT and MOH PBF UNIT June 2013 12292 113085.4 Three PBF staff members and one from Procurement Unit to participate in the Joint Workshop for Fiduciary, Governance, Fraud and Anti-Corruption in South Africa. MOH PBF and Procurement Units May 7-9 2013 Prepare TOR for consultancy for Lesotho PBF web-enabled application MOH IT Unit and MOH PBF Unit June 2013 National Sexual and Reproductive Health Steering Committee (NSRHSC) meeting to approve Project Implementation Manual and PBF annual workplan and budget MOH PBF Unit July 3, 2013 PIM and PBF 2013/2014 annual work plan and budget endorsed Enrollment in one year training of nurse anesthetists in Zimbabwe and Tanzania (2 enrolled in Tanzania in May 2013, 3 will enroll in Zimbabwe in July 2013, and up to 6 in Tanzania in August 2013) Director of Nursing July 2013 156000 1435200 Two nurses left for training in Tanzania in May two left for Zimbabwe
MOH Ethics committee approval of impact evaluation design WB March 2014 Start preparations in scale-up districts MOH PBF Unit, PPTA April 2014 42000 386400 Review PPTA performance for contract extension for another year MOH PBF Unit April 2014 Total 4, 264, 522 39, 233, 602
Table 8. DHMT performance indicators (full details are in Annex 22): ASSESSED ACTIVITIES Maximum score possible % 1 100% of Health Centres have received at least one comprehensive quality assessment applying the appropriate checklist and protocol, and providing adequate feedback per quarter 35 17.5 2 100% of all health centres have a quarterly renewable contract with a business plan attached 20 10 3 100% of health centres have received one quarterly visit for data verification jointly with PPTA 15 7.5 4 DHMT prepares quarterly progress report 15 7.5 5 At least one Meeting at district headquarters with Health Centres’ staff during the past quarter 20 10 6 At least one hour training on a specific topic, offered immediately following the quarterly HC staff meetings 10 5 7 Monthly HC HMIS report entered in the HMIS database; report has a separate page with PBF indicators 20 10 8 DHMT activity planning well organized 5 2.5 9 Participation in the quarterly district PBF Steering Committee Meetings 15 7.5 10 HCs have 100% of qualified staff as per minimum criteria based on HC establishment list and assessed by actual presence 20 10 11 Management of the District Pharmacy 20 10 12 Maintain regular communication with health facilities 5 2.5 Total points 200 100 Regular adjustment of the quality assessment methodology Quality has various dimensions, and the PBF checklists can only measure some dimensions. Lessons learned from other PBF projects point at the importance of regular – typically once per year - review of the quality checklists. New norms and guidelines can thus be incorporated as they become available. Feedback from the end users can inform the design. Over time the quality bar will be put progressively higher to motivate health staff to continue improving the quality of the services. Adjusting the quality bar can be done in various ways: by adjusting the points value of certain items; by revising the items; by increasing the requirements where a numerical value is used and by lifting the threshold bar before a quality bonus is offered (at present set at 50%). Lastly, it is possible to increase the weight factor for quality scores, which currently stands at 25%. Usage of PBF benefits
Going concern – this accounting principle dictates that the financial statements be prepare as if the project shall exist into the foreseeable future. Consistency concept – as much as possible like transactions shall be treated similar in order to facilitate comparison from one period to the other. Financing agreement – the PBF unit shall comply with all the principles and policies of the financiers as stipulated in the financing agreement and also comply with the reporting requirements as agreed between the parties. The financial accounting year shall be a period of twelve months beginning in 1st April and ending 31st March. The accounting cycle The accounting cycle shows the flow of documents from the time a transaction is initiated, documents produced and the information on them entered into the system, the system will process the data and finally produces the useful reports. The chart below shows the flow; Monthly routines The following is a monthly accounting checklist that must be followed to ensure the accuracy and completeness of financial information. (Will be aligned to TOMPRO): TASK RESPONSIBLE OFFICER Date Enter all receipts and payments for the month using check/payment requisitions, deposit books, receipts etc Accountant PBF unit, hospital accountant, Accountant DHMTs Every day Raise and process invoices for services provided or costs to be recharged Accountant PBF unit, hospital accountant, Accountant DHMTs As required Fixed costs once a month Process petty cash and expense claims and ensure all supporting documentation is received (such as log books, petrol slips, etc.) Accountant PBF unit, hospital accountant, Accountant DHMTs Month end and whenever a replenishment is required Ensure bank balances are updated Accountant PBF unit, hospital accountant, Accountant DHMTs Weekly and whenever there has been a major transaction
data etc DHMT Motivation agreement for DHMT staff Motivation agreements, interviews of DHMT staff, District PBF Steering committee members Quarterly MOH Primary Health Care Directorate, PPTA Ex-ante verification – quantity of services at health centres: comments on the quality of data, timeliness of submission of report, over reporting or fraudulent data, Which services are (or not) performing well and why etc Health centre monthly report, ; interviews of health centre personnel Monthly PPTA verification officers and DHMT Ex-ante verification – quantity of services at hospitals comments on the quality of data, timeliness of submission of report, over reporting or fraudulent data Which services are (or not) performing well and why etc Hospital monthly report, interviews of hospital personnel Monthly PPTA verification officers, MOH Clinical Services Directorate Ex-ante verification – quality of services at health centres: Challenges noted in supportive supervision visits, have recommendations been addressed – why or why not; appropriateness of the checklist DHMT health centres supervision reports/quality checklist; interviews of