C2.

Antenatal (ANC) & Postnatal (PNC) Care Inventory

Part A: Antenatal Care Inventory

RESPONDENT: CHIEF DOCTOR OF ANC CLINIC OR OTHER BEST INFORMED STAFF MEMBER

# QUESTION RESPONSE
401 How many days a week the facility works?
/---------------/
402 RECORD THE WORKING HOURS PER EACH
WORKING DAY
402_1 Monday
--------:--------
402_2 Tuesday
--------:--------
402_3 Wednesday
--------:--------
402_4 Thursday
--------:--------
402_5 Friday
--------:--------
402_6 Saturday
--------:--------
402_7 Sunday
--------:--------

Referral antenatal services mean referrals from the General Practitioner or Family Doctor or Gynecologist to other
specialist care when the pregnant women belong to risk group (has particular health problems that may lead to
the complicated delivery).

# QUESTION CODE GO TO RESPONSE

YES NO
403 Does this facility offer routine antenatal
services?
403_1 Does this facility have a system whereby
measurements or procedures for ANC
clients are routinely carried out before the
consultation?
# QUESTION CODE GO TO RESPONSE
404 Are the following activities below being YES NO DK
conducted routinely?

INTERVIEWER: DO NOT READ OPTIONS ALOUD.

FOR EACH OPTION, RECORD "1" IF MENTIONED,
"2" IF NOT MENTIONED, RECORD “98” IF DK
404_1 Measure height and weight and calculate 1 0 98
body mass index
404_2 Routine fetal-movement counting 1 0 98
404_3 Routine auscultation of the fetal heart 1 0 98
404_4 Breast or pelvic examination 1 0 98
404_5 Routine ultrasound scanning after 24 weeks 1 0 98
404_6 Measure blood pressure 1 0 98
404_7 Determination of risk factors for pre- 1 0 98
eclampsia and gestational diabetes
 404_8 Screening for asymptomatic bacteriuria 1 0 98
404_9 Screening for structural anomalies. 1 0 98
404_10 Ask about any past or present severe 1 0 98
mental illness or psychiatric treatment
404_11 Ask about mood to identify possible 1 0 98
depression
404_12 Ask about the woman’s occupation to 1 0 98
identify potential risks.
404_13 Identify women who may need additional 1 0 98
care and plan pattern of care for the
pregnancy.
404_14 Measure and plot symphysis–fundal height 1 0 98
404_15 Offer anti-D prophylaxis to women who are 1 0 98
rhesus D-negative1
404_16 Management of prolonged pregnancy 1 0 98
405 Are the following Laboratory Tests below
being conducted routinely?
405_1 Haemoglobin level 1 0 98
405_2 Urine test for proteinuria 1 0 98
405_3 Blood tests to check blood group and 1 0 98
Rhesus D status
405_4 Hepatitis B virus 1 0 98
405_5 HIV 1 0 98
405_6 Rubella susceptibility test 1 0 98
405_7 Syphilis test 1 0 98
406 Are the following information provided
routinely?
406_1 Food hygiene, including how to reduce the 1 0 98
risk of a food-acquired infection
406_1 Discuss smoking status and give information 1 0 98
about the risks of smoking during pregnancy
406_1 Give information, advice and support on 1 0 98
how to stop smoking throughout the
pregnancy
406_1 Advise women planning a pregnancy to 1 0 98
avoid alcohol
406_1 All antenatal screening, including risks, 1 0 98
benefits and limitations of the
screening tests.
406_1 How the baby develops during pregnancy 1 0 98
406_1 Nutrition and diet, including vitamin D 1 0 98
supplements
406_1 Breastfeeding 1 0 98
406_1 Review, discuss and record the results of 1 0 98
screening tests
406_1 care of the new baby, vitamin K prophylaxis 1 0 98
and newborn screening tests
406_1 postnatal self-care, awareness of ‘baby 1 0 98
blues’ and postnatal depression
407 Are the following treatment routinely 1 0 98
prescribed?
407_1 When hemoglobin level below 11 g/100 ml 1 0 98
iron supplements.
407_2 Anti-D prophylaxis to women who are 1 0 98
rhesus D-negative1
407_3 Vitamin D intake during pregnancy and 1 0 98
breastfeeding
407_4 Vitamin A intake 1 0 98
 ASK TO SEE THE ROOM WHERE EXAMINATIONS CODING GO TO REPONSE
FOR ANTENATAL CLIENTS ARE CONDUCTED
408 Does the ANC have a separate area where YES 1
an initial examination or assessment is NO 0
conducted when a woman first presents?

