Facility Name
Type of Facility
Expected Pregnancies 2008 E.C
Expected Pregnancies 2009 E.C
Facility has functional incinerator
Facility has functional placenta pit
Does the facility have electric power supply
Dexamethasone/bethamethasone IV available
Methyldopa- 1st line available
Hydralazine available
Nifedipine available
Ampicillin (IV) available
Gentamycin (IV) available
Metronidazole (IV) available
TTC eye ointment available
Vitamin K available
MgSO4 available
Calcium gluconate available
Oxytocin available
Proportion of women that received antenatal care four or more times during the c
Proportion of births attended by skilled health personnel (midwife, nurse, healt
Proportion of pregnant women attending antenatal care clinics tested for syphili
Proportion of births that received post natal care at least once during the earl
Still Birth rate per 1000 LB
Proportion of women with pre-eclampsia who are treated with IV/IM MgS04
Proportion of pregnant women with pPRoM who are not in labor and are given oral
Proportion of Postpartum Hemorrhage cases managed per protocol
Proportion of asphyxiated neonates who were resuscitated (with bag & mask) and s
Proportion of Sick Young infants treated for sepsis/VSD
Proportion of low birth weight or premature newborns for whom KMC was initiated
Proportion of deliveries which danger signs assessed on admission (BP measured)
Proportion of deliveries which partograph started when cervical dilatation at le
Proportion of mothers who received 10 IU IV/IM Oxytocin
Proportion of newborn who had assessment (does the baby need special care and mo
Proportion of deliveries (newborns) who received immediate skin to skin and init
Proportion of deliveries (newborns) who received Vit K1
Proportion of deliveries (newborns) who received Tetracycline Eye Ointment
Water availability in the HF either Pipe water or Hand pump
Normalsaline or Ringer Lactate availability
Oxygen concentrator/Oxygen cylinder avalaiblity
RECODE of IsthereNewborncornerinthede (Is there Newborn corner in the delivery r
Well equiped Ambulance availability
Weighing scales for Newborn with 50 precision at one
Complete delivery set availability at least three per facility
Towel for drying and wrapping availibility
Bulb/pigeon suction availibility at least two per facility
Ambubag with neonatal face mask for neonates size 0 at least per facility)
Ambubag with neonatal face mask for neonates size 1 at least two per facility)
Radiant warmer availability at least one per facility)
Running water availability at delivery ward
Soap availability in the delivery ward
Infrustructure input score
Equipment and supply input score
Essential drugs score
Overall Inputs score
total Clinical care/bundle at labor/delivery
Overall process component score
average Clinical care/bundle at labor/delivery
Complication managment Score
Output Score
Over all Input Score Category
Over all Process Score Category
Over all Output Score Category
All components result
Proportion of health facilities with all infrastructure inputs available
Proportion of health facilities with all drugs inputs available
Proportion of health facilities with all Equipment/supply inputs available