health centre personnel who were present during supervision visits Quarterly DHMT and PPTA verification officers Ex-ante verification – quality of services at hospitals Challenges noted in supportive supervision visits, have recommendations been addressed – why or why not; use of the checklist Peer review mechanism/quality checklist, supervision reports; interviews of hospital personnel who were present during supervision visits Quarterly Personnel from other hospitals, MOH Clinical Services Directorate, DHMT, PPTA verification officers Ex-post verification – quantity and quality of services at health centres and hospitals: Challenges, areas for improvement, success stories, Randomly selected clients from the health facility registers for client satisfaction surveys by phone interviews or home visits Quarterly CBOs/NGOs contracted by PPTA Independent health facility quality of care assessments Health centre and hospital quality checklists In May each year MOH Quality Assurance Unit, PPTA Review and validation of invoices submitted by health centres Variation in quantity and quality of services among health centres within and across districts and why Heath centre invoice; interviews of health centre personnel, district PBG Steering committee, DHMT Monthly District PBF Steering Committee
Review and validation of invoices submitted by hospitals Variation in quantity and quality of services across hospitals and why Hospital invoice, interviews of hospital personnel Monthly MOH Clinical Services Directorate Review and validation of invoices submitted by DHMT DHMT invoice Monthly District PBF Steering Committee Use of incentive payments at health centres and hospitals Health centre and hospital quarterly report, field visits, interviews/group discussions Quarterly DHMT, PPTA, PBF Unit Performance of National Sexual and Reproductive Health Steering Committee Minutes and observation of meetings; interview of committee members, TWG, MOH PBF Unit Quarterly PPTA, PBF Unit Performance of the District PBF Steering committees Minutes and observation of meetings; interview of committee members, DHMT, health centres Quarterly PPTA, PBF Unit Performance of the health centre committees Minutes and observation of meetings; interview of committee members, DHMT, health centres Quarterly DHMT, PBF Steering committee Working relationships between district PBF steering committees and health centre committees Interviews of members of both committees Quarterly PPTA Performance of CBOs/NGOs on ex-post verification timeliness of the reports Review of ex-post verification reports, interviews of CBOs/NGOs Quarterly PPTA HMIS – quality of data, challenges, timeliness, areas for improvements; did the PBF help improve HMIS data? Health facility monthly reports on quantity of services, PPTA reports on data summited in invoices, PBF application Quarterly PBF M&E officer, PPTA PBF web-enabled application – usefulness, challenges and success stories, areas for improvement, is data in the paper monthly invoices the same as that in the website Review of the functioning of the PBF web-enabled application Quarterly MOH IT Unit, PPTA Performance of PPTA- Key performance indicators in the PPTA contract Interviews of various entities in the PBF institutional arrangements described in chapter 3 Quarterly PPTA, MOH PBF Unit Performance of PBF Unit: overall management of the project; adequacy of staffing Interviews of various entities in the PBF institutional Quarterly PPTA, MOH PBF Unit
Mokhotlong – 70 Thaba Tseka – 70 Berea - 65 Botha-Bothe - 76 Qacha's Nek - 59 71 71 66 77 60 72 72 67 78 61 73 73 68 79 62 74 74 69 80 63 Intermediate Result indicator Eight: People receiving tuberculosis treatment in accordance to the “Directly Observed Treatment Short course” (DOTS) X Number Aggregate – 8,553 Leribe - 1724 Quthing - 361 Mafeteng – 1003 Mohale’s Hoek- 1222 Mokhotlong – 318 Thaba Tseka – 297 Berea - 1424 Botha-Bothe - 1794 Qacha's Nek - 410 8,600 17,600 26,600 35,600 Yearly HMIS MOH HPSD Number of people receiving tuberculosis treatment in accordance to the “Directly Observed Treatment Short course” (DOTS) Intermediate Result indicator Nine: Pregnant women living with HIV who received ARV prophylaxis or complete course of ARV to reduce the risk of MTCT Percent Aggregate – 4,972 Leribe - 1977 Quthing - 295 Mafeteng – 601 Mohale’s Hoek- 478 Mokhotlong – 262 Thaba Tseka – 297 Berea - 568 Botha-Bothe - 269 Qacha's Nek - 225 5,000 10,500 16,000 21,000 Yearly HMIS MOH HPSD Number of pregnant women living with HIV who received ARV prophylaxis or complete course of ARV to reduce the risk of MTCT/Number of HIV pregnant women Intermediate Result indicator Ten: Children under 5 years whose weight and height are monitored regularly X Number Aggregate – Leribe - Quthing - Mafeteng – Mohale’s Hoek- Mokhotlong – Thaba Tseka – Berea - Botha-Bothe - Qacha's Nek - Yearly HMIS MOH HPSD Number of children under 5 years whose weight and height are monitored regularly according to the following protocol (six times in the first year, four times in the second year, and thereafter three times yearly from 2 to 5 years) recommended
manual Intermediate Result indicator Sixteen: Hospital and DHMT pharmacists receiving ESAMI training courses X Number 0 2 4 9 18 Yearly PBF Unit administrative records MOH Directorate of Pharmaceuticals Number of hospital and DHMT pharmacists receiving ESAMI training courses Intermediate Result indicator seventeen: Personnel receiving training in procurement and financial management Number 0 2 4 8 16 Yearly PBF Unit administrative records MOH Procurement Unit Number of personnel receiving training in procurement and financial management Intermediate Result indicator Eighteen: Village health workers trained Number 0 100 500 750 1,500 Yearly PBF Unit administrative records MOH Family Health Division Number of village health workers trained Intermediate Result indicator Nineteen: Monitoring and Evaluation officers and District Health Information Officers receiving formal M&E training X Number 0 2 4 8 12 Yearly PBF Unit administrative records MOH HPSD Number of Monitoring and Evaluation officers and District Health Information Officers enrolled in formal M&E training course *Please indicate whether the indicator is a Core Sector Indicator (see further ) **Target values should be entered for the years data will be available, not necessarily annually.