In 409 Record whether there is a private room or only auditory privacy. Auditory privacy refers a situation where
the discussion between the provider and client cannot be overheard. While the most reliable means is to conduct
discussions in a private room, it is possible to achieve auditory privacy without a private room, if care is made to
separate the location where the client and provider are talking, and where other people are waiting or working.

The interviewer must assess the situation and judge whether auditory privacy can reasonably be assured under
the existing service provision conditions. Visual privacy refers to any means for ensuring that the client and
provider are not seen by others. This is often achieved using a screen or curtain that can be pulled to shield a
client from others.

CODE GO TO RESPONSE
409 DESCRIBE THE SETTING OF THE Private room with
EXAMINATION ROOM visual and auditory 1
privacy
Shared room with
visual and auditory 2
privacy
Visual privacy only 3
no privacy 0

NOTE THE AVAILABILITY AND CONDITION OF SUPPLIES AND EQUIPMENT REQUIRED FOR DELIVERY SERVICES IN EACH
DELIVERY ROOM

CODING GO TO RESPONSE
428 SUPPLIES Observed Reported, Not available
(1) not seen (3)
(2)
428_1 Sharps container 1 2 0
428_2 Hand disinfectant 1 2 0
428_3 Waste receptacle with 1 2 0
lid
428_4 Soap for hand washing 1 2 0
428_5 Water for hand washing 1 2 0 If “0” ► 412

Soap (solid or liquid) and hand disinfectant are important for infection control. Health care settings should have
such items available in each unit to avoid spread and contamination of infections.

The secure container in which needles or sharp items can be safely disposed has different names and usually comes
in different shapes. For the purpose of this survey, it is referred to as a “Sharps Container”.

To qualify as a sharps container, it must be made of a substance that a needle does not readily penetrate (e.g.
hard cardboard or plastic) with a sealed lid that has only a small opening to allow the sharp object to be placed
inside. The container is used for placing sharp items, such as blades and needles.

None of the following, which may be found in some health facilities, qualify as a sharps container: an open-top
box, a plastic-lined trash bin where the plastic bag is later removed, an open basin or bowl where used needles
are placed for later disposal.

CODING GO TO RESPONSE
PIPED (1) BUCKET TAP (3)
(2)
411 How is water being made available 1 2 3
for use in the examination area
today?
CODING GO TO
412 DRUGS AND VACCINES REQUIRED FOR Observed, at Reported, Not available
ANTENATAL CARE SERVICES least 1 valid not seen
412_1 Iron and/or folic acid 1 2 0
412_2 Tetanus toxoid vaccine 1 2 0
412_3 SP (Fansidar) 1 2 0
412_4 Zidovudine 1 2 0
412_5 Lamivudine 1 2 0
412_6 Nevirapine 1 2 0
412_7 Hypotensive medicines 1 2 0
412_8 Urine Test Strip for Protein 1 2 0
412_9 Ability to do boiled urine test 1 2 0
412_10 RPR Kit (Syphilis Test) 1 2 0

NOTE THE AVAILABILITY AND CONDITION OF OTHER EQUIPMENT. EQUIPMENT MAY BE IN EXAMINATION
ROOM, AN ADJACENT ROOM, OR ROOM WHERE MEASURE IS TAKEN.

413 NOTE THE AVAILABILITY AND CODING GO TO RESPONSE

CONDITION OF OTHER Observed Reported, Not
EQUIPMENT. EQUIPMENT MAY (1) not seen available
(2) (3)
BE IN EXAMINATION ROOM,
AN ADJACENT ROOM, OR
ROOM WHERE MEASURE IS
TAKEN.
413_1 Blood pressure apparatus 1 2 0
413_2 Stethoscope 1 2 0
413_3 Fetal stethoscope (Fetoscope) 1 2 0
413_4 Adult weighing scale 1 2 0
Part B: Postnatal Care Inventory
RESPONDENT: CHIEF DOCTOR OF ANC CLINIC OR OTHER BEST INFORMED STAFF MEMBER

# QUESTION CODE GO TO RESPONSE

YES NO
421 Does this facility offer postnatal care 1 2 ► End
services?
CODING GO TO REPONSE
422 Does the clinic have a separate area where an YES NO
examination or assessment is conducted for 1 2 ►424
PNC clients?

ASK TO SEE THE ROOM WHERE

EXAMINATIONS FOR ANTENATAL CLIENTS
ARE CONDUCTED
CODE GO TO RESPONSE
423 DESCRIBE THE SETTING OF THE Private room with visual
EXAMINATION ROOM and auditory privacy 1
Shared room with visual
and auditory privacy 2
Visual privacy only 3
no privacy 0
QUESTION CODE GO TO RESPONSE
424 Are the following essential routine PNC for YES NO DK
all mothers being provided by the facility?

INTERVIEWER: DO NOT READ OPTIONS ALOUD.

FOR EACH OPTION, RECORD "1" IF MENTIONED,
"0" IF NOT MENTIONED, RECORD “98” IF DK
424_1 Assess and check for bleeding, check 1 0 98
temperature
424_2 Support breastfeeding, checking the breasts 1 0 98
to prevent mastitis
424_3 Manage anaemia, 1 0 98
424_4 promote nutrition and give vitamin A 1 0 98
supplementation
424_5 Complete tetanus toxoid immunization, if 1 0 98
required
424_6 Provide counseling and a range of options for 1 0 98
family planning
424_7 Refer for complications such as bleeding, 1 0 98
infections, or postnatal depression
424_8 Counsel on danger signs and home care 1 0 98
425 Are the following essential routine PNC for
all newborns being provided by the facility?
425_1 Assess for danger signs, measure and record 1 0 98
weight, and check temperature and feeding
425_2 Support optimal feeding practices, 1 0 98
particularly exclusive breastfeeding
425_3 Promote hygiene and good skin, eye, and 1 0 98
cord care
425_4 Identify superficial skin infections, such as pus 1 0 98
draining from umbilicus, redness extending
from umbilicus to skin, more than 10 skin
pustules, and swelling, redness, and hardness
of skin, and treat or refer if the baby
also has danger signs
425_5 Encourage and facilitate birth registration 1 0 98
425_6 Refer for routine immunizations 1 0 98
425_7 Counsel on danger signs and home care 1 0 98
426 Does the facility provide extra care for low birth 1 0 98
weight (LBW) or small babies and other
vulnerable babies, such as those born to HIV-
infected mothers (two or three extra visits)?
426_1 Identify the small baby 1 0 98
426_2 Assess for danger signs and manage or refer as 1 0 98
appropriate
426_3 Provide extra support for breastfeeding, including 1 0 98
expressing milk and cup feeding, if needed
426_4 Pay extra attention to warmth promotion, such as 1 0 98
skin-to-skin care or Kangaroo Mother Care
426_5 Ensure early identification and rapid referral of 1 0 98
babies who are unable to breastfeed or accept
expressed breast milk
426_6 Provide extra care for babies whose mothers are 1 0 98
HIV-positive, particularly for feeding support
# QUESTION CODE GO TO RESPONSE
427 Does the facility provide early identification and YES NO DK
referral /management of emergencies for mother 1 2 98
and baby?
QUESTION CODE GO TO RESPONSE
428 DESCRIBE THE SETTING OF THE Private room with visual
EXAMINATION ROOM FOR POSTNNATAL and auditory privacy 1
CLIENTS Shared room with visual
and auditory privacy 2
Visual privacy only 3
no privacy 0

NOTE THE AVAILABILITY AND CONDITION OF SUPPLIES AND EQUIPMENT REQUIRED FOR DELIVERY SERVICES IN EACH DELIVERY
ROOM

CODE GO TO RESPONSE
429 SUPPLIES REQUIRED FOR Observed Reported, Not
POSTNATAL SERVICES (1) not seen available
(2) (3)
429_1 Clean (or sterile) gloves 1 2 0
429_2 Sharps container 1 2 0
429_3 Already mixed decontaminating 1 2 0
solution
429_4 Hand disinfectant 1 2 0
429_5 Waste receptacle with lid and 1 2 0
plastic liner
429_6 Hand washing soap 1 2 0
429_7 Water for hand washing 1 2 0 If “0” ► 430
CODING GO TO RESPONSE

PIPED BUCKET (2) TAP (3)

(1)
430 How is water being made available for 1 2 3
use in the examination area today?
CODE GO TO RESPONSE
431 DESCRIBE THE SETTING OF THE Private room with visual
EXAMINATION ROOM FOR POSTNNATAL and auditory privacy 1
CLIENTS Shared room with visual
and auditory privacy 2
Visual privacy only 3
no privacy 0

NOTE THE AVAILABILITY AND CONDITION OF SUPPLIES AND EQUIPMENT REQUIRED FOR DELIVERY SERVICES IN EACH DELIVERY
ROOM

CODING GO TO RESPONSE
432 SUPPLIES REQUIRED FOR Observed Reported, Not
POSTNATAL SERVICES (1) not seen available
(2) (3)
432_1 Clean (or sterile) gloves 1 2 0
432_2 Sharps container 1 2 0
432_3 Already mixed decontaminating 1 2 0
solution
432_4 Hand disinfectant 1 2 0
432_5 Waste receptacle with lid and 1 2 0
plastic liner
432_6 Hand washing soap 1 2 0
432_7 Water for hand washing 1 2 0 If “0” ► 434
CODING GO TO RESPONSE

PIPED BUCKET (2) TAP (3)

(1)
433 How is water being made available for 1 2 3
use in the examination area today?
CODING GO TO
434 DRUGS AND VACCINES REQUIRED FOR Observed, at Reported, Not available
PNC SERVICES least 1 valid not seen
Iron and/or folic acid 1 2 0
434_1 Zidovudine 1 2 0
434_2 Lamivudine 1 2 0
434_3 Nevirapine 1 2 0
434_4 Condoms 1 2 0
434_5 Injectables 1 2 0
434_6 Implants 1 2 0
434_7 IUDs 1 2 0
434_8 Progestogen only pills (POP) 1 2 0
434_9 Combined oral contraceptive pills (COC) 1 2 0

NOTE THE AVAILABILITY AND CONDITION OF OTHER EQUIPMENT. EQUIPMENT MAY BE IN EXAMINATION ROOM, AN
ADJACENT ROOM, OR ROOM WHERE MEASURE IS TAKEN.
435 NOTE THE AVAILABILITY AND CODING GO TO RESPONSE
CONDITION OF OTHER Observe Reported, Not
EQUIPMENT. EQUIPMENT MAY BE d not seen available
(1) (2) (3)
IN EXAMINATION ROOM, AN
ADJACENT ROOM, OR ROOM
WHERE MEASURE IS TAKEN.
435_1 Blood pressure apparatus 1 2 0
435_2 Stethoscope 1 2 0
435_3 Adult weighing scale 1 2 0
435_4 Thermometer 1 2 0
435_5 Infant scale 1 2 0
435_6 Vaginal speculum 1 2 0
435_7 Infant stethoscope 1 2 0
435_8 measuring tape 1 2 0 R
There are national guidelines that are expected to be available widely. If not available, “other” such guidelines, not
necessarily national, do count.

If a copy of any of the guideline/protocol is not in the service delivery area, it can be assumed that it is not easily accessible
for utilization, even if a copy is elsewhere in the facility.

436 GUIDELINES/ PROTOCOLS CODING GO TO RESPONSE

Does this clinic have written guidelines Observed Reported, Not
on: not seen available

436_1 Antenatal care management 1 2 0

436_2 Postnatal care management for women 1 2 0
436_2 Postnatal care management for 1 2 0
children
436_3 Prevention of Mother To Child 1 2 0
Transmission of HIV/AIDS?
436_4 Breastfeeding
436_5 Sterilization of disinfection 1 2 0
436_5 Management of LBW 1 2 0
437 CODING GO TO RESPONSE
INFORMATION /EDUCATION Observed Reported, Not
MATERIALS not seen available

Observe the availability of information/education materials (posters, brochures, leaflets etc.) in the hallway, patient waiting
area, examination rooms, doctor’s rooms, consultation rooms etc. If not observed ask the respondent to show all available
brochures, leaflets, posters. Select those listed below.

436_1 Does this clinic have readily available 1 2 0

information material for clients on:

INTERVIEWER: DO NOT READ OPTIONS

ALOUD.
436_2 Healthy behaviors during pregnancy 1 2 0
436_2 Danger signs during pregnancy 1 2 0
436_3 Breastfeeding 1 2 0
436_4 Integrated Management of Childhood 1 2 0
Illnesses
436_5 Immunization 1 2 0
436_6 HIV/AIDS 1 2 0
436_7 Family Planning 1 2 0
436_8 Sexually Transmitted Diseases 1 2 0
436_9 Tuberculosis 1 2 0
436_10 Cardio Vascular Diseases 1 2 0