Staff Competency checklist for CHO

Staff Name: ______Swastika roy

This checklist outlines the essential competencies expected from our Community Health Officer, Staff
members are required to review and ensure their proficiency in these areas.

Scores in Likert
Sl.
Competency Checkpoints Scale
No.
(1 - 5)
1 Conducting patient assessments
2 Administering medications and treatments
3 Managing medical emergencies
4 Ensuring infection control practices
5 Conducting health awareness sessions
6 Providing counselling on preventive healthcare
7 Promoting healthy lifestyle practices
8 Effective communication with patients and families
9 Coordinating with healthcare team members
10 Liaising with community resources for patient support
11 Accurate and timely documentation of patient information
12 Monitoring and reporting community health trends
13 Utilizing electronic health records proficiently

Following Gaps on Training needs & adequate skill needs are Identified upon competency
assessment & Actions Planned on Training & adequate skill Gaps:

CHO is trained as per mandate, Still following training will help improve performance of the CHO

1) Refresher Training
2) Training on Capacity Building
3) Refresher Training on Methods of QA viz PSS, 5S, PDCA etc

Evaluating Assessor’s Signature: __________________________

 Staff Competency Checklist for 1st & 2nd Auxiliary
Nurse Midwife (ANM)

Staff Name: _______ (HAF)__________________

This checklist outlines the essential competencies expected from our 1st & 2nd ANM, Staff members
are required to review and ensure their proficiency in these areas.

Scores in Likert
Sl.
Competency Checkpoints Scale
No.
(1 - 5)
1 Assisting in patient examinations
2 Administering prescribed medications
3 Monitoring vital signs
4 Assisting in minor medical procedures
5 Providing prenatal care to expectant mothers
6 Assisting in deliveries and postnatal care
7 Immunization administration for children
8 Conducting family planning counselling
9 Educating on maternal and child nutrition
10 Promoting immunization and vaccination awareness
11 Maintaining accurate records of patient care activities
12 Ensuring proper documentation of immunizations and treatments

Following Gaps on Training needs & adequate skill needs are Identified upon competency
assessment & Actions Planned on Training & adequate skill Gaps:

1st & 2nd ANM is trained as per mandate, Still following training will help improve performance of
the 1st & 2nd ANM.

1) Refresher Training
2) Training on Capacity Building
3) Refresher Training on Methods of QA viz PSS, 5S, PDCA etc

Evaluating Assessor’s Signature: __________________________

 Staff Competency Checklist for 1st & 2nd Auxiliary
Nurse Midwife (ANM)

Staff Name: ______ (CHA)__________________

This checklist outlines the essential competencies expected from our 1st & 2nd ANM, Staff members
are required to review and ensure their proficiency in these areas.

Scores in Likert
Sl.
Competency Checkpoints Scale
No.
(1 - 5)
1 Assisting in patient examinations
2 Administering prescribed medications
3 Monitoring vital signs
4 Assisting in minor medical procedures
5 Providing prenatal care to expectant mothers
6 Assisting in deliveries and postnatal care
7 Immunization administration for children
8 Conducting family planning counselling
9 Educating on maternal and child nutrition
10 Promoting immunization and vaccination awareness
11 Maintaining accurate records of patient care activities
12 Ensuring proper documentation of immunizations and treatments

Following Gaps on Training needs & adequate skill needs are Identified upon competency
assessment & Actions Planned on Training & adequate skill Gaps:

1st & 2nd ANM is trained as per mandate, Still following training will help improve performance of
the 1st & 2nd ANM

1. Refresher Training
2. Training on Capacity Building
3. Refresher Training on Methods of QA viz PSS, 5S, PDCA etc

Evaluating Assessor’s Signature: __________________________

 Staff Competency checklist for ASHA

Staff Name: _______ (ASHA)__________________

This checklist outlines the essential competencies expected from our ASHA workers. Staff members
are required to review and ensure their proficiency in these areas.

Scores in Likert
Sl.
Competency Checkpoints Scale
No.
(1 - 5)

1 Identifying healthcare needs within the community

2 Conducting door-to-door health surveys

3 Facilitating community health meetings

4 Promoting institutional deliveries and antenatal care

5 Encouraging immunization and family planning practices

6 Raising awareness about sanitation and hygiene

7 Guiding community members to healthcare facilities

8 Providing emotional support to patients and families

9 Facilitating timely referrals for specialized care

10 Compiling and reporting community health data

11 Ensuring accurate and timely reporting of health-related activities

Following Gaps on Training needs & adequate skill needs are Identified upon competency
assessment & Actions Planned on Training & adequate skill Gaps:

ASHA worker is trained as per mandate, Still following training will help improve performance of the
ASHA worker

1. Supplementary & Refresher Training

2. Training on Capacity Building
3. Training on Domestic Violence
4. NCD Training
5. HBYC Training

Evaluating Assessor’s Signature: __________________________

 Staff Competency checklist for ASHA

Staff Name: _______ (ASHA)__________________

This checklist outlines the essential competencies expected from our ASHA workers. Staff members
are required to review and ensure their proficiency in these areas.

Scores in Likert
Sl.
Competency Checkpoints Scale
No.
(1 - 5)

1 Identifying healthcare needs within the community

2 Conducting door-to-door health surveys

3 Facilitating community health meetings

4 Promoting institutional deliveries and antenatal care

5 Encouraging immunization and family planning practices

6 Raising awareness about sanitation and hygiene

7 Guiding community members to healthcare facilities

8 Providing emotional support to patients and families

9 Facilitating timely referrals for specialized care

10 Compiling and reporting community health data

11 Ensuring accurate and timely reporting of health-related activities 5

Following Gaps on Training needs & adequate skill needs are Identified upon competency
assessment & Actions Planned on Training & adequate skill Gaps:

ASHA worker is trained as per mandate, Still following training will help improve performance of the
ASHA worker

1. Supplementary & Refresher Training

2. Training on Capacity Building
3. Training on Domestic Violence
4. NCD Training
5. HBYC Training

Evaluating Assessor’s Signature: __________________________

 Staff Competency checklist for ASHA

Staff Name: _______ (ASHA)__________________

This checklist outlines the essential competencies expected from our ASHA workers. Staff members
are required to review and ensure their proficiency in these areas.

Scores in Likert
Sl.
Competency Checkpoints Scale
No.
(1 - 5)

1 Identifying healthcare needs within the community

2 Conducting door-to-door health surveys

3 Facilitating community health meetings

4 Promoting institutional deliveries and antenatal care

5 Encouraging immunization and family planning practices

6 Raising awareness about sanitation and hygiene

7 Guiding community members to healthcare facilities

8 Providing emotional support to patients and families

9 Facilitating timely referrals for specialized care

10 Compiling and reporting community health data

11 Ensuring accurate and timely reporting of health-related activities

Following Gaps on Training needs & adequate skill needs are Identified upon competency
assessment & Actions Planned on Training & adequate skill Gaps:

ASHA worker is trained as per mandate, Still following training will help improve performance of the
ASHA worker

1. Supplementary & Refresher Training

2. Training on Capacity Building
3. Training on Domestic Violence
4. NCD Training
5. HBYC Training

Evaluating Assessor’s Signature: __________________________

 Staff Competency checklist for ASHA

Staff Name: _______ (ASHA)__________________

This checklist outlines the essential competencies expected from our ASHA workers. Staff members
are required to review and ensure their proficiency in these areas.

Scores in Likert
Sl.
Competency Checkpoints Scale
No.
(1 - 5)

1 Identifying healthcare needs within the community

2 Conducting door-to-door health surveys

3 Facilitating community health meetings

4 Promoting institutional deliveries and antenatal care

5 Encouraging immunization and family planning practices

6 Raising awareness about sanitation and hygiene

7 Guiding community members to healthcare facilities

8 Providing emotional support to patients and families

9 Facilitating timely referrals for specialized care

10 Compiling and reporting community health data

11 Ensuring accurate and timely reporting of health-related activities

Following Gaps on Training needs & adequate skill needs are Identified upon competency
assessment & Actions Planned on Training & adequate skill Gaps:

ASHA worker is trained as per mandate, Still following training will help improve performance of the
ASHA worker

6. Supplementary & Refresher Training

7. Training on Capacity Building
8. Training on Domestic Violence
9. NCD Training
10. HBYC Training

Evaluating Assessor’s Signature: __________________________