To support provider data collection as well as independent verification strategies (by the PPTA and by contracted agencies for counter-verification) to ensures maximum reliability and accuracy To provide technical guidance and training in PBF data planning, data collection and entering, recording and reporting requirements at various levels in the PBF project. To contribute – in close collaboration with the PPTA – to strengthening M&E capacity at facility, district level and national level To ensure that monitoring and evaluation of PBF is harmonized with M&E systems practices by other donors or development partners. To manage the PBF database, the PBF web-enabled invoicing and administrative processes website. This website will allow sharing of information on the Lesotho PBF Participate in the M&E technical working group (which has representation from the MOH and Development Partners) Qualifications: BA in Economics and Statistics or BSc in Public Health or Epidemiology. A degree in Epidemiology or Public Health (Monitoring & Evaluation) will be an added advantage; At least 4 years of professional experience in M&E of projects (including formulation of data collection tools, developing and supervising data collection, analysis and reporting systems); Previous experience and progressively increasing responsibility in the areas of supervision and continuous quality improvement; Extensive experience in Health Management Information System, including ability to develop and monitor database systems for data management and routine reporting, will be an added advantage; Extensive experience in working with district leaders/officials in a decentralized setting; Strong interpersonal communication skills, resourcefulness, ability to work independently, preserve high work ethics and trustworthiness; Strong computer skills including word, PowerPoint, excel and access; Experience in (web based) database management will be an added advantage; English (verbal and written) and Sesotho language fluency required. Position: Operations Officer; Duty station: Maseru General responsibilities The Operations Officer will support the PBF unit in all operational matters related to the primary task of the PBF unit, i.e. to lead the introduction and gradual up-scaling of the PBF project in Lesotho. A road map, which has been compiled during the preparation period, will guide a pilot phase, which entails introduction of PBF in two pilot districts. The pilot phase is expected to generate valuable experiences that will inform a detailed plan for the second phase. The Operations Officer will capture these experiences and prepare a detailed road map for this drawing from technical guidance provided by the PPTA. graduate out,
Community Mapping - HH per Village Date District Community Council Health Facility Code Village Code Chief VHW House Hold Head House Hold code Women of Child Bearing Age House Hold Member Code no dob/age to Hold Head in Health Post Family < 1 < 5 TB
Community Mapping Total for All Villages Health Centre District Name Council HC Women of Child Bearing Age (WCBA) Date Total Total Health Total Total Ante Natal Care Total Health Centre Total Post Natal Care Total Family Clients Total < 1 Total <5 Total on TB Total HIV Total clients on Therapy Patient
1 General Management Possible max score Obtained score Comments/action taken?) 1.1. Staffing 11 1.1.1 Duty roster present and guarantees qualified staff present during all official working hours and on call 7/24h (including for obstetric services) All or nothing 5 1.1.2 Staff clocking sheet updated and kept by in charge. If applicable, actions taken for leave without permission? All or nothing 3 1.1.3 Staff meeting conducted monthly Each monthly minutes contain: (1) date of the meeting; (2) signed list of participants; (3) follow-up of decisions taken during the previous meeting; (4) there is a list of developed recommendations or decisions taken; (5) each month the monthly financial balance is discussed; (6) minutes of the meeting are signed by the chair. At least three One point per meeting 3 1.2 Records, information management and planning 13 1.2.1 HMIS reports are filled, updated and submitted to the DHMT on schedule The report is submitted by the 7th day of the following month to the DHMT. If the report misses, give zero. 2 1.2.2 HMIS data analysis report for the quarter being assessed concerning priority problems according to the business plan Three priority health problems are followed each quarter and data have been updated up to the month prior to the supervisor's visit Each priority met is 1 point 3
1.2.3 Business plan The HC business plan is complete and provides sufficient analysis translated into action. The HC convincingly demonstrates that it implements plans expressed in last business plans according to 3 strategies. Each criteria met is 1 point 3 1.2.4 Financial and accounting documents in relation to PBF available and well kept (Bank statements, receipts, invoices etc.) (1)Filed in clearly labelled files. (2)Cashbook is well balanced and indicates both receipts of PBF benefits and expenditures; (3)data last quarter have been correctly reflected in business plan Each criteria met is 1 point 3 1.2.5 Weekly schedule of health education sessions visible on the wall All or nothing 2 Total Points General Management 24 2 Child survival including IMCI and EPI Possible max score Obtained score Comments/action taken?) 2.1 Integrated Management of Childhood Illnesses strategy is applied 7 2.1.1 Protocol is available and accessible to the staff in the consultation room All or nothing 1 2.1.2 Observe three children in consultation room if they are diagnosed and treated according to IMCI strategy/protocol One 3 2.1.3 Under 5 services (EPI, growth monitoring, curative care, health promotion) are available every day (at least five days a week). Verify with Under 5 register If not 5 days, 0 points 3 2.2 Stock of Child health booklets (bukana) available No of child health booklet should correspond to U 5 target population, and at least 1/3 of the target population in the 3 months stock All or nothing 1 Check if there is any stock of bukana at the facility
