Table 1.
Service standards for nurses in health centers and clinics, Namibia 2012
| Activities | Service standards for health centers | Service standards for clinics | Workload data for the most recent fiscal year |
|---|---|---|---|
| Admit a patient |
20 minutes/admission |
n/a |
Total admissions |
| Discharge a patient |
5 minutes/discharge |
n/a |
Total discharges |
| Death: last office |
60 minutes/death |
n/a |
Total deaths |
| Conduct a daily ward round |
10 minutes/inpatient |
n/a |
Total admissionsa |
| Routine nursing care |
30 minutes/inpatient |
n/a |
Total admissions |
| Give injections |
10 minutes/injection |
10 minutes/injection |
Total injections, other than immunizations and family planning (FP) |
| Take lab specimens, including for antiretroviral therapy (ART) |
10 minutes/lab specimen |
10 minutes/lab specimen |
Total lab specimens taken, including ART |
| Perform a dried blood spot (DBS) test |
10 minutes/DBS test |
10 minutes/DBS test |
Total DBS tests done |
| Monitor and manage normal delivery |
240 minutes/normal delivery |
n/a |
Total normal deliveriesb |
| Monitor and manage emergency delivery |
180 minutes/emergency delivery |
180 minutes/emergency delivery |
Total emergency deliveries |
| Immediate post-natal care of mother and baby |
60 minutes/delivery |
60 minutes/delivery |
Normal + forceps + vacuum + emergency deliveries + born before arrival |
| Screen and treat outpatients |
25 minutes/outpatient |
25 minutes/outpatient |
Total outpatients (OPD first visits and revisits) |
| Outpatient department (OPD) procedure |
25 minutes/procedure |
25 minutes/procedure |
Total OPD procedures |
| Take a pap smear |
20 minutes/pap smear |
20 minutes/pap smear |
Total pap smears |
| Antenatal care (ANC) first visit |
30 minutes/ANC first visit |
30 minutes/ANC first visit |
Total ANC first visits |
| ANC revisit |
20 minutes/ANC revisit |
20 minutes/ANC revisit |
Total ANC revisits |
| Post-natal visits |
30 minutes/post-natal visit |
30 minutes/post-natal visit |
Total post-natal visits |
| Growth monitoring of children |
10 minutes/child |
10 minutes/child |
Total children growth monitored |
| Immunization of women of reproductive age |
10 minutes/immunization |
10 minutes/i006Dmunization |
Total tetanus toxoid immunizations for women aged 15 to 49 years - all doses |
| Immunization of children under one year old |
10 minutes/immunization |
10 minutes/immunization |
Total immunizations of under-one year-olds - all vaccines, all doses |
| Family planning first visit |
15 minutes/FP first visit |
15 minutes/FP first visit |
Total FP first visits |
| Family planning revisit |
10 minutes/FP revisit |
10 minutes/FP revisit |
Total FP revisits |
| Integrated management of adult illness (IMAI) |
30 minutes/HIV/AIDS revisit |
30 minutes/HIV/AIDS revisit |
80% of the total HIV/AIDS revisits plus 80% of enrolled in HIV/AIDS care and treatmentc |
| Pre-test counseling of voluntary counseling and testing (VCT) clients |
15 minutes/VCT client |
15 minutes/VCT client |
10% of the total VCT clients pre-test counseled |
| Post-test counselling of VCT clients |
30 minutes/VCT client |
30 minutes/VCT client |
10% of the total VCT clients post-test counseled |
| Provide prevention of mother-to-child transmission (PMTCT) counseling and testing |
10 minutes/client |
10 minutes/client |
Total clients who received PMTCT |
| Provide TB DOTS |
10 minutes/DOTS visit |
10 minutes/DOTS visit |
40% of the total DOTS visits |
| Provide ART care and treatment |
15 minutes/ART revisit |
15 minutes/ART revisit |
20% of total ART revisits plus 20% of enrolled in care and treatment |
| Dressing wounds | 10 minutes/dressing | 10 minutes/dressing | Total dressings |
aHealth centers do not keep data on patient days since a client stay cannot exceed 48 hours. Therefore using the number of admissions as the data source gives an estimate for daily ward rounds and routine nursing care at a health center.
bClinics only provide emergency deliveries; normal deliveries should occur at hospitals and certain health centers.
cSeveral activities are done by more than one cadre; the percent represents the proportion of time the specific cadre conducts that activity.
ANC: antenatal care; ART: antiretroviral therapy; DBS: dried blood spot; DOTS: directly observed treatment, short-course; FP: family planning; IMAI: integrated management of adult illness; OPD: outpatient department; PMTCT: prevention of mother-to-child transmission; VCT: voluntary counseling and testing.