Service Protocol Reference Guide for the Complementary Package of Health Services (CPA)

Service Protocol Reference Guide for the Complementary Package of Health Services (CPA)

NSHPIC

Version 111009

No / Name CPA Service / Description / Primary Data Collection Tools[1] / Secondary Data Collection Tools[2] /
1 / New outpatient consultation by a doctor / Any new curative care OPD visit attended by a Doctor during the evaluated month / Curative Care Register / Original prescription for drugs dispensed kept at the pharmacy which includes cost of drugs. Drugs register and stock cards conform.
Lab/radiology register contains proof of requested exams.
2 / New outpatient consultation by a doctor of an indigent patient / Any new curative care OPD visit by an indigent patient attended by a Doctor during the evaluated month. Indigents identified according to local norms. Maximum of 20% of all new curative consultations and or admissions during the previous month. / Indigent register / Proceedings Indigent committee
Community Client Satisfaction Survey
3 / Counter-referral slip arrived at the Health Center / A counter-referral note filled by the MD, sent to the health center, during the evaluated month. The feedback must at least mention the diagnosis and treatment received. The carbon copy of the referral note is only remunerated when it is accompanied by a short note with name, date and signature of the health center in-charge. / Carbon copy of the original referral slip, filled in by the MD. / Original prescription for drugs and medical consumables dispensed kept at the pharmacy which includes cost of drugs/consumables. Drugs register and stock cards conform. Lab/radiology register contains proof of requested exams. Original referral slip available at the Health Center
4 / Minor Surgery / Any new minor surgical intervention during the evaluated month. Minor Surgery defined as (i) Suture; (ii) Herniotomy; (iii) Subcutaneous cyst removal; (iv) I&D; (v) amputation of a finger/toe / Minor Surgery Register / Original prescription for drugs and medical consumables dispensed kept at the pharmacy which includes cost of drugs/consumables. Drugs register and stock cards conform. Lab/radiology register contains proof of requested exams.
5 / Major Surgery (ex CS) / Any new major surgical intervention during the evaluated month. Major surgical intervention defined as a laparatomy for any cause (bar CS), or amputation of a large limb. / Theater register / Original prescription for drugs and medical consumables dispensed kept at the pharmacy which includes cost of drugs/consumables. Drugs register and stock cards conform. Lab/radiology register contains proof of requested exams.
6 / Normal delivery / A normal delivery attended by a trained attendant in this facility, during the evaluated month. / Delivery register / Partogram and inpatient file; eventual drugs and medical consumables dispensed through the prescriptions kept at the pharmacy; drugs register and stock cards conform.
7 / Assisted delivery / An assisted delivery attended by a Doctor in this facility, during the evaluated month. / Delivery register / Partogram and inpatient file; eventual drugs and medical consumables dispensed through the prescriptions kept at the pharmacy; drugs register and stock cards conform.
8 / CS / A CS carried out at this facility during the evaluated month. / Delivery register or theater register / Partogram and inpatient file; eventual drugs and medical consumables dispensed through the prescriptions kept at the pharmacy; drugs register
9 / Inpatient Day / One day admission of an admission of a minimum of three days duration and discharged alive, during the past month. / General admission register for each department / In patient form kept at the health facility
10 / Postnatal consultation / A post natal consultation held within 48 hours after giving birth, during the past month. / ANC register / ANC card kept at the health facility
11 / First ANC consultation before four months pregnancy / A first ANC consultation occurs before 4 month’s pregnancy, during the evaluated month. / ANC register / ANC card kept at the health facility.
12 / ANC standard visit (2-4) / Any 2-4th standard visit according to the focused antenatal care visit schedule and approach. Second visit between 24-28 weeks; third visit at 32 weeks and the fourth visit at 36 weeks. During the evaluated month. / ANC register / ANC card kept at the health facility. Medical prescriptions for Ferrosulphate, Mebendazole and Fansidar kept at the pharmacy. Drugs register and stock cards conform.
13 / FP: total of new users of modern FP methods / Any new or existing user of injectable contraceptive or oral contraceptive pills, during the past month. An injection represents three month’s protection and a FP visit for OAC should provide three month’s worth of pills. / FP register / Eventual drugs and medical consumables dispensed through the prescriptions kept at the pharmacy; drugs register and stock cards conform.
14 / FP: implants and IUDs / Any new user of implant or IUD, during the evaluated month. / FP register / Eventual drugs and medical consumables dispensed through the prescriptions kept at the pharmacy; drugs register and stock cards conform.
15 / FP: vasectomy and bilateral tuba ligation / A vasectomy and bilateral tuba ligation carried out at this facility, during the evaluated month / Theater register / Family Planning Register
16 / VCT/PMTCT/PIT test / Any new VCT or PMTCT or PIT test carried out during the evaluated month. / VCT/PMTC register / Laboratory register; stock records
17 / PMTCT: HIV+ pregnant mothers and children born to are treated according to protocol / Any new HIV+ mother and newborn child treated according to the PMTCT protocol, during the evaluated month. / ARV register; delivery room register / PMTCT register; laboratory register; stock records.
18 / STD treated / Any new STD treated according to the syndromic treatment protocol, during the evaluated month / Curative Care Register / Drugs and medical consumables dispensed through the prescriptions kept at the pharmacy; drugs register and stock cards conform.
19 / New Client put under ARV treatment / Any new patient (pediatric or adult) HIV positive who started ARV (Antiretroviral therapy), including transferred in, during the evaluated month. / ART Register / Patient files
20 / New AAFB+ PTB patient / A new AAFB sputum positive Pulmonary Tuberculosis patient diagnosed, at the facility, during the past month. / Tuberculosis register / Laboratory register: Slides kept for counter-verification/quality assurance.
21 / PTB patient completed treatment and cured / A former AAFB+ PTB patient completed DOTS, and cured after treatment proven by negative sputum examinations, during the past month. / Tuberculosis register / Laboratory register: Slides kept for counter-verification/quality assurance.
Drugs register.

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[1] See Annex ‘Primary Data Collection Tool Column Headers’. These registers ought to be well-legible with filled all columns filled in. The PBF column header formats are mandatory. If information is lacking, automatically this service is not remunerated/validated. The verificator can use a red pen to cross out the service and or to make annotations. If the mobile phone number is not recorded, the service risks not being remunerated. In case of absence of mobile phone number the client can provide any number, i.e. from a family member, the neighbor, or the village chief. But a recorded number is mandatory. In the unlikely case that the client has no number at all to provide, the patient will need to sign the register’s column header.

[2] The secondary data collection tools can be partially at the health facility, partially with the client. They can be subject to scrutiny during either the routine data verification exercises, and or during the community client satisfaction surveys. In case there is no trace of such services rendered in the secondary data collection tools, then the service might be considered ‘not rendered’ ex-post, and sanctions will be applied as per contract.