Multidisciplinary Team Approach for Delivery of

Community Health Service for Rural Communities

Implementation guide

November 2023
1 Outline

Outline ............................................................................................................................................................... 1
Acronyms ........................................................................................................................................................... 2
Introduction ....................................................................................................................................................... 1
Purpose and scope of the document .................................................................................................................. 1
Role of health centers and Primary Hospitals in providing community health services .................................. 2
Role of CHPU in coordinating the multidisciplinary team and community outreach services ....................... 2
Multidisciplinary Team ...................................................................................................................................... 3
Outreach services ............................................................................................................................................... 4
Planning and Coordinating Outreach Services .................................................................................................. 5
Kits for the outreach activities ........................................................................................................................... 5
Monitoring and evaluation strategies ................................................................................................................ 6
Annex 1: Service packages provided through outreach..................................................................................... 7
A. Outreach services at Health centers/ health posts by the primary hospital or health centers .............. 7
B. Home-based and community-level outreach services .......................................................................... 7
C. Service provided in school and youth centers ...................................................................................... 10
Annex 2. Monitoring the functionality of the Multidisciplinary team-based outreach service delivery
approach and Community health Program unit ............................................................................................. 12
Annex 3: Community outreach activities recording template ........................................................................ 15

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2 Acronyms
• AYH: Adolescent and Youth Health
• BCC: Behavior Change Communication
• BHP: Basic Health Post
• CBNC: Community-Based Newborn Care
• CHP: Comprehensive Health Post
• CHPU: Community Health Program Unit
• DM: Diabetes Mellitus
• EPI: Expanded Program on Immunization
• FP: Family Planning
• GBV: Gender-Based Violence
• HC: Health Center
• HEW: Health Extension Worker
• HEP: Health Extension Program
• HPV: Human Papillomavirus
• HP: Health Post
• HPTN: Hypertension
• HIV: Human Immunodeficiency Virus
• ICCM: Integrated Community Case Management
• IEC: Information, Education, and Communication
• IRS: Indoor Residual Spraying
• LF: Lymphatic Filariasis
• LLIN: Long Lasting Insecticidal Net
• MAM: Moderate Acute Malnutrition
• MCH: Maternal and Child Health
• MNSD: Mental, Neurological, and substance use disorders
• NCD: Non-Communicable Disease
• NTD: Neglected Tropical Disease
• ODF: Open Defecation Free
• PH: Primary Hospital
• PMTCT: Prevention of Mother-to-Child Transmission of HIV
• PPH: Postpartum Hemorrhage
• STI: Sexually Transmitted Infection
• TB: Tuberculosis
• WASH: Water, Sanitation, and Hygiene

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3 Introduction
This document is a guide for implementing multidisciplinary team-based community health service delivery
processes to facilitate the implementation of the Health Extension Program (HEP) optimization roadmap in
rural settings in Ethiopia. The document is aligned with the Health Extension Program Roadmap (2020-2035)
implementation manual, which aims to optimize community health programs and strengthen primary health
care functions.
By 2023, the Ministry of Health (MoH) categorized 16,898 health posts into basic and comprehensive types,
with 1,873 identified as comprehensive, 12,470 as basic, and 2,555 to be merged with the supervising health
facility. Based on this categorization, the MoH initiated 49 comprehensive HEP services and additional 91
comprehensive health posts under construction. Regional health bureaus deployed nurses to 3,213 health
posts, and 1,574 health posts have been merged with nearby health centers/primary hospitals. About 1,455
health facilities (health centers and primary hospitals) have established Community Health program Units
(CHPUs) in the same period.
However, there are challenges in implementation of CHPU and delivery of HEP or community health services
especially in merged HPs. The challenges include decreasing community-based health service where merged
HPs happen, weak collaboration and integration between the health extension workers (HEWs) and health
workers of hosting facilities, confusion about the role of health center/primary hospital, and lack of clarity on
the scope of service packages and the roles of HEWs and other health workers.

