The Community Score Card Tool

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As a part of our programme, we are administering this scorecard to communities living around and being served by this facility [ ]. The objective is: To assess communities' perceptions and experiences on health service provision; To assess their general knowledge of the health services that are offered and the roles of HSPs and CHPs. The aim is to determine factors that impede access to meaningful, timely, responsive and affordable care and services with particular interest to AYPs. Participation in this assessment is voluntary and the discussions will take approximately 1 hour. During this period, you are free to ask questions and seek any clarifications. We will also take photos that shall be used in the report. Based on the data/information collected, Y+ Kenya will share feedback with you for validation through a findings report prior to meetings with Health Service Providers at the Health Facility.

At this point, would you like to participate in this discussion?

Yes

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Can we take photos of you to be used in the report?

Yes

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County

Sub County

Ward

Interview Start Time
*

Date of Interview
*

Lead Interviewer's Name
*

Name of the County
*

Name of the Sub County
*

Name of Facility
*

Facility Level
*

Name (as it appears in the identification documents)
*

Gender
*

Status in the Community/County
*

Contacts (Tel. Numbers &/or Email)
*

Skills, Knowledge, Relations, Experience, Awareness, Expertise, Involvement

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