Assessment Tool of

Universities and Affiliate

Hospitals for Hospital
based Surgical and
Obstetrics/Gynecology
Residency Program

Introduction
Hello, my name is _____________.
The federal ministry of health (FMOH) with the federal ministry of
education has planned to commence hospital based Ob/Gyne and
surgery residency program in selected universities and their affiliated
hospitals. This facility has been listed as one of the
hospitals/universities that would possibly be embraced in this initiative.
I am here today on behalf of federal ministry of health to collect
baseline information about your institution.
Our stay here for this purpose will approximately take two hours and
would involve visits of OB/Gyne and surgical wards, Outpatient
departments, FP Units ,OR and labor wards. Your participation in the
discussion is very much appreciated.

Thank you

Name of Hospital_______________________________________ Region______________________

City _____________________________
Telephone____________________________e-mail_______________________________________
Date of assessment_______________________
Person Interviewed________________________

Owner (tick appropriate)

a. University Teaching Hospital

[ ]

b. Government Hospital

[ ]

c. Private Hospital

[ ]

d. NGO/faith-based/Mission

[ ]

e. Other: (specify) ____________________________________________________________

Total Number of beds_____________

Annual Budget______________________________________

Name of Assessors:
1. ______________________ Designation________________ Institution____________________
2. ______________________ Designation________________ Institution____________________
3. ______________________ Designation________________ Institution____________________
4.______________________Designation___________________Institution_______________________

Section One
Cross Cutting Information

I. Human Resource Availability and Facilities

Information on this section can be gathered by interviewing CEOs/Medical directors of
hospitals or review of administrative records

Facilities

Numbers

Remarks

Yes/No
1 Surgical and OB/Gyn facilities
No of General Surgeons:
No of obstetrician/Gynecologists
Number of subspecialists( specify):
No of Orthopedic surgeons
No of scrub nurses:
No of anesthetists
No of surgical ward nurses
No of midwives

II. SUPPORT SERVICES availability

SUPPORT SERVICES availability

Yes/No

Remarks

Pathology
Bacteriology
Clinical Chemistry
Hematology
Blood transfusion
Medical & other specialty support
Dedicated OB/Gyn lecture rooms(if yes
number on the remark)
Dedicated surgery lecture rooms(if yes
number on the remark)
Library & IT Facilities
Meeting room
Audit & Morning Meetings

Availability of

Endoscopy

Hysteroscopy

Laparoscopy

Ultrasound

Plain X/ray

Hystero-slapingio-graphic
(HSG)study

Fluoroscopy

Barium study

Others.

Pharmacy

Physiotherapy

Technical Department
Accommodation for Trainees

Functional Ambulances/similar
Vehicles serving as Ambulance(if yes
number in the remark)
Electric Generator
Laundry services
III.Hospital Laboratory Functional status

Service hours _________________ Remark __________________

CBC 1. Yes
2. No
3. Remark ____________________________
Cross match 1. Yes
2. No
3. Remark ____________________
HIV test 1. Yes
2. No 3. Remark __________________
Urine test 1. Yes
2. No
3. Remark ____________________
If yes, specify the kind of available urine test
___________________________________________________________________
Chemistry 1. Yes
2. No
3. Remark ____________________
If yes, specify the kind of available chemistry test
_______________________________________________________________________
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IV.

Blood for transfusion: specify availability, storage facility and

adequacy__________________________________

Radiology unit
Type of facility

Required number

Available number

Functional (1)
Non-functional (2)

Required number

Available number

Functional (1)
Non-functional (2)

X-ray machine
Ultrasound
Service hours, please
specify ________

V. Operation Theatre
Type of facility
Major OR
Operating tables in the
operation theatres

Anesthesia
machine/accessories
Minor OR for Gyn/OBS
Minor OR for Surgery
Dedicated C/S room
ICU

No of ICU/High
Dependency beds

No of mechanical
Ventilators

Recovery room

VI.

Equipments in the Operation Theater

Type

Required
number

Available
number

Functional
(1)
Nonfunctional (2)

General abdominal sets

Gyn-abdominal set (laparatomies set)
Vaginal hysterectomy set
C/S set
Minor surgical sets
Orthopedic sets
Orthopedic appliances
OR light
Water supply
Autoclave
Suction machine
Oxygen source
Resuscitation set (Adult)
Resuscitation set (Pediatric)
Monitor- ECG, pulse oxymeter
Consumables (anesthetics, suture materials)
OR personal protective equipments (OR
clothes, Apron, Googles, Face shield, shoe)
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VII.

If yes specify the available PPE

VII. Trainee load

Information on this section can be gathered by interviewing key personnel at the
registrar office of universities, deans of Health Science and Medical colleges and
CEOs of affiliate hospitals
TYPE OF TRAINEE

AVAILABILITY NUMBERS REMARK

(YES/NO)

Health science and medical students

1. Medical students
2. Midwives
3. Anesthetists
4. Health officers
Other category of students who require surgical
and obstetrics/gynecology training
1. Surgical residents
2. Obs-Gyn residents
3. Trainees on IESO

VIII. Teaching Facility

Information on this section can be gathered by interviewing deans of Health
Science and Medical colleges and CEOs or seniors at affiliate hospitals
1. Classrooms
a. Number of classrooms available for the training
___________________________
b. Total seat capacity per room
________________________________________________
a. Availability of Weekly schedule to use the hall Yes ---- No--9

2. Library
a. Is there a library in the facility? Yes ---- No--b. Are students issued with library borrowing cards? Yes ---- No-----c. Service hours ______________________________________
d. Seat capacity ____________________________
e. Availability of text books

TEXT BOOK

NUMBER
OF
COPIES
AVAILAB
LE

EDITION

REQUIRED
NUMBER

Current Diagnosis & Treatment Obstetrics &

Gynecology
Williams Obstetrics
Novaks Gynecology
Bailey and Love's Short Practice of Surgery
Schwarz's Principle of Surgery
Primary Surgery, Vol 1, Non-trauma
Primary Surgery, Vol 2, Trauma
Surgical care at district hospital by WHO

Gray's Anatomy: The Anatomical Basis of

Medicine & Surgery
Gerard J. Tortora. Principles of Anatomy and
Physiology
Guyton and Hall Textbook of Medical Physiology
Robbin's Basic Pathology
Books in Emergency Medicine, please specify
________________________________________
Books in Anesthesia, please specify

3. Skills laboratory
a. Are there clinical skills labs for acquiring surgical skills? Yes ------ No--------b. Are there clinical skills labs for acquiring skills for family planning, MVA,
D&C and delivery? Yes ------ No--------10

c. If yes are students allowed access to these facilities? Yes ------- No----------d. List of essential holdings (models/mannequins, equipments and materials) for a
surgical skill lab
________________________________________________________________
________________________________________________________________
________________________________________________________________
_____________
e. Is there any assigned professional to run the skill lab? Yes ------ No--------f. How many regular sessions per week? _____________________________

4. Teaching-Learning Aids
Indicate availability and number of teaching and learning aids for the training

LEARNING AID

AVAILABLE NUMBER

REQUIRED
NUMBER

Dissection room
Cadavers for anatomy session
Biomedical lab
TV and VCD/DVD player
Internet access
VCD/DVDs for surgical training
E-Books
Desktop computers
Laptop computers
Overhead projector
LCD projector
Printer
Photocopier
White board
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Black board

IX. Transport Facility

a. Is there any transport service for students (from university to hospital)?
Yes ------ No--------b. The kind of available vehicle
Bus Yes ------ No---------, How many ------------, Seat capacity ----------- Land Cruiser
Yes ------ No---------, How many ------------, Seat
capacity ------------ Other type
Yes ------ No---------, How many ------------, Seat
capacity -------------

X. Sites for practical attachment (affiliate hospitals)

Status of selection of sites for practical attachment
a. Sites identified based on the requirement of at least one general surgeon and one
Gyn-Obs specialist Yes ------ No--------b. Name
of
selected
practical
attachment
sites
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
c. MOU signed between university and affiliate hospitals? Yes ------ No--------d. If MOU not signed, any agreement reached between university and affiliate
hospitals? Yes ------ No---------

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Section Two
Specific Department Based
Information

I. Obstetrics and Gynecology Department

A. Case Load
13

Please provide information on number of Gyne/ Obs cases based on the past one year
(2006 EFY) record. HMIS/facility registers will be used as source of information
TYPE OF CASES

NUMBER OF REMARK
CASES

All gynecologic OPD patients seen

Cases coming for ANC( of all visits)

Cases coming for postnatal care

Post abortion cases
First trimester safe abortion cases
Second trimester safe abortion cases
Number of deliveries (total)
Instrumental deliveries( both vacuum and obstetrics forceps)
Elective caesarean sections
Emergency caesarean sections
Elective abdominal hysterectomies
Elective vaginal hysterectomies
Annual number of other emergency obstetric and gynecologic
surgeries, if yes specify in the remarks
Interval bilateral tubal ligation for family planning
Cesarean tubal ligation for family planning
Vasectomies
Pospartum IUCD insertions
Postpartum implant insertions
Postpatum short acting family planning methods (pills, injectables,
condoms)
IUCD insertions in the family planning unit

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Implant insertions in the family planning unit

Short acting family planning methods (pills, injectables, condoms)
provided in the family planning unit

B. Supplies, Support Facility and equipments

Information in this section can be gathered by inventory of resources, interviewing key
personnel like heads at the Gyne/Obs departments (like labor ward, maternity wards, etc.)
Type of facility

Total

beds

Required number

Available number

Functional(
not
expired) (1)
Nonfunctional( expired)
(2)

in

Gyne/Obs
OPD( emergency beds)

Total Gyn ward Beds

Total maternity Beds

for prenatal care

Total beds in the labor

ward

First stage bed

Second stage beds

Total beds for postnatal

care

Duty rooms
Discussion corners

15

Delivery sets
Vacuum
Obstetrics Forceps
Destructive delivery
sets
Labor
monitoring
chart (Partograph)
Pinnard fetoscope
Doppler fetoscope
CTG
Radiant
heater/Warming bulb
New born
resuscitation corner
Bag and mask
ventilator
Mucus
extractor/suction
catheter
Vitamin K ampoules
Rectal thermometer
Weighing scale
Naloxone
Endo-tracheal tube
Pediatric
laryngoscope
Umbilical catheter
Newborn couch
16

Pulse oximeter
Fetal heart
monitoring tools
MVA set
E & C set
D & C sets
Misoprostol
Mifeprostol
IUCD
Implant

II. Surgery Department

A. Case Load
Please provide information on number of cases based on the past one year (2006 EFY)
record. HMIS/facility registers will be used as source of information

17

TYPE OF CASES

NUMBER OF REMARK
CASES

Annual number of major elective general surgeries

Annