Needs Assessment Tool (Individual Forms)

Phase 1: Situational assessment

Situational assessment, which involves a systematic review of local literature regarding GAS, ARF, and RHD and characterisation of candidate sites.

Phase 2: Facility-based Assessment

Facility-based assessment, which includes reviewing clinical records, evaluating capacity to deliver care around GAS, ARF, and RHD in the site’s health facilities, and seeking an understanding of how services around ARF/RHD integrate with the rest of the health system.

Form 2.1 Primary Care Sore Throat (ARF Cover Sheet)

Data Collection (PDF 38.00 KB)

Form 2.2 Primary Care Sore Throat

Data Collection (PDF 38.68 KB)

Form 2.3 Primary Care (Acute Rheumatic Fever)

Data Collection (PDF )

Form 2.4 Secondary Tertiary Facility Cover Sheet

Data Collection (PDF 35.41 KB)

Form 2.5 Secondary Tertiary Facility ARF RHD

Data Collection (PDF 51.93 KB)

Form 2.6 Secondary Tertiary Facility Patient Health Services Utilisation

Data Collection (PDF 47.14 KB)

Form 2.7 Pregnancy

Data Collection (PDF 31.60 KB)

Form 2.8 Primary Care Facility Survey

Data Collection (PDF 83.11 KB)

Form 2.9 Independent Dispensary Facility Survey

Data Collection (PDF 50.27 KB)

Form 2.10 Secondary Tertiary Facility Survey

Data Collection (PDF 102.73 KB)

Form 2.11 Interview Guide for Country Contacts

Data Collection (PDF 51.16 KB)

Phase 3: Understanding the patient and provider experience

Understanding the patient and provider experience, which uses qualitative methods to understand barriers and facilitators along the CoC©

Form 3.1 Sore Throat Parent and Patient Interview Schedule

Data Collection (PDF 41.15 KB)

Form 3.2 ARF Adult Patient Interview Schedule

Data Collection (PDF 45.45 KB)

Form 3.3 ARF Child Patient Interview Schedule

Data Collection (PDF 45.71 KB)

Form 3.4 RHD Child Patient Interview Schedule

Data Collection (PDF )

Form 3.5 RHD Adult Patient Interview Schedule

Data Collection (PDF 44.77 KB)

Form 3.6 Health Care Provider Interview Schedule

Data Collection (PDF 42.34 KB)

Phase 4: Planning the intervention

Planning the intervention, which implements a rigorous process approach to mapping and dialoguing with stakeholders and then designing the intervention and also includes a monitoring and evaluation framework.

Needs Assessment Tool (Individual Forms)

In this page

Phase 1: Situational assessment

Form 1.1 Systematic Review Protocol

Form 1.2 Health System Assessment

Form 1.3 Suggested Key Informants

Form 1.4 Topic Guides and Interview Schedules

Form 1.5 Existing Data Review

Phase 2: Facility-based Assessment

Form 2.1 Primary Care Sore Throat (ARF Cover Sheet)

Form 2.2 Primary Care Sore Throat

Form 2.3 Primary Care (Acute Rheumatic Fever)

Form 2.4 Secondary Tertiary Facility Cover Sheet

Form 2.5 Secondary Tertiary Facility ARF RHD

Form 2.6 Secondary Tertiary Facility Patient Health Services Utilisation

Form 2.7 Pregnancy

Form 2.8 Primary Care Facility Survey

Form 2.9 Independent Dispensary Facility Survey

Form 2.10 Secondary Tertiary Facility Survey

Form 2.11 Interview Guide for Country Contacts

Phase 3: Understanding the patient and provider experience

Form 3.1 Sore Throat Parent and Patient Interview Schedule

Form 3.2 ARF Adult Patient Interview Schedule

Form 3.3 ARF Child Patient Interview Schedule

Form 3.4 RHD Child Patient Interview Schedule

Form 3.5 RHD Adult Patient Interview Schedule

Form 3.6 Health Care Provider Interview Schedule

Phase 4: Planning the intervention

Form 4.1 Procedure for stakeholder identification interviews and mapping

Form 4.2 Key Stakeholder Interview Schedule

Form 4.3 Tools for Quantifying Needs and Setting Targets

Form 4.4 Intervention Monitoring and Evaluation Worksheet

Form 4.5 Summary Work Plan Monitoring and Evaluation

Form 4.6 Understanding the Barriers

Form 4.7 Understanding the facilitators

Form 4.8 The TIPS Checklist Analysis

Form 4.9 Baseline Assessment Indicators and Benchmarks