CMW Administrative Supervisory Checklist - AAP-Health-MNCH
CMW Administrative Supervisory Checklist - AAP-Health-MNCH
CMW Administrative Supervisory Checklist - AAP-Health-MNCH
CMW is working with any other organization? (If Yes No Org:
1.8
yes, mention the name of organization.)
Complete address (Either residential or official) of
1.9
CMW
Section II: Please check the appropriate box (Yes’ No’ and Not Available) (Check
physically with stock register)
Functional
Section II-A: Basic Equipment Not Available
Yes No
A.1 BP apparatus
A.2 Stethoscope
A.3 Fetoscope
A.4 Emergency rechargeable light
A.5 Baby weighing machine
A.6 Weighting machine Adult
A.7 Baby Warmer (Optional)
A.8 Sterilizer (Electric 12 X 16)
A.9 Normal delivery set
A.10 Episiotomy set
A.11 Safety box
A.12 Bulb sucker
A.13 Thermometer
A.14 Measuring Tape
A.15 Safe delivery kit (SDK) (Packed)
A.16 Ambo bag with mask (If mask is not
present, then it is incomplete)
A.17 IUCD set
A.18 Glucometer (Optional)
A.19 Hemoglobin meter
A.20 Manual Vacuum Aspiration (MVA) Kit
B.20 Chlorhexidine
Section II.C Family Planning
commodities
Section III: Please check the appropriate box after Status Remarks
consulting CMW
Timely
3.2 Has CMW kept the copy of monthly report of Yes No
previous month?
3.3 Does the CMW Monthly Report Data tally with the Yes No
Register data?
3.4 Has CMW technical/administrative supervisor Yes No
visited during last three months?
Section III. B Disposal of Waste
3.b.1 Is the Placenta appropriately disposed through Yes No
burial?
3.b.2 Are blade/syringe/sharps burned or buried Yes No
properly?
Summary of Findings:
PLEASE GIVE WRITTEN AND VERBAL FEEDBACK TO THE CMW FOR IMPROVEMENT
BASED ON THE ABOVE FINDINGS