4 Purpose and scope of the document

The document is intended to provide practical guidance and tools for health managers and service providers
at different levels of the health system to implement multidisciplinary team community health service delivery
approach, and to address the challenges related to restructuring of the HPs. It primarily focuses on the
community health service provided by the health center and primary hospital. The document covers the
following topics:
• The roles of health centers, primary hospitals and the respective CHPU at the facilities in
facilitating and implementing the multidisciplinary team approaches and outreach community
health services
• Multidisciplinary team and how they function
• Services packages for the multidisciplinary team
• kits for outreach community health services
• Monitoring and evaluation strategies

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5 Role of health centers and Primary Hospitals in providing
community health services
The HEP roadmap (2020-2035) recommends that every health center and primary Hospital establishes a
CHPU and provide team-based community health service to community to optimize community health
programs and strengthen primary health care functions. They are responsible for performing community health
program functions. They are expected to provide comprehensive HEP services to the communities in the
kebele where the HC/PH is located, even if there is no merged HP/HEWs present as well as provide selected
services in the health facilities under their catchment areas. These services are usually delivered through a
team-based outreach approach at household, community, school, and youth centers levels. As indicated in
the roadmap, they are also expected to provide comprehensive supports through the CHPU to the facilities
(health center and or health posts) to strengthen the community health program.
The health center's CHPU will be headed by the deputy director of the center. The unit will consist of HEP
focal person and Health Extension Workers (HEWs) if there is a merged health post. Similarly, the CHPU at
primary hospitals will be led by either a focal person assigned by the hospital or the medical director of the
hospital
One of the main roles of the CHPU, in addition to providing the technical, managerial, and logistical support
to Basic Health Posts (BHP) and Comprehensive Health Posts (CHP), is to coordinate the provision of team
based HEP services in the catchment areas through the outreach approach.

6 Role of CHPU in coordinating the multidisciplinary team and

community outreach services

As mentioned above one of the key roles of the CHPU is organizing comprehensive health services through
outreach. This includes facilitating outreach programs to provide comprehensive HEP or community health
services for communities in the kebele where the facility exists as well as selected curative services at the
health facilities in their catchment areas (health centers at health posts or primary hospitals at the health
centers and health posts) as listed in annex 1. The major roles of CHPU may include, but are not limited to,
the following.
• Facilitate and form a team for the outreach services.
• Set schedule with the communities and health facilities for the outreach services.
• Make sure comprehensive services are provided to the communities at community,
school, households, and facility levels.
• Organize necessary logistics for the outreach activities
• Organize need-based training
• Organize report of the outreach activities and review meeting

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7 Multidisciplinary Team
A multidisciplinary team approach is a service delivery model that involves the staff of the HC/PH and HEWs,
in providing HEP or community health services at both the facility and community levels. The team is made
up of a medical doctor/health officer/nurse, midwife, HEWs, and environmental health professionals, and is
led by the CHPU head. Additionally, pharmacists and laboratory technicians from the health facilities will be
member of the unit and contribute their expertise to the outreach activities based on need. However, the team's
composition can be adjusted based on the facility's capacity and context to ensure that quality HEP services
are provided to the community. Roles and responsibilities of the team members are listed in the table below.

Table 1: Roles and responsibilities of outreach team members

Team member Roles and responsibilities
HEWs • Map communities and Households for outreach services
• Facilitate outreach schedule and services at the household, community,
and school levels
• Mobilize and empower the community members to participate in service
delivery and to adopt healthy behaviors.
• Work under the supervision of the CHPU head
• Collaborate with other team members
• Document and manage community-based data
CHPU head • Lead and manage the outreach HEP service delivery
• Coordinate outreach services both at the community and facility levels
• Supervise, mentor, and support the HEWs and other health center staff
involved in the outreach activities
• coordinate with other sectors and stakeholders at the district and kebele
level
• Organize learning /experience sharing visits
• Facilitate performance review and compile reports
• Take over the roles in the absence of HEWs

Midwifery • Participate on the outreach activities and provide MCH services.

Environmental health
professionals
Doctors/health
officer/clinical nurse
• Build the capacity HEWs and other staff under the health center/PH on
MCH activities
• Participate on the outreach activities and provide WASH packages
• Build the capacity HEWs under the health center/PH on WASH
packages
• Support multi-sectoral and community engagement activities
• Participate in outreach services and provide service mentioned under
communicable, non-communicable disease and NTD control and
prevention.
• Build the capacity of the HEWs

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 • Support the community engagement activities
Laboratory, • Participate in outreach activities based on needs
pharmacist and • Participate and support the HEWs and other team members per their
others expertise

8 Outreach services
Outreach services refer to the health services provided outside of health centers or primary hospitals. These
services are offered at various levels within and out of the kebele where facilities exist. Outreach services aim
to improve the access, coverage, quality, and equity of HEP services, especially for hard-to-reach and
vulnerable populations. They also aim to enhance community participation, empowerment, and ownership of
HEP service delivery.
Outreach services include community health services that are provided in the kebele where the facilities (HC
or PH) exist at households, communities, schools, and youth centers levels as well as selected service that
are provided at facilities within their catchment. This means that primary hospitals provide community health
services in the kebeles where they exist and also provide selected services through outreach at their
respective catchment health centers and health posts, in coordination with their staff. In the same way, health
centers deliver comprehensive community health services in kebeles where they are located and organize
outreach programs to provide selected services at their catchment health posts.
The services offered during outreach include health education, promotion, prevention, referral, curative, and
rehabilitative services as well as community mobilizations, training for different community structures, and
participate in various health campaigns. These services will be tailored to the health needs and preferences
of the target population at each site.
• Health promotion and disease prevention activities: These are activities are awareness creation,
education, and support the target population to adopt healthy behaviors and prevent diseases. These
activities may include health education sessions, counseling, screening, immunization, distribution of
health commodities, referral, follow-up, and selected curative services (See annex 1 for the list of
service)
• Community and multi-sectoral engagement: These are activities that aim to engage, empower, and
enable the community members to participate in HEP service delivery and to take ownership of their
own health. These activities may include training, mentoring, supervision, feedback, recognition, and
support for community-based health workers such as village health leaders (VHLs), Women
Development Groups (WDss), Men Development Groups, youth groups, etc. Other activities will also
be facilitating community meetings, pregnant women conferences, open house sessions, local
campaigns, etc. The team will also coordinate with other sectors and stakeholders such as education,
agriculture, water and sanitation, etc.
• Selected curative services: The PHs and HCs organize outreach services at health centers and/or
health posts under their catchment. Please see annex 1 for the list of proposed services)

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9 Planning and Coordinating Outreach Services
Scheduling outreach services is a crucial component of the process. The CHPU is responsible for planning,
organizing, coordinating, monitoring, and evaluating outreach services in the catchment area of the health
center or primary hospital. This involves working with the HEWs and other staff involved in service delivery to
determine the weekly schedule for outreach activities. The team composition, date, sites, and services to be
all decided during this process.
When scheduling the date for outreach community services, it is important to consider the availability,
preference, and convenience of the target population, as well as the patient load of the facility. These services
are scheduled for two days per week for outreach services within the kebele and once in a month for the
outreach services at the catchment facilities. The respective health facilities can choose the days that work
best for them based on their specific context.
The sites for outreach activities include households, communities, schools, and youth centers, and should be
selected based on the availability of physical space, infrastructure, equipment, supplies, and security for
conducting outreach activities.
The target groups for outreach activities are identified and categorized based on their demographic
characteristics, health status/needs, health risks/behaviors, and health service utilization. Mapping sites and
target groups help to plan and prioritize outreach activities according to their relevance and urgency.
Community groups with low service coverage, hard-to-reach areas, schools, and risk areas for disease
outbreaks will be prioritized during the outreach services. Similarly, households with under 5, pregnant
mothers, sick family members, and low uptake of HEP service will be targeted for the household visit. Mapping
the community/household is the primary responsibility of the HEWs. In the absence of HEWs, the focal person
of the primary hospital, or HC will take responsibility to map households or community groups.

10 Kits for the outreach activities

The team will use the following kits for the community-based outreach activities
• Weighing scale
• Thermometer
• Muac tape measure
• First aid kit (bandages, gloves, antiseptic solutions, scissors, face mask, hand sterilizers..)
• Pain reliving pills
• ORS
• RDT and anti-malaria drugs
• Pills for family planning
• Iron
• Blood pressure cuff
• Stethoscope
• Pregnancy test kit
• DM test kit
• FHG, home visit checklist and other educational materials

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11 Monitoring and evaluation strategies

Monitoring strategy: The monitoring strategy aims to track the progress, quality, and challenges of the
outreach service delivery on a regular basis. The monitoring strategy may include the following components:
Regular supportive supervision: The woreda health office and head of the health facilities will
conduct regular supportive supervision visits to the multidisciplinary team involved the outreach
service delivery at least every quarter. The supervision can be done by integrating with other routine
supportive supervision programs. The supervision visits will include observation, feedback, on the site
technical support (problem solving), and documentation (identifying success and challenges) of the
outreach activities.
Review meeting system: The CHPU head/coordinators will organize review meetings with the the
staff involved in the outreach service delivery at least once a month. The review meetings will include
presentation, discussion, analysis (identifying achievements, challenges, and best practices) and
evaluation of the outreach performance indicators. The review meetings can also be integrated into
the existing platforms such as monthly cluster review meetings and regular quarterly performance
review meetings.
Tracking systems of outreach activities: A system will be developed to capture the activities
conducted through the outreach service delivery. Until the system is established, we can use a field
book that will include information such as facility profile, date, sites, target groups/patients,
beneficiaries’ profile, and types of service provided. The HEWs and other health center staff (when
the HEWs are not involved) will fill in the information in the field book after each outreach activity and
submit it to the CHPU head/coordinators on a weekly basis. Please use the template proposed under
annex 3 by modifying it to the local context.
Evaluation of strategy: The evaluation strategy aims to measure the outcomes, impacts, and sustainability
of the outreach service delivery on a periodic basis. The following the outcome indicators may be included to
evaluate the performance of the strategies:
• Coverage of HEP services among hard-to-reach and vulnerable populations
• Quality of HEP services provided at different levels.
• Equity of HEP service delivery among different groups
• Perception of the staff about the approach
• Community participation, empowerment, and ownership of HEP service delivery

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12 Annex 1: Service packages provided through outreach
A. Outreach services at Health centers/ health posts by the primary
hospital or health centers
These are services provided to the communities through outreach services by the primary hospital at the
health centers or health posts, and the health centers at the catchment health posts. The service will include
but are not limited to the following
• Maternal and child health (MCH) services:
▪ ANC aided by ultrasound and lab tests
▪ Long-acting family planning methods, such as intrauterine devices (IUDs), or
permanent methods, such as tubal ligation or vasectomy
▪ Cervical cancer screening and treatments
o Chronic care services:
▪ Consultation and follow-up for HIV, TB, HPTN, DM patients
▪ Screening, testing and linking for HIV, TB, HPTN, DM
• Surgical care services (by primary hospital) such as cataract, hernia, and hydrocele surgery….
Take part in the process of identifying and controlling disease outbreaks and emergencies.

B. Home-based and community-level outreach services

These are services provided through community outreach in the kebele where health facilities are located.
Table 2: List service provided through home-based and community level outreaches
Programs Interventions
Maternal Health • Promote early ANC, PMTCT, LLIN use, maternal nutrition, birth
preparedness and complication readiness, danger signs, maternal
waiting services, skilled delivery, postpartum care, postpartum FP, and
breastfeeding, PNC visits for home-based for both the new-born and
the mother
• Pre-referral PPH treatment (if applicable)
• Perinatal and maternal death surveillance and response

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 • Identification of fistula and uterine prolapse. And refer
• Promote cervical cancer identification and referral services
New-born and • Provide Essential newborn care
Child Health • Promote Kangaroo mother care
• Detection of congenital anomalies and referral
• MAM - treatment for moderate acute malnutrition
• Deworming and Vitamin A supplementation every 6 months
• Management of Pharyngitis/Tonsillitis/Sinusitis
• Management of Scabies
• Prevention and identification of Child Abuse
EPI • Promotion and counseling on immunization
• Provision of all antigens as per the national EPI schedule
• Manage adverse effects following immunizations and referral
• Vaccine-preventable diseases outbreak identification and response
• Social mobilization and health promotion on EPI
• Conduct surveillance of vaccine-preventable diseases
AYH and FP • Counseling for individuals and couples
• Post-abortion follow-up
• Education on menstrual hygiene
• Self-breast examination promotion
• HPV vaccine provision
• Adolescent sexual and reproductive health risk factors, and FP
education
• Comprehensive education on GBV
• Psycho-social support and pregnancy test for GBV victims
• Community advocacy against HTP
Nutrition • Encouraging early initiation and exclusive breastfeeding, as well as
colostrum feeding
• Screening the nutritional status and weight gain of pregnant and
lactating women and children through monthly growth monitoring and
promotion, MUAC and oedema screening, and treating malnutrition
with therapeutic foods
• Involving family members and community leaders in providing
nutritional care and support for pregnant and lactating women and
children
• Educating and counseling on adolescent, maternal, and child nutrition,
including optimal complementary feeding practices, use of iodized salt
and fortified food
• Responding to nutritional emergencies and disasters
• Engaging multisectoral stakeholders at the local level for improved
nutrition interventions
• Providing STIs prevention services for female sex workers and their
partners

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Communicable • BCC targeting HIV/STI risk reduction like safer sexual behaviors, TB
disease control prevention in HIV/AIDS patients.
• Provision of HIV Counseling and testing: self-testing
• Participate and coordinate active surveillance of cases
• BCC targeting risk reduction like community participation, sleep under
LLINs, window screening, use of repellents and precaution in IRS
interventions
• Conduct malaria outbreak surveillance and response
• Screening and identification of TB and leprosy suspected cases and
link with HC for diagnosis and treatments: any cough or contact tracing
• BCC targeting HIV prevention for TB patients
Non- • Promote protection from tobacco smoke and hazardous alcohol use
communicable • Educate on breast and cervical cancer risks and promote self-
Diseases (NCDs) examination
• Provide basic palliative care for cancer and healthy lifestyle counseling
for hypertension and diabetes prevention
• Screen for hypertension
• Prevent indoor air pollution and other risk factors
•
Mental, • BCC and awareness creation program, identification and linkage of all
neurological and MNSD cases to the next level of care
• Identification and assessment of new cases of drug use/dependence
substance use
• Safer storage of pesticides in the community and farming households
disorders [MNSD] and emergency management of poisoning
• Awareness creation and screening for cataracts
• Awareness creation of refractive error (RE) and the importance of
eyeglasses
• Awareness creation on glaucoma, screening and referral for glaucoma
for selected population groups
•
NTDs • Preventing and treating diseases such as LF, Onchocerciasis,
Trachoma, and Guinea-worm, including
o Surveillance
o Mass drug administration
o BCC campaigns
o Promotion of personal hygiene and sanitation
o Identification and referral of cases for treatment

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 Hygiene and • Proper/improved latrine construction in all households and communal
sanitation services latrines
• Hand washing facilities near/in the latrine and personal hygiene
practice
• Menstrual hygiene management awareness
• Communal cloth-washing facilities and face washing with soap
• Oral hygiene practice awareness
• Proper water management at household level as per water safety plan
(household disinfection and storage, point use of water filter, source-
based protection of water supply, household chlorination, filtration,
disinfection and flocculation)
• Proper liquid waste and solid waste collection and disposal mechanism
• Water quality sanitary surveillance

Multi-sectoral and • Create demand for all health packages through IEC, BCC, family
Community conversations, and advocacy at individual, family, community, and
facility levels
engagement
• Community engagement and multi-sectoral activities
activities • Improve health and health system literacy of individuals, families, and
communities
• Distribute and use targeted SBCC materials.
• Conduct community mobilizations with different community structures
• Promote community scorecard

C. Service provided in school and youth centers

These are service provided to students and youth at their schools or youth centers. The target population at
these levels includes school-age children (5-14 years) and youth (15-24 years). The team-based outreach
program provides a range of services as indicated in the below table at these levels.
Table 3: List service provided in school and youth center through community outreach
Programs Interventions
Child and Adolescent Health and • Detection of congenital anomalies and referral
Nutrition • Education on SRH
• Deworming and Vitamin A supplementation every 6
months
• Promote nutrition in schools using teachers and parents'
associations and schools' nutrition clubs
• Demonstrate food diversification through school gardening
nutrition clubs
• Provide school-based de-worming service

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 • Promote the establishment of nutrition clubs in schools
• Promote the establishment of a school gardening program

Communicable Diseases, • BCC targeting HIV/STI risk reduction like safer sexual
prevention and control behaviors, TB prevention in HIV/AIDS patients.
• Provision of HIV Counseling and testing: self-testing
• BCC targeting risk reduction for malaria like community
participation, sleep under LLINs, window screening, use of
repellents and precaution in IRS interventions.

Non-communicable diseases, • Breast cancer education and self-examination

Mental Health and NTD • Healthy Life lifestyle counseling for prevention and control
Prevention and control of hypertension (tobacco cessation, reduction/avoidance of
alcohol use, healthy diet, and physical activity)
• Mental health awareness among school children and
structured physical activity, programs that advance positive
thinking, stress reduction programs, psychological and
educational counseling
• Healthy Lifestyle Counseling for prevention and control of
Diabetes Mellitus)
• Prevention of indoor air pollution and other risk factors to
prevent asthma
• Emergency management of poisoning
• Awareness creation of refractive error (RE) and importance
of eyeglasses
• Awareness creation on glaucoma, screening and referral
for glaucoma for selected population groups
• Education of communities on prevention and management
of ear, nose, air- way foreign bodies and choking
• Conduct surveillance for all relevant NTDS
• Early diagnosis and treatment of Active Trachoma
• Participate and coordinate Mass Drug Administration
(azithromycin) to eliminate trachoma.
• Promote face washing and healthy housing
• BCC targeting risk reduction like avoiding swimming in
fresh water, use of latrine (ODF)
• Promote personal hygiene to prevent NTDs

Hygiene and sanitation • Promote health housing, solid and liquid waste
management, latrine utilization, school led ODF
• Promote institutional health (schools, health posts,
religious places, marketplaces, small scale industries,

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 sector offices, youth centers, and farmer training centers)
for hygienic, safety and healthy environment with relevant
stakeholders

13 Annex 2. Monitoring the functionality of the Multidisciplinary

team-based outreach service delivery approach and
Community health Program unit
The community health program unit of the health centers and primary hospitals has a key role in organizing
and facilitating the team-based service delivery approach. The functionality and performance of this
approach is monitored as part of the overall CHPU functionality tracking system. The table below shows the
domains, indicators, and verification criteria for measuring the functionality of CHPU.
Table 4: CHPU and outreach activity monitoring matrix
Sn Thematic areas Role of the Community health Verification Yes/No (1/0)
unit system

1 A unit coordinator is assigned Check the letter of

assignment
2 HEWs are part of the unit in merged Observe and
The Community HPs interview the
health unit has a HEWs
3 dedicated office in a There is a dedicated office for the Observe
HC/PH with the unit
4 required human The office is equipped with essential Observe
resources and materials such as a computer,
materials shelves, tables, and chair
5 A unit coordinator is a member of Ask the
the management committee of coordinator
HC/PH Check the list of
the mgt committee
6 Provide Organize integrated supportive Check the SS
comprehensive supervision visits to the catchment checklist,
technical and HPs on a regular basis schedule, and SS
leadership support report
7 to the catchment Organize mentorship programs for Check the
HPs on a regular the catchment HPs (and HC) on a mentorship
basis regular basis checklist,
schedule, and
report

