This form is to be used to collect data on the prices paid by public stores and facilities or other organizations conducting procurements for essential health commodities. To collect data on prices charged to patients use Price Comparison Form A.
Archive | Tanzania
RSSPrescribing & Dispensing Analysis
OffUse this form to review 30 patient records in public health centers and hospitals, NGO/Mission clinics and hospitals, and Private clinics and hospitals
Price Comparison Form A
OffThis form is to be used to collect information about prices charged to patients and customers in all facilities. Use Price Comparison Form B to collect data on prices paid by facilities to obtain products.
SEAM DCF – Log of Drug Samples
OffLog of Drug Samples for _____________ Region, __________(Country)
Mission Clinic Survey
OffThis survey is to be conducted at NGO/Mission (not for profit) clinics and hospitals (outpatient department only). Ask to speak to the person in charge. Present the letter signed by the Director General of the Ministry of Health. Explain the purpose of the study and the amount of time required to complete the questionnaire. Respond […]
Patient Exit Interview for Facilities
OffUse this form to interview patients as they exit the facility. Interviews should be conducted with at least 10 patients.
List of Products Sold in Pharmacies
OffList of Products Sold by Type of Facility, etc.
Procedure for Data Collection
OffSuggested Data Collection procedure by facility.
Instructions For Forms
OffSee here for instructions on how to use the forms.
Questionnaire/Mapping Tool for Duka La Dawa Baridi Owners
OffThis questionnaire is designed to capture information which will be used by the Tanzania Ministry of Health to improve access to quality medicine and other services provided by duka la dawa baridi.