The Republic of Uganda

ANNEX II: PUBLIC SERVICE INDIVIDUAL BALANCED SCORE CARD

INDIVIDUAL BALANCED SCORECARD TOOL

COMMITMENTS
 Government commits to provide resources to facilitate the Officer to meet his/her Performance
Objectives and respective Targets.
 Government commits to ensure timely release of resources as per the Annual Work Plan
 Government commits to provide an enabling environment for proper execution of tasks.
 The Public Officer commits to ensuring that there is effective service delivery as far as the
service standards of his/her roles are concerned.
 The Public Officer commits to observe the Professional Code of Conduct and the Public
Service Code of Conduct and Ethics.

SECTION 1: SUPERVISEE AND SUPERVISOR PARTICULARS

SUPERVISEE PARTICULARS SUPERVISOR PARTICULARS
Employee No. 973624 Employee No.
Name OKUMU Name OKWONGA
FRANCIS ALFRED
Job Title ANO (NURSING) Job Title SCO
Salary Scale: U5 MED Salary Scale: U4MED2
Year of Planning 2024/2025
and Review

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 SECTION 2: BSC STRATEGIC ELEMENTS

MANDATE To provide quality, affordable, accessible, and comprehensive nursing care services to the community, support health
service delivery, promote health education, and assist in managing nursing services at Puranga Health Centre III

VISION ‘’A healthy and productive population with equitable access to quality health care.’’

MISSION “To provide promotive, preventive, curative, and rehabilitative health services in partnership with stakeholders
to improve the health status of the people leaving in Puranga Town-council plus neighboring communities”

GOAL “To contribute to the reduction of morbidity and mortality in the community by delivering effective nursing and
health services at Puranga Health Centre III”

NATIONAL 1. Health Service Delivery Improvement

DEVELOPMENT
PLAN PROGRAMMES 2. Maternal and Child Health
3. Disease Prevention and Control
4. HIV/AIDS and TB Control
5. Nutrition Improvement
6. Water, Sanitation and Hygiene (WASH)
7. Mental Health Services
8. Immunization Programs
9. Health Infrastructure Development

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 10. Human Resource for Health Development
11. Health Financing and Insurance
12. Community Health and Outreach Services
13. Health Information Systems strengthening
14. Non-Communicable Diseases Control
15. Sexual and Reproductive Health Services
16. Health Research and Innovation
17. Emergency Preparedness and Response
18. Health Promotion and Education

DEPARTMENTAL To deliver nursing and midwifery services that improve individual, family, and community health through effective patient
MANDATE care, health promotion, disease prevention, and rehabilitation at all levels of the health care system.

STRATEGIC Objective 1: Enhance Quality Nursing Care Delivery

OBJECTIVES Objective 2: Strengthen Community Health Outreach

Objective 3: Improve Health Facility Management

Objective 4: Capacity Building and Continuous Professional Development

SECTION 3: PERFORMANCE PLAN AND PERFORMANCE APPRAISAL

PERSPECTIVES Performance Objectives Actions/Activities Expected Results Key Performance Score Comments on
Indicator actual
performance

FINANCIAL…. 25% 1.Ensure proper - Develop -Budget aligns with -Costed activity plan
planning and costed activity approved activity submitted and
budgeting of TB

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 activity funds plan. work plan approved (100%)

- Justify budget -Resources are -Budget deviation

items based on sufficient for ±10%
TB guidelines implementation
and local needs.

-Get approval
before spending

2.Use funds for -Spend only on -No fund misuse or -% of funds spent
intended purposes budgeted items irregularities according to plan
only (≥95%)
-Avoid -Activities completed
reallocation as planned -Number of misuse or
without written misallocation cases
approval (0)

-Monitor use
during activity

3.Achieve value for -Negotiate fair -More beneficiaries -Cost per beneficiary
money in TB activity prices reached with reached
implementation available funds
-Avoid -Percentage of budget
unnecessary -Cost-effective used efficiently
spending delivery (≥90%)

-Maximize
outreach per
shilling spent

CUSTOMER / 1.Provide patient- -Greet patients -Improved patient -Patient satisfaction

COMMUNITY…. 25% centred and respectively satisfaction and trust rating (≥85%)
respectful care -Ensure privacy

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 and dignity -Reduced patient -Number of
during care complaints complaints related to
-Listen actively staff behaviour (0-1)
to patient
concerns.
2.Educate patient and -Offer health -Patient understand -Percentage of
caregivers education during their conditions and patients who report
care or in group follow carefully understanding their
sessions
instructions treatment (≥90%)
-Use simple
language to -Increased adherence -Number of health
explain
to treatment talks or sessions per
conditions and
treatments quarter (≥2)

3.Support early -Screen patients -Reduced delays in -Percentage of

detection and referral for danger signs care appropriate referrals
of conditions -Refer patients made (100%)
promptly to -Improved clinical
appropriate outcomes -Time from
services or identification to
specialists
referrals ( ≤2 hour for
urgent cases)

INTERNAL 1.Facilitate effective -Prepare -Safe and timely -Percentage of

PROCESSE…. 25% patient referrals and referral forms patient movement complete referral
transfers and accompany documentation
patients when -Improved care (≥100%)
needed. continuity
-Time taken to process
-Ensure proper urgent transfers
handovers (≤2hrs)
between
departments or

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 facilities

2.Participate in -Attend QI -Better coordination -Attendance at

quality improvement reviews and and continuous QI/team meetings
and team meetings ward meetings improvements in care (≥90%)
-Provide input
delivery
on nursing -Number of
workflow improvement ideas
improvements
contributed or
implemented

3.Enure efficient -Organize and -Timely and -Percentage of

patient care delivery monitor nursing appropriate nursing patients with updated
care plans care nursing care plans
-Prioritize care
(≥95%0
based on acuity -Patient needs are
-Monitor met with minimal -Nurse-to-patient care
patients
delays round completion rate
regularly
(≥90%)

LEARNING AND 1.Stregthen team -Support junior -Positive team -Number of peer
GROWTH…. 25% collaboration and staff and culture and learning or mentorship
mentoring students knowledge sharing sessions led (≥1 per
-Share skills
quarter)
during team
meetings or
-Peer review score or
ward training
feedback ( ≥4/5)

2.Strengthen clinical -Attend in- -Improved -Number of CPD

knowledge and skills service training competence in hours completed (≥12
and CPD patient care per quarter)
sessions
-Participate in -Up-to-date -Clinical competence
ward-based case knowledge of clinical assessment score (
reviews and

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 mentorship guidelines ≥80%)

3.Improve -Attend -Accurate and --Number of charts

documentation and documentation consistent patient with complete nursing
communication skills and report records documentation (
writing sessions
≥95%0
-Use nursing -Clear and timely
notes, registers shift handovers -Number of
and handover
tools correctly documentation errors
reported ( decreasing
trend)

TOTAL SCORE OUT

OF 100%

DEFINITION OF PERFORMANCE SCORES

PERFORMANCE DESCRIPTION ELIGIBILITY
LEVEL
5 OUTSTANDING The Officer has achieved 100% (Overall performance, including Core Values)
4 VERY The Officer has achieved 80% to 99% (Overall performance, including Core Values)
SATISFACTORY

3 SATISFACTORY The Officer has delivered 60% to 79% (Overall performance, including Core Values)
2 MODERATE The Officer has performed 50% to 59 % (Overall performance, including Core Values)
1 UNSATISFACTORY The Officer has achieved 1% to 49% (Overall performance, including Core Values)
0 VERY The Officer has achieved 0% (Overall performance, including Core Values)

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 UNSATISFACTORY

SECTION 4: PERFORMANCE APPRAISAL - BEHAVIORAL ASSESSMENT

General behavioral attributes Description Score Comments with justification
1 Professionalism Demonstrates
ethical behavior,
integrity and
adherence to
nursing and medical
standards.
Maintains patient
confidentiality and
complies with
protocols
2 Teamwork and collaboration Works effectively
with colleagues
including nurses,
clinical officers,
support staff and
VHTs. Shows
respect, cooperation
and communication
in team settings
3 Patient-centered care Displays
compassion, respect

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 and cultural
sensitivity.
Attentive to patient
needs ensures
informed consent
and encourages
community health
promotion
4 Commitment to learning Participates in
CMEs, seeks
feedback, and
applies learning to
practice
5 Conflict Resolution Manages
interpersonal or
professional
conflicts calmly and
constructively,
seeks resolution
without escalation
6 Respect for Authority and Adheres to health
protocols Centre policies,
follows supervisor
instructions and

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 respects the chain of
command
7 Time management and Reports to duty on
Punctuality time, manages
workload
efficiently, meets
deadlines and
avoids unnecessary
absenteeism
Total score
Overall Score (Section 3 and 4)
Performance level

SECTION 5: PERFORMANCE IMPROVEMENT PLAN (To be completed by the Supervisor after a joint discussion to identify the
competences and skills that the Supervisee requires to improve performance.)
Identified Performance Gap Support offered to improve Agreed Action Time Frame
performance
Limited initiative in handling Pairing with experienced clinical Conduct at least 2 supervised Q3 AND Q4 (Jan – June 2025)
emergency cases officer during triage/ emergency emergency case assessments per
care month

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Inadequate infection prevention IPC (Infection Prevention and Observe IPC protocols strictly: Q2 and Q4 (Oct 2024 – June 2025)
practices (e.g. glove use, hand Control) re-orientation and monthly audit of IPC compliance
hygiene) demonstration by senior nurse
Low participation in health education Training in health promotion and Participate in 2 community Ongoing throughout FY
and outreach activities community mobilization outreaches per quarter

SECTION 6: COMMENTS

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Supervisee’s Comment:

Name, Signature & Date: Okumu Francis Signature: ……………………… Date: ………………………………

1st Level Supervisor’s Comment:

Name, Signature & Date:

Name: Mr. Okwonga Alfred Signature ………………….. Date: …………………………………
2nd Level Supervisor’s Comment:

Name, Signature &Date:

Responsible Officer’s Comment:

Name, Signature &Date:

ANNEX III: PERFORMANCE REVIEW TEMPLATE QUARTER ONE

Performance Actions/Activities Progress on Current Statistics Comments and
Objective implementation of on achievement of recommendation for

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 required action KPIs improvement
Improve patient Timely Implemented SOPs in -1,200 OPD patient -Patient feedback is
care quality and assessment of 85% of patient cases attended generally positive;
safety patients, accurate -98% treatment documentation improving

diagnosis, accuracy rate -Continue clinical

adherence to mentorship and on-the—

job training
SOPs
Strengthen Use of PPE, Hand hygiene -2 IPC spot checks -Good progress, but
Infection handwashing, compliance at 80% per done lapses noted during busy
Prevention and waste segregation IPC audit -1 infection case hours
control (IPC) reported vs. 3 in last -Reinforce IPC practices
quarter through weekly
reminders and staff
rotation
Accurate and Completing 3 of 3 monthly reports -100% HMIS -Marked improvement
timely HMIS registers daily, submitted on time submission compared to previous
reporting submitting compliance quarter

monthly reports -905 accuracy in -Recommend peer review

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 data entries before report submission
-90%
Participate in Attend/lead Conducted 3 of 4 -3 health talks -Excellent engagement
community health health talks and scheduled talks conducted with VHTs
education outreaches -210 people reached -Encourage more
proactive planning with
health educators
Manage Early triage, Supported triage team -25 emergency cases -Demonstrates initiative
emergency cases stabilize cases, twice attended and sound judgement
effectively escalate when -92% patient -Enroll in basic

needed stabilization rate emergency skills

refresher course
Improve Maintain Late reporting reduced -90% punctuality -Noticeable improvement
professional attendance, by 70% rate since last quarter
conduct report to duty on -2 days of absence -Maintain punctuality and

time (excused) reduce avoidable

absences further

Name, Title & Signature of Supervisee: OKUMU FRANCIS Date ……………………………..

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Name, Title & Signature of Supervisor: OKWONGA ALFRED Date ……………………………..

ANNEX III: PERFORMANCE REVIEW TEMPLATE QUARTER TWO

Performance Actions/Activities Progress on Current Statistics Comments and
Objective implementation of on achievement of recommendation for
required action KPIs improvement
Maintain and Timely patient Maintain high service -1,310 OPD patients -Sustained care quality;
enhance quality review, proper delivery; introduced seen follow-ups improved

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patient care treatment follow-up for chronic -96% treatment chronic care
protocols, follow- cases accuracy -Encourage regular
ups -40 follow-ups made review meetings for high-
risk patients

Strengthen IPC Consistent PPE IPC compliance rate -2 IPC audits -Excellent improvement
practices use, regular hand improved to 88% -0 facility acquired from Q1; zero infection
hygiene audits infections cases
-100% PPE -Maintain routine IPC
availability mentorship; include
support staff
Ensure timely Real-time register All reports submitted -100% HMIS -Data quality and
and accurate updates, complete on time; improved submission submission timeliness
documentation HMIS reports record detail -95% accuracy very good
-3 registers fully -Conduct quarterly peer-
updated review of documentation
Community Health talks, Exceeded target: more 5 health talks -Community engagement
health home visits, talks conducted than -300 people reached is commendable
engagement working with planned -2 VHT outreaches -Document impact of
VHTs supported talks and feedback from
VHTs
Improve triage Participate in Participated in 3 -40 emergencies -Stronger response
and emergency triage rotation, emergency response handled capacity than Q1
case response attend emergency drills -95% stabilization -Plan one refresher
drills rate session in emergency
-1 referral obstetric care
compilation
Uphold Maintain Full adherence to duty -100% attendance -Professionalism highly

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professional discipline, report schedule; no -0 late arrivals improved
conduct and timely, adhere to complaints logged -Participated in 2 -Continue mentorship and
punctuality code of ethics CMEs maintain ethical standards

Name, Title & Signature of Supervisee: OKUMU FRANCIS Date ……………………………..

Name, Title & Signature of Supervisor: OKWONGA ALFRED Date ……………………………..

ANNEX III: PERFORMANCE REVIEW TEMPLATE QUARTER THREE

Performance Actions/Activities Progress on Current Statistics Comments and
Objective implementation of on achievement of recommendation for
required action KPIs improvement
Sustain high- Prioritize critical Maintain consistent 1,400 OPD patients -Quality care delivery is
quality patient patients, follow- quality and case -97% treatment stable and reliable

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care up on chronic prioritization accuracy -Introduce more
cases -60 follow-ups structured
Adhere to IPC Conduct IPC spot Conduct 2 peer -90% IPC -Peer-led IPC training has
protocols checks, mentor mentorship sessions on compliance helped improve team
peers IPC -0 nosocomial performance
infections -Formalize IPC peer
100% PPE use mentorship program
Maintain accurate Ensure daily Documentation quality -3 reports submitted -Data entry consistency is
health records register entries consistent; minor -93% HMIS strong; minor corrections
and tally sheet HMIS errors noted accuracy needed
updates 1 late entry -Encourage cross-
checking entries before
submission
Enhance Participate in Participated in school -4 health talks -Strong VHT
community village activities outreach and 2 schools reached collaboration; impact
involvement and school health immunization drive -250 children visible in community
talks educated feedback
-Plan quarterly
community health
calendar with VHTs
Respond Join emergency Led 2 triage sessions; -35 emergencies -Emergency handling
effectively to response drills, mentored one junior attended well-coordinated
emergencies lead triage during staff -96% stabilization -Enroll in district-level
peak times rate BEMONC training ( if
-2 referrals available)
Exhibit Maintain positive 100% presence; -100% attendance -Demonstrates leadership
professionalism work ethic, avoid engaged in daily -3 CMEs attended by example
and punctuality absenteeism handovers and CMEs -No disciplinary -Encourage continuous

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 concerns CME participation and
mentoring

Name, Title & Signature of Supervisee: OKUMU FRANCIS Date ……………………………..

Name, Title & Signature of Supervisor: OKWONGA ALFRED Date ……………………………..

ANNEX III: PERFORMANCE REVIEW TEMPLATE QUARTER FOUR

Performance Actions/Activities Progress on Current Statistics Comments and
Objective implementation of on achievement of recommendation for
required action KPIs improvement
Maintain quality Timely clinical Sustained good patient -1380 OPD patients -Maintain clinical quality
and safe patient decisions, good care practices - 98% treatment despite high workload

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care nursing accuracy - Train in integrated
assessments - 55 chronic patient management of chronic
reviews conditions
Promote infection Daily Implemented 100% -915 IPC -IPC performance
prevention and enforcement, daily hand hygiene compliance remained strong
control (IPC) routine checks, audits -0 in-facility -Introduce IPC champion
mentorship infections system for each shift
Ensure data HMIS data All reports submitted -100% HMIS -Excellent data reporting;
accuracy and cleaning, timely accurately and on time submission improvement from Q3
reporting submission, -98% data accuracy -Continue mentorship on
improved tallying -All registers HMIS for new
updated staff/interns
Support Mobilize with Led antenatal health -3 outreaches -Valuable support to
community-based VHTs, focus on education in 3 -280 people reached maternal health outreach
health services maternal and child communities -30 ANC clients -Broaden coverage to
health referred to facility understand villages
next FY
Lead and manage Participate in Led emergency -38 emergencies -Demonstrated solid
emergency drills, lead in response team 3 times attended emergency decision-
response triage during night 94% stabilization making
shifts -1 neonatal referral -Recommend formal
training in emergency
obstetric care
Upload Show leadership, Continued full -100% punctuality -Leadership growth
professionalism, support staff attendance; involved in -3 CMEs facilitated observed
ethics and cohesion, peer support -0 disciplinary -Consider role in CME
punctuality maintain issues coordination next FY
discipline

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Name, Title & Signature of Supervisee: OKUMU FRANCIS Date ……………………………..
Name, Title & Signature of Supervisor: OKWONGA ALFRED Date ……………………………..

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ANNEX IV: PEER REVIEW QUESTIONNAIRE

Please answer the questions thoroughly and truthfully

Name of Officer under review OKUMU FRANCIS Date
……………………………..
Ratings definitions
0 Never 1 Rarely 2 A few times 3 Averagely 4 Most of the times 5 Always
Circle the number that most accurately describes the conduct of the officer.
Please note that NE (Not Evaluated) is applicable where the evaluator has no firsthand
knowledge of the Officer or has not interacted with the individual in that area

RATINGS 1 2 3 4 5 NE
1. Behaves in a manner that is consistent with the Organization’s
Vision, Mission and values
2. Is viewed as a person of integrity by co- workers
3. Has attitude of helpfulness towards co-workers
4. Complies with government policies and procedures
5. Is professional and courteous when communicating with workers
6. Represents the Organization in a positive manner when
communicating with clients
7. Follows through with tasks and responsibilities in an appropriate
and timely manner
8. Demonstrates respect for workers and ideas of others
9. Is willing to accept responsibility for his or her own actions
10. Is some one that you feel would make an effective supervisor

Name and signature of the Reviewer Okwonga Alfred

ANNEX V: SCHEDULE OF DUTIES

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Name of Officer

Okumu Francis

Title and Salary Scale Assistant Nursing Officer (Nursing)

U 5 Med

Name and title of Supervisor

Okwonga Alfred

Senior Clinical Officer

Names and titles of supervisees -Enrolled Nurses

-Enrolled Midwives

Job summary/ purpose To provide quality nursing care to patients

at Health Centre III level by implementing
clinical nursing procedures, participating
in disease prevention and health promotion
activities, and ensuring adherence to
professional and ethical standards of
nursing practice.

Key Results Areas/ Duties/ i. Patient Care and Clinical Nursing

Responsibilities ii. Maternal and Child Health
Support
iii. Infection Prevention and Control
(IPC)
iv. Health Education and Promotion
v. Documentation and Records
management
vi. Emergency and Referral support
vii. Professional and Ethics
viii. Teamwork and coordination
ix. Supply and Equipment
Management
x. Supervision and Leadership (when
delegated0
xi. Patient Advocacy

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 xii. Participation in Quality
Improvement (QI) initiatives
xiii. Continuing Professional
Development (CPD)
xiv. Community linkages and
outreaches
Outputs i. Provision of Nursing Care services

ii. Patient Assessments and Care

Plans

iii. Infection Prevention and Control

(IPC0 compliance

iv. Medication Administration and

Treatment Support

v. Health Education and Patient

Counseling

vi. Nursing Records and Reports

vii. Support IN Emergency and

Critical Care

viii. Supervision and Mentorship

ix. Community Outreach

Participation

x. Continued Professional
Development

Activities i. Patient Assessment and Care

Planning
ii. Provision of General Nursing
Care
iii. Emergency and First Aid
Management
iv. Documentation and Record
Keeping
v. Infection Prevention and
Control (IPC)
vi. Patient and Family Education
vii. Supervision and Mentorship
viii. Participation in Outreach

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 Services
ix. Inventory and Supply
Management
x. Professional Development and
Team Collaboration
xi. Maternity and Reproductive
Health Support
xii. Outpatient Department (OPD)
Services
xiii. Monitoring and Evaluation
Activities
xiv. Leadership and Administrative
Support
xv. Collaboration with Other Units
and Stakeholders
xvi. Infection Surveillance and
Waste Management
xvii. Support to Non-Communicable
Disease (NCDs) Clinics
xviii. Participation in Research and
Community Surveys
xix. Emergency Preparedness and
Epidemic Response
Clients/ People the Officer relates with in  Senior Clinical Officer/In charge
execution of his/her duties  Enrolled Nurses an Midwives
 Laboratory Staffs
 Health Assistant
 Support Staffs
 Health Unit Management
Committee Members
 Community

Reporting arrangements i. Reports to In-charge/Senior

Clinical Officer
ii. Receives Supervision from
Health Sub-district and District
Health Office
Guiding documents in execution of duties i. National Health Policy (NHP)

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 ii. Uganda Clinical Guidelines
(UCG)
iii. Essential Medicines and Health
Supplies list for Uganda
(EMHSLU)
iv. Midwifery and Nursing Scope
of Practice (by Uganda Nurses
and Midwives Council
(UNMC)
v. National Infection Prevention
and Control (IPC) Guidelines
vi. Primary Health Care (PHC)
Guidelines
vii. Nursing and Midwifery Code
of Conduct and Ethics (UNMC)
viii. Integrated Management of
Childhood Illness (IMCI)
Guidelines
ix. Reproductive, Maternal,
Newborn, Child and
Adolescent Health (RMNCAH)
Policy and Strategy
x. Standard Operating Procedures
(SOPs) for HC III Services
xi. Human Resource for Health
Strategic Plan
xii. Health Management
Information System (HMIS)
Tools and Manuals

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