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8 Do a continuous capacity gap Check the report
assessment of the catchment HPs and action plan
(and HC) and plan capacity
enhancement activities
9 Facilitate the application of Verify the report
performance-based incentive
initiatives
10 Ensure the availability & Interview
implementation of minimum HRM
functions at the HPs such as Job
Description/JEG, annual leave,
performance evaluation and
promotion, Transfer, Career
development / educational
opportunities, and motivational
Packages
11 Facilitate selective out-reach Check the
curative services schedule and
report
12 Facilitate training for catchment staff Check the report
13 Establish a strong Organize bi-annual advocacy Check the
relationship with sessions to accelerate the schedule, and
Woreda Health implementation of HEP verify major
Offices and other optimization, and get the necessary achievements by
stakeholders to support for example equipping, reviewing the
seek the required renovating/upgrading HPs, fulfilling report
supports which basic infrastructures, HR, and
includes leadership community engagement
managerial,
financial, and
material
14 The unit facilitates The health center/PH organizes Check the
comprehensive HEP community outreaches on a regular schedule and
service to the basis report
15 catchment A team-based approach that Interview the
areas/kebele includes the HEWs (where merged HEWs
HPs exist) and other HC staff.
16 Ensure comprehensive HEP Check the report
services are provided through HH, includes all service
outreach, school-based, and facility packages
levels
17 Ensure the quality of health services Check quality
at HPs (BHPs and CHPs) Improvement
Initiatives

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18 The Unit facilitates Ensure the functionality of the Check the
referral systems broader referral system availability of
registration of
outgoing and
incoming referrals,
Referral tools
Referral networks,
feedback
collection boxes,
and referral
directory
19 The unit follow-up Ensures budget is allocated for the Check the
on the allocation of HPs in the catchment by the woreda submitted budget
earmarked budget plan and allocated
for the HPs amount
20 Ensure the proper utilization and Check the report
liquidation of the allocated budget and included it in
21 Follow up on the proper the follow-up
management of User fees by the checklist
CHP
22 Coordinate the mobilization of
community resources
23 The unit Make sure the supply chain Check all HPs
coordinates the management system is in place at receiving the
establishment of HPs and functional required
24 smooth supply Ensure uninterrupted supply of medicines,
chain systems essential drugs and medical supplies, and
equipment medical equipment
using the
appropriate tools
25 The unit Coordinate experience-sharing Check the report
strengthens the visits within and out of the PHCU
performance catchment every quarter
26 management A unit has integrated and up-to-date Verify by reviewing
system of the annual and quarterly plans that the plan
catchment HPs include all the catchment HPs.
27 The unit organizes monthly review Observe report
meetings at the HC/PH level
28 Ensure e/CHIS is established in all Verify from the
health posts report
29 Prepare basic data of all health Check the profile
posts of all catchment
health posts

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30 Collect, organize, and analyze Check the report
routine service data of the health of all HPs
posts monthly
31 The unit supports comprehensive Check the report
The unit ensures community engagement is
meaningful implemented.
community ● WDA
participation in HEP ● VHLs
and multi-sectoral ● MDA
engagement ● Youth
● Other socials
structures and motivation
packages are implemented
32 Provides technical support to Interview
catchment HPs in implementing full Verify from a
cycles of community scorecards report
33 The unit works closely with and Check multi-
facilitates multi-sectoral sectoral plan and
engagement in HEP at the report
catchment kebele level
Performance /functionality of the Unit= total number of criteria met (Yes) X100
33
● Very good=>85%
● Good= 70-85%
● Poor=60-70%
● Very poor=50-60%
● Not functional=<50%

14 Annex 3: Community outreach activities recording template

Table 5: Outreach activities recording template
Facility Name: Facility type: Visit Date:

Team members 1. 2. 3.

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 4. 5. 6

SN Beneficiary's name Age Sex Type/s of service provided (list all Remark
services provided)

16