5.4 IUCD available and staff trained to use it (1)At least five IUCDs and (2) at least one staff trained to use it Each criteria met is 1 point 2 5.5 Implant method available and staff trained to use it (1) At least five implants available and (2) at least one staff trained to use it Each criteria met is 1 point 2 5.6 Women referred to hospital for permanent method with a medical indication or voluntarily. All or nothing 2 5.7 Equipment available and working Scales, sphygmomanometer, vaginal specula, light source, gloves, decontaminants/disinfectant, Ayre’s spatula, cervical brushes, slides & fixative (also for PAP smears), IUCD insertion kits For each non item, deduct 0.5 point 5 Total Points Reproductive Health 15 6 Essential Medicine (EM)Management Possible max score Obtained score Comments/action taken?) 6.1. Staff maintains stock cards for EM showing security stock levels = monthly average consumption x 3 Supply in register corresponds with 3 monthly physical supply: random sample of three EM Each criteria met is 1 point 3 6.2 Main pharmacy of the Health Centre delivers medicines to health facility departments according to requisition 6 missing
nothing 8.1.2 All: Laboratory: HB, results available All or nothing 2 8.1.3 All: Obstetrical examination done: Uterine height, recorded All or nothing 2 8.1.4 All: Minimum Tetanus 2 administered All or nothing 1 8.1.5 All: Tested for Syphilis ((VDRL test)at first visit All or nothing 1 8.1.6 All: Tested for HIV at first ANC visit All or nothing 1 8.1.7 All re-tested at 36 weeks All or nothing 1 8.1.8 All pregnant women received their MBP (ARV prophylaxis or complete course of ARV to reduce the risk of MTCT) All or nothing 3 8.1.9 All columns well filled including the identification of problems if any, and actions taken All or nothing 1 8.2 Lesotho Obstetrical Record (LOR) booklets for mother available: at least 50 in stock 1 8.3 Did women pay for any of the services (LOR), Ferrous Sulphate or other items). Ask 4 women in the waiting room ad randomly If any woman paid, then 0 points 2 8.4 ANC conducted by qualified personnel Registered nurse midwife, verified in ANC register All or nothing 1 8.5 Functional equipment Weighing scale and calibrated to zero, Stethoscope and BP machine available and functional in ANC room All or nothing 1 8.6 ANC shelter, being utilised and clean All or nothing 5
8.13 Availability of at least 2 sterilized delivery packs with as content Content at the least 1 pair of episiotomy scissor, 2 artery forceps non toothed, 2 artery forceps toothed 1 kidney dish, 2 bowls (medium and large), 4 dressing towels, and one needle holder, All or nothing 2 8.14 Under buttocks drapes 1 box in stock All or nothing 1 8.15 Delivery table in good state Table in two parts with removable non-torn plasticized mattress and two functional leg supports All or nothing 1 8.16 Use of the Partogramme in the Lesotho Obstetric Record Verify three randomly selected partogrammes whether filled according to the norms Each criteria met is 1 point 3 8.17 Deliveries performed by skilled personnel Identification of the Registered Midwife from names in the register All or nothing 1 8.18 Newborn Care 3 8.18.1 Sterile clip for umbilical cord All or nothing 1 8.18.2 1% tetracycline eye ointment All or nothing 1 8.18.3 Vitamin K All or nothing 1 8.19 APGAR during delivery noted Filled in the partogramme 1st , 5th and 10th minutes. Supervisor verifies 3 partogrammes with APGAR scores If not correct 0 points 3 8.20 Adequate in-patient rooms 2 Mattress covered in impermeable plastic All or nothing 1
(1) date of the meeting; and signed list of participants; (2 )follow-up of decisions taken during the previous meeting; (3) there is a list of developed recommendations or decisions taken; (4) Training topics (5) minutes of the meeting are signed by the chair. met is 1 point 10.4 Monthly meetings with HCC (1) date of the meeting; and signed list of participants; (2 )follow-up of decisions taken during the previous meeting; (3) there is a list of developed recommendations or decisions taken (4) minutes of the meeting are signed by the chair. Each criteria met is 1 point 4 Total Points Community Based Services 21
Annex: List of tracer medicines The following Tracer medicines and supplies are available Criteria Max score Score Obtained Comment 1 Amoxycillin Each criteria met is 1 point 1 2 Cotrimoxazole Each criteria met is 1 point 1 3 Erythromycin Each criteria met is 1 point 1 4 Ceftriaxone Each criteria met is 1 point 1 5 Diazepam injection Each criteria met is 1 point 1 6 Gentian violet or nystatin Each criteria met is 1 point 1 7 Paracetamol syrup Each criteria met is 1 point 1 8 Oral iron preparation (Ferrous gluconate or ferrous lactate) Each criteria met is 1 point 1 9 Folic Acid Each criteria met is 1 point 1 10 Vitamin A Each criteria met is 1 point 1 11 Albendazole Each criteria met is 1 point 1 12 Salbutamol MDI and Appropriate Spacers Each criteria met is 1 point 1 13 Salbutamol solution for nebuliser Each criteria met is 1 point 1 14 Adrenaline + solution for nebulisers Each criteria met is 1 point 1 15 Atropine Each criteria met is 1 point 1 16 Prednisone tablets Each criteria met is 1 point 1 17 ORS packets Each criteria met is 1 point 1 18 IV solution : N Saline, 5% dextrose, Ringer Lacate Each criteria met is 1 point 1 19 Sterile syringes and needles Each criteria met is 1 point 1 20 Swabs and skin disinfectant Each criteria met is 1 point 1 21 Cannulae 24G, 22G Each criteria met is 1 point 1 22 IV sets (60drops/ml) Each criteria met is 1 point 1 23 Naso gatric tubes (5,8,10 FG) Each criteria met is 1 point 1 24 Medicine measures and glasses Each criteria met is 1 point 1 25 Paediatric nebulizer mask, chamber and tubing Each criteria met is 1 point 1
Total Points EM management 17 Remarks 4 Tracer Medicines and supplies (Minimum Stock = Monthly Average Consumption x 3) List in annex – See the priority list Criteria Possible max score score Comments/action taken?) 4.1 Minimum stock (3 month supply of all medicines) 50 4.1.1 All (100%) drugs/supplies have a minimum stock 50 4.1.2 Between 75% and 100% of the tracer medicines have a minimum stock 25 4.1.3 Less than 75% of the medicines have a minimum stock 0 Total points tracer drugs and supplies 50 Remarks 5 Emergency Services Criteria Possible max score score Comments/action taken?)
6.5 Conditions in waiting area for child services Sufficient benches and or chairs, protected against sun, rain and cold? All or nothing 1 6.6 Immunization and cold chain 22 6.6.1 Child immunization register well maintained (1)System is capable of identifying drop outs and Fully Vaccinated Children (2) action taken for drop outs? (Schedule and record of appointments in register, action taken also to be noted in register) Each criteria met is 1 point 2 6.6.2 EPI refrigerator 6.6.2.1 Presence of a fridge – temperature monitoring form at fridge available, filled twice a day If both not met 0 points 1 6.6.2.2 Temperature remains between +2 and +8 C on temperature monitoring form 1 6.6.3 Appropriate storage of vaccines 6.6.3.1 Freezing compartment: Polio All or nothing 1 6.6.3.2 Non-freezing compartment: BCG, Pentavalent, TT, HPV, measles All or nothing 1 6.6.3.3 Absence of vaccines which are expired All or nothing 1 6.6.3.4 Readable labels on all vaccines All or nothing 1 6.6.3.5 Vaccine Vial Monitor (VVM) The VVM shows the temperature exposure hence the potency of the vaccines; if not favourable appropriate action has been taken All or nothing 1 6.6.4 Appropriate stock of vaccines
7.9 Examination bed available with mattress Non-torn, plastic cover, clean sheet, specific for the OPD consultations only All or nothing 1 7.10 Common illnesses management (Observe 5 patients during consultation and/or collect bukanas from patients present) Each case correctly diagnosed and treated met is 1 point 5 Total Points General Consultation 22 Remarks 8 Reproductive health Criteria Possible max score Obtained score Comments/action taken?) 8.1 Confidentiality in consultancy room assured Room with closed and lockable doors, curtains at windows or glass All or nothing 1 8.2 Family planning methods available for demonstration potential users Contraceptive Injections; Implants; Intrauterine Contraceptive Device (IUCD); oral contraceptives, penis model and condoms (F and M) are available for demonstration (the latter also for HIV education) All or nothing 2
8.3 Stock of oral and injectable contraceptives in adequate quantity 3 months stock available All or nothing 1 8.4 IUCD available and staff trained to use it (1)At least ten IUCDs and (2) at least one staff trained to use it Each criteria met is 5 point 10 8.5 Implant method available and staff trained to use it (1) At least ten implants available and (2) at least one staff trained to use it Each criteria met is 1 point 2 8.6 Women referred to hospital for permanent method with a medical indication/voluntarily All or nothing 2 8.7 Equipment available and working Scales, sphygmomanometer, vaginal speculae, light source, gloves, decontaminants/disinfectant, Ayre’s spatula, cervical brushes, slides & fixative (also for PAP smears), IUCD insertion kits For each missing/ non functional item deduct 0.5 point 5 Total Points Reproductive Health 23 Remarks
9.6 Postnatal Care 5 9.6.1 Post Natal care register available, including , Family Planning, PMTCT, etc. according to guidelines All or nothing 1 9.6.2 Postnatal care register with PNC visits examinations within 6 hours, 48 hours, 6-8 weeks and 14 weeks indicated All or nothing 4 Total Points ANC and PNC services 27 Remarks 10 STIs, HIV and TB Criteria Possible max score Obtained score Comments/action taken?) 10.1 Guidelines available, accessible to staff and followed 10 10.1.1 HIV/AIDS Protocol. Verify with 3 patients if HIV testing and counselling was provided (after consultation) Each criterion met, one point 3 10.1.2 ART Protocol Identify 3 HIV+ patients on ART and check if protocol was followed properly Each criterion met, one point 3 10.1.3 Post exposure protocol for sexual assault survivors, ask nurse if knowing the procedure All or nothing 1 10.1.4 STI management. Check 3 patients from OPD register for proper classification of STIs Each criterion met, one 3
point 10.2 Existence of a HTC register according to norms All or nothing 1 10.3 Existence of a lab register correctly completed according to norms All or nothing 1 10.4 Staff trained in HIV rapid testing and counselling Counselling and testing is done by a trained provider All or nothing 1 10.4 Follow up for HIV clients All or nothing 3 10.4.1 Monitoring tracking tool is used All or nothing 1 10.4.2 CD4 cell counts available All or nothing 1 10.4.3 PCR register for infant follow up, especially for infants born to HIV positive mothers is available All or nothing 1 10.5 TB Treatment Register (take 3 ad random patients) National TB Control Guidelines . Check 3 TB cases from TB register whether (1) sputum was taken and (2) results known (3) HIV test taken (4) initiated treatment (5) End of treatment/cured is recorded Each criteria met is 1 point 5 10.6 Referral system and follow up for TB patients Each (AFB PTB )patient has a person attached to him/her who supervises DOTS: proof of in register; mobile phone number of such a supervisor is registered All or nothing 2 Total Points STIs, HIV and TB management 22 Remarks
diagnosis and is compliant with clinical protocols and compliance with national 'treatment guidelines'. nothing 11.9.4 Copy of discharge summary in file with final diagnosis on discharge and treatment follow-up. All or nothing 2 Total points in-patients wards 32 Remarks 12 Delivery Room Criteria Possible max score score Comments/action taken?) 12.1 Running Water and liquid soap in delivery room available A functioning water source. All or nothing 2 12.2 Light in delivery room 24 hours Electricity, solar light or rechargeable battery lamp or gas/paraffin lamp filled with paraffin/gas All or nothing 2 12.3 Waste from Maternity correctly handled Placenta is disposed in a red plastic container with lid All or nothing 1 12.4 Delivery room is well-maintained 5 12.4.1 Walls with durable materials and painted All or nothing 1 12.4.2 Curtain between delivery bed and door All or nothing 1 12.4.3 Delivery room cleaned with disinfectant. Ask for proof/disinfectant bottle All or nothing 1
14.1.1 One transfusion certified/ laboratory staff member on call All or nothing 1 14.1.2 Sufficient supply of reagents for grouping and X-matching, properly stored All or nothing 1 14.1.3 Minimum units of fresh blood O rhesus negative type, expired available (Guideline for minimum to be checked) All or nothing 1 14.1.4 Blood stored according to the norms (between 2 to 4C); refrigerator is functional temperature measured twice daily All or nothing 2 14.1.5 Test kits for HIV, VDRL and HepB tests available, and stored blood tested All or nothing 1 14.2 Sterilization according to the norms 4 14.2.1 Functioning sterilizer available All or nothing 1 14.2.2 Sterilizer in separate room from theatre All or nothing 1 14.2.3 Use of chemical heat indicators All or nothing 1 14.2.4 Register for sterilizations used and completely filled All or nothing 1 14.3 Minor surgery done in a separate room from the major surgical procedures All or nothing 1 14.4 Functioning theatre lamp and mobile lamp All or nothing 1 14.5 Functioning theatre table All or nothing 1 14.6 Emergency Preparedness 8 14.6.1 At the least 5 sterilized major surgery sets available, with date of sterilization indicated on the pack All or nothing 1
15.4 Results recorded correctly in laboratory register and match with results in inpatient sheets or OPD examination cards Supervisor verifies last five results Each criteria met, one point 5 15.5 Availability of parasites demonstrations On plastic paper, in a color book, or put on wall Stools: entamoeabae, flagellates: All or nothing 1 15.6 Microscope available and functional functional objectives; immersion oil available, mirror or electricity, blades, cover glass, All or nothing 1 15.7 HIV tests available 2 15.7.1 At the least one HIV rapid kit (sealed) available in the laboratory; non-expired All or nothing 1 15.7.2 CD4 counts performed All or nothing 1 15.8. TB tests are available 2 15.8.1 At the least 20 (sputum) tests available in the laboratory; All or nothing 1 15.8.2 DST (Culture and drug susceptibility) performed (for regional laboratory) All or nothing 1 15.9 Centrifuge available and functional All or nothing 1 15.10 Waste evacuation correctly carried out 2 15.10.1 Organic waste in a bin with lid All or nothing 1 15.10.2 Security container for sharp objects available and destroyed according to waste disposal guidelines All or nothing 1
15.11 Availability of a functional safety cabinet in the laboratory All or nothing 2 Total Points Laboratory 20 Remarks 16 Radiological Services Criteria Possible max score score Comments/action taken?) 16.1 Radiological department manned by qualified staff All or nothing 2 16.2 Frequent monitoring for radiological exposure according to protocol. Monitors sent to SA for reading exposure. All or nothing 3 16.3 Radiological equipment available and functional (x-ray, ultrasound scan) All or nothing 3 16.4 Availability of protective clothing and necessary safety precautions in place All or nothing 3 16.5 Availability of 3 month stock of consumables (x-ray films, fixers, envelopes etc. ) Daily consumption known? All or nothing 3 Total points Radiological Services 14 Remarks 17 Specialized Services: Physiotherapy, dentistry, Criteria Possible Comments/action
met is 1 point Reproductive Health Magnesium Sulphate Each criteria met is 1 point 1 Oxytocin Each criteria met is 1 point 1 Ergometrine Each criteria met is 1 point 1 Male Condoms Each criteria met is 1 point 1 Female condoms Each criteria met is 1 point 1 Copper - T Each criteria met is 1 point 1 Noristerate Each criteria met is 1 point 1 Microgynon Each criteria met is 1 point 1 Lofeminal Each criteria met is 1 point 1 Nordette Each criteria met is 1 point 1 Microlut Each criteria met is 1 point 1 Solo Shot Each criteria met is 1 point 1 Depo Provera Each criteria met is 1 point 1 Microval Each criteria met is 1 point 1 Others Amoxycillin Each criteria met is 1 point 1 Cotrimoxazole Each criteria met is 1 point 1 Erythromycin Each criteria met is 1 point 1 Ceftriaxone Each criteria met is 1 point 1 Diazepam injection Each criteria met is 1 point 1 Gentian violet or nystatin Each criteria met is 1 point 1 Paracetamol syrup Each criteria met is 1 point 1 Oral iron preparation (Ferrous gluconate or ferrous lactate) Each criteria met is 1 point 1 Folic Acid Each criteria met is 1 point 1 Vitamin A Each criteria 1
met is 1 point Albendazole Each criteria met is 1 point 1 Salbutamol MDI and Appropriate Spacers Each criteria met is 1 point 1 Salbutamol solution for nebuliser Each criteria met is 1 point 1 Adrenaline + solution for nebulisers Each criteria met is 1 point 1 Atropine Each criteria met is 1 point 1 Prednisone tablets Each criteria met is 1 point 1 ORS packets Each criteria met is 1 point 1 IV solution : N Saline, 5% dextrose, Ringer Lacate Each criteria met is 1 point 1 Sterile syringes and needles Each criteria met is 1 point 1 Swabs and skin disinfectant Each criteria met is 1 point 1 Cannulae 24G, 22G Each criteria met is 1 point 1 IV sets (60drops/ml) Each criteria met is 1 point 1 Naso gatric tubes (5,8,10 FG) Each criteria met is 1 point 1 Medicine measures and glasses Each criteria met is 1 point 1 Paediatric nebulizer mask, chamber and tubing Each criteria met is 1 point 1 HIV test kits Each criteria met is 1 point 1 PCR kit Each criteria met is 1 point 1 Lignocaine Each criteria met is 1 point 1 PMTCT IMCI Diabetes Hypertension Oral Health
9 Participation in the quarterly district PBF Steering Committee Meetings 15 10 HCs have 100% of qualified staff as per minimum criteria based on HC establishment list and assessed actual presence 20 11 Management of the District Pharmacy 20 12 Communication with health facilities 5 13 PBF funding is made available to HCs in a timely manner and accountability for use of PBF funds is ensured 10 TOTAL 200 No Indicator/Performance Measure Data Sources Composite Criteria/Validation Criteria points Score Justification of score 1 100% of Health Centres have received at least once per quarter a comprehensive quality assessment applying the appropriate checklist and protocol, and providing adequate feedback DHMT quarterly work plan File containing HC quality assessment reports Travel request forms signed HC assessment reports will be reviewed to verify that the DHMT has performed quality assessments of each HC according to the agreed protocol mentioned in quality checklist health centres. In case HCs have not been assessed during the quarter in line with above requirements, there will be 5 points deduction for each HC not assessed during quarter. 25 2 100% of all health centres have a quarterly renewable contract with a business plan attached File containing HC contracts with business plans HCs will have contracts that have a 3 month duration equal to the quarters in a year. These contracts should be: complete and duly signed as per approved 20
participants List description of the session Feedback received from participants suggestions collected for topics upcoming training sessions In case training report is missing: nil points. For each HC not attending: 2 points deduction 7 Monthly HC HMIS report entered in the HMIS database; report has a separate page with PBF indicators Printed HC HMIS Monthly / Cumulative (per quarter) Report Data available in the HMIS DB Monthly HC HMIS reports (original) HMIS/PBF reports received from HCs are “cleaned” in case of errors and complemented in case of missing items. Subsequently the following needs to be done: Processed monthly HC HMIS/PBF Report available and filed; one copy sent to PPTA for routine data verification Original HC HMIS/PBF reports submitted by HC available and filed Monthly cumulative HMIS/PBF reports available Report printed within 7 working days after end of the month Routine HMIS data monthly reports compared and harmonised with PBF indicators data report For each HC report not processed, filed, etc. as indicated within the stated time limit: 3 points deduction. 20 8 DHMT activity planning well organized Activity plan Activity calendar Brief activity report Annual plan is available and displays the regular pattern of reviews and meetings Monthly Activity Plan is available according to set format at the start of each 5
cooperation with the DHMT. However, an in-charge will have one extra performance criterion to be met: all staff should have had their performance evaluation done in each quarter. For each member of staff who has not receive a performance review: the in charge will face a deduction of her/his performance score of 10 points. Quarter assessed: Individual Performance Evaluation for Health Centre Staff Criteria 25% Score 50% Score 100% Score Max Score Professional Awareness includes the following: (20 points) (see note on last page) Timeliness Arrived frequently late (at the least four times past month Arrived sometimes late (1 to 3 times per month) Was always on time 8 Availability Has been frequently absent from his/her service without any clear motive (at the least four times past month) Has been a few times absent from his service without clear motive (1 to 3 times per month) Was never absent from his/her service without known and valid motive 8 Uniform Did not wear a uniform during working hours (even once per month) Neglected uniform (dirty or torn or not ironed) Uniform always worn and proper (washed ; ironed and not torn) 4 Team spirit includes the following: (30 points) (see note on last page) Interpersonal Relationship Frequently in conflict with colleagues (reported more than once to his/her superior during the past month) Sometimes in conflict with colleagues (reported once to his/her superior) Never in conflict with colleagues 6 Collaborative spirit Frequently refused to assist colleagues when asked (more than once per month) Sometimes refused to assist colleagues (even once) Never refused to assist colleagues 6 Dedication Frequently left work unfinished without somebody taking over under the argument that official working hours were up (more than 3 times past month) Sometimes left work unfinished without somebody taking over using the argument that official working hours were up (1 to 3 times per month) Never left work unfinished without somebody taking over 6
Initiative Has never done any additional work Has always awaited a command from higher up to carry out additional work Has at least once done additional work without supervisor asking him/her to do so 6 Care 0ff duty hours to guarantee 24/7 care Not applicable (staff not on off-duty roster) or very hesitant to participate in off duty roster, on three or more occasions not available during last month, leaving duty to colleague Most of the time willing to participate in off duty roster, but on two occasions last month was not available and left duty to colleague Always willing to participate in off duty roster and is always available when patient care demands this 6 Technical Competency and flexibility during work: (40 points) Organization Never has a daily work schedule (assessed during internal work supervision) Not always has a daily work schedule (at least once during internal supervision) Always has a daily work schedule 10 Quality of work Never adheres to specific work related norms and standards (assessed during internal supervision) Not always adheres to work related norms and standards (found at least once during internal supervision) Always adheres to specific work related norms and standards 14 Quantity of work Never finishes his/her daily work based on his/her own daily work schedule (assessed during internal supervision) Not always finishes his/her work based on his/her own daily work schedule (found at least once during internal supervision) Always finishes his/her work according to his/her daily work schedule 16 Willingness and aptitude for personal development : (10 points) Takes into account advice and from previous internal and Never takes care of such recommendations (concluded during internal and external supervisory visits) Not always takes care of such recommendations (if this happens once or more) Always takes into account recommendations of internal and external supervisory visits 10
guidance) Health centre name: xxxx Health centre in/charge Ms A period for which bonus is allocated 3rd Q 2013 maximum bonus for HC staff motivation in LSM set aside (A) LSM 5000 Amount based on decision taken in business plan name (staff who completed one full quarter) position held Per full gross salary (with allowances) 100 LSM 1 points allocated; rounded additional 20 points for In/ch and 10 points for focal point VHW total Individual score during last quarter total score relative score bonus B C D=B+C E H= F/G I=H*A Ms A Nurse clinician in Charge 122 20 142 84% 0.49 2441 Ms B Midwife 89 89 79% 70.31 0.29 1439 Ms C Nurse assistant (focal point) 43 10 53 66% 34.98 0.14 716 Mr D Cleaner 10 10 90% 9 0.04 184 Mr E Night watchmen 12 12 90% 10.8 0.04 221 TOTAL 294 100% 5.000 Annex 25. INDIVIDUAL PERFORMANCE EVALUATION DHMT STAFF Individual Performance Evaluation for District Health Management Team Staff
DHMT: District Name Employee In case of (acting) DHMT Director: the District Council will decide how to appraise the individual performance of the DHMT director in cooperation with PHC Directorate of the MOH. However, the director will have one extra performance criterion to be met: all staff should have had their performance evaluation done in each quarter. For each member of the DHMT staff who has not receive a performance review: the DHMT director will face a deduction of her/his performance score of 10 points. Quarter assessed Criteria 25% Score 50% Score 100% Score Max Score Professional Awareness includes the following: (15 points) (see note on last page) Timeliness Arrived frequently late or left early without proper reason (at the least four times past month) Arrived sometimes late or left early without proper reason (1 to 3 times per month) Was always on time and left at the regular end of duty time 7 Availability Has been frequently absent from his/her service without any clear motive (at the least four times past month) Has been a few times absent from his service without clear motive (1 to 3 times per month) Was never absent from his/her service without known and valid motive 8 Team spirit includes the following: (30 points) (see note on last page) Interpersonal Relationship Frequently in conflict with colleagues (reported more than once to his/her superior during the past month) Sometimes in conflict with colleagues (reported once to his/her superior) Never in conflict with colleagues 8 Collaborative spirit Frequently refused to assist colleagues when asked (more than once per month) Sometimes refused to assist colleagues (even once) Never refused to assist colleagues 8
Dedication Frequently left work unfinished without somebody taking over under the argument that official working hours were up (more than 3 times past month) Sometimes left work unfinished without somebody taking over using the argument that official working hours were up (1 to 3 times per month) Never left work unfinished without somebody taking over 7 Initiative Has never done any additional work Has always awaited a command from higher up to carry out additional work Has at least once done additional work without supervisor asking him/her to do so 7 Technical Competency and flexibility during work: (40 points) Organization Never has a daily work schedule, including fieldwork (assessed during internal work supervision) Not always has a daily work schedule including fieldwork (at least once during internal supervision) Always has a daily work schedule, including field work 10 Quality of work Never adheres to specific work related norms and standards (assessed during internal supervision) Not always adheres to work related norms and standards (found at least once during internal supervision) Always adheres to specific work related norms and standards 14 Quantity of work Never finishes his/her daily work based on his/her own daily work schedule (assessed during internal supervision) Not always finishes his/her work based on his/her own daily work schedule (found at least once during internal supervision) Always finishes his/her work according to his/her daily work schedule 16 Willingness and aptitude for personal development : (10 points) Takes into account advice and from previous Never takes care of such recommendations (concluded during internal and external supervisory visits) Not always takes care of such recommendations (if this happens once or more) Always takes into account recommendations of internal and external supervisory visits 10
Annex 27. BUSINESS PLAN FOR HEALTH CENTRES HEALTH CENTRE:....................................... Agreement No : Agreement Period : Approval date : District : Ownership : Catchment population : Year : 2013 Signed at………………………………. the ……./……./2013 Name HCC chairman……………… Name HC in charge……………………………. Signature Signature Name DHMT……………………………… Name PPTA……………………………………… Signature Signature Copies : HC, DC-DHMT/PBF Unit-PPTA Target Population Catchment area= No Incentivized indicator % of catchment population Yearly target population in numbers Per quarter (target population divided by 4) 1 Number of new outpatient consultations for curative care consultations 2 Number of pregnant women having their first antenatal care visit in the first trimester 3% 3 Number of pregnant women with four antenatal care visits 3% 4 Number of women delivering in health facilities 2.71%
monthly select a random sample of users of the health services of health facilities mentioned in this contract provide names and addresses that enable the CBO to trace the user verify if questionnaires are filled in correctly Compile a summary of all CBO reports and present it to the CBO and the RHC during half half-yearly meetings Insert the patients satisfaction score into the quality subsidy Pay a sum of .....LSM per completed questionnaire Article 14 If all questionnaires are correctly filled in and timely submitted, a quality bonus of maximal 20% will be paid to the CBO III Payment modalities Article 15 a. Payment will be done within 25 days after submission of the questionnaires depending on availability of funds b. Payment will be transferred in a bank account of the CBO. IV. Duration Article 16 The present agreement has duration of three months renewable . It will take effect from the first of (date) onwards and will expire on (date) V. Sanctions, suspending or no renewal of the agreement Article 17 The present agreement might be suspended in case of: Fraudulence in completing the questionnaires. In case of suspected fraud, the contract and all payments will be suspended until fraud mitigating measures have been put in place and verified and approved by PPTA. In a first fraud case, 50% of the payment will be withheld. A second fraud cause will lead to termination of the contract. Non-respect of the commitments assigned to each party: The claimant party shall notify the other party of the suspending of the agreement and give in writing an explanation of what reasons led to this suspension VI. Settlement of disputes, disagreements Article 18 Any dispute regarding the interpretation and the execution of the present agreement will be referred to the District Council, and if still cannot be resolved will be filed to the RBF District Steering Committee to decide. Article 16 Both parties are bound to carry out in good faith this agreement Article 17 There will be no provision for indemnification at the end of the agreement Place………………………… date…………
sales etc. received Give change if applicable Count all the cash collected at the end of the day Balance the Cash with the receipt book. Transfer the amount to the Daily and Weekly worksheet (CHC001). Lock the cash in a cash box. Cash Cash book Daily and Weekly worksheet (CHC001). None Same time End of day End of day End of day End of day None None Cash book None None Nurse Nurse Nurse Nurse Nurse
of and PBF funds Check if funds have been transferred into the health centres bank account. If transferred issue a receipt to the amount credited in the bank account Enter the transaction in the Daily and Weekly worksheet (CHC001) Bank Statements Receipt Worksheet CHC001 Same time Same time Same time None Receipt Book Worksheet “ “ Petty cash Determine the cash requirement and complete the petty cash requisition form Present to the nurse in charge or authorised official for authorisation Present the authorised requisition form to the designated cashier to obtain Form CHC003/1 Form CHC003/1 Form CHC003/1 Same time “ “ None None None officer and officers officer and cashier
cash Petty cash Obtain a completed petty cash requisition form from the requesting officer Check and verify the validity and authenticity of the requisition form submitted Obtain payee’s signature on the requisition form and disburse the amount requested Process the payment in either the Daily and Weekly workbook or the petty cash book Obtain cash and retain the petty cash reconciliation form for subsequent reconciliation Petty cash requisition form CHC003/1 Petty cash requisition Cash, petty cash requisition form CHC003/1 workbook CHC001, petty cash requisition CHC003/1 Cash, petty cash form CH003/2 Same time Same time Same time Daily Same time None None Cash book or petty cash book Daily workbook or petty cash book None Cashier Cashier Cashier Cashier Payee Petty cash Enter details of payments on the petty cash reconciliation form to reconcile cash and receipts Return the reconciled form CHC003/2 plus receipts and change to the cashier Petty cash form CHC003/2 Petty cash form CHC003/2, receipts Petty cash form Daily Daily Daily None None None Payee Payee Payee, cashier
Worksheet (CHC002). Make PAYE deduction per tables supplied by Lesotho Revenue Authority (LRA). Enter all other deductions under their respective columns on the Payroll Worksheet Cross check for arithmetic errors. Send the form for checking and authorization to the manager. Draw a cheque equal to the net pay in the form. Cash the cheque and pay staff or send to the bank for payment into the staff accounts. Complete the Nominal Roll form required by CHAL Secretariat Obtain the staff members signatures on the form and send to LRA Tax Tables Deductions schedule, Payroll form CHC002 “ Payroll form CHC002 Cheque Cheque Nominal Roll, Payroll Worksheet CHC002 Nominal Roll Payroll form CHC002, file Month end Same time “ Same time “ “ “ “ Same time “ None None “ None “ None “ “ None “ “ “ “ “ “ “ “
the supporting documentation. Deliver or cash the cheque as the case may be. File the documents by numerical sequence File “ “ “ Bank Obtain (Monthly) bank statement from the bank. Check if the cheques written have gone through. Keep the statement safe for the accountant who will perform the reconciliation. Bank statement Bank statement File Month end Month end “ None None “ Nurse INVENTORY Drugs a) Record receipt of drugs into a bin card showing quantity received. (CHC005) Update the balance with new receipts. (CHAL005) Delivery note, bin card CHC005 Invoices Same time “ Bin card “ Nurse “
Issues a) The dispensary prepares drugs requisition b) Send the request to the for approval and issue from stores. c) Issue requested drugs using First In First Out (FIFO). d) Record the drugs issued to the dispensary in the Bin card. e) Update the balance with the issues. e) Number and file the requisition in the drug issues file. f) Lock the stores for unauthorized access. Drugs requisition form CHC006 “ Bin card Bin card File Lock and key Same time “ “ “ Same time “ “ None None “ “ None “ “ “ “ “ “ “