| Instrument | Who uses it | What it is used for | Major data to include | Making it easy to use | What you can learn |
|---|
| Client record | Physician
Nurse Clinical family planning provider | Identify client characteristics.
Monitor side effects and complications.
Monitor method changes.
Monitor contraceptive efficacy. | Demographic data.
Fertility history.
Health problems.
Contraceptive choices.
Contraceptives outcomes. | Provide plenty of space for data entries.
Use checklists whenever possible.
Include instructions for filling in data.
Limit number of entries to one page to avoid overcrowding and illegibility.
Highlight data areas of particular interest for easy reference. | Simple tabulations to get average characteristics of clients.
Cross tabulations of two different data items such as complications and methods. |
| Register | Nurse Auxiliary | Differentiate new clients from continuing users.
Compare utilization of different methods.
Compare utilization of contraceptives with inventory data.
Determine service utilization and outputs. | Status of acceptors.
Contraceptive selected. | Provide sufficient space for data entries.
Limit number of columns on a page.
Include instructions for filling in data.
Provide space for periodic summaries and daily tallies. | Total number and percentages of new clients and continuing users per month.
Total number and percentages of contraceptive methods per month. |
| Inventory form | Administrator
Clerical assistant | Determine monthly contraceptive needs.
Determine when to place orders for contraceptives. | Opening and daily balances for each contraceptive.
Quantities entered and withdrawn.
Daily and final closing balances.
Dates for each entry and withdrawal. | Provide separate column for each item of information.
Provide instructions for entering information.
Clearly distinguish between opening and closing balances. | Monthly utilization rates for each contraceptive.
Safety and reserve quantities for each contraceptive. |
| Supervisory forms | Supervisor | Determine quality of staff performance and service delivery. | Tasks of provider.
Availability of supplies and equipment.
Upkeep and maintenance of infrastructure. | Provide checklist of items.
Provide space to summarize assessment.
Provide instructions for completing form. | Problems in service delivery.
Problems in personnel and program management. |
| Community-based contraceptive distribution form | Local non-clinic distributor CBD worker | Monitor contraceptive supply in village or urban neighborhood. | Client names.
Contraceptive method.
New client or continuing user. | Provide sufficient space for data entries.
Limit number of columns on a page.
Include instructions for filling in data.
Provide space for periodic summaries and daily tallies. | Percentages of clients in area paying for contraceptives. |
| Map of current target population | CBD worker
Village family planning aide | Monitor acceptor status in village or urban neighborhood among target population. | Residences.
User status.
Current contraceptive method.
Past contraceptive methods. | Prepare map of family planning acceptors.
Use color code for acceptor status and use of different methods. | Contraceptive pre-valence in a small area.
New clients and continuing users.
Frequency of method-switching in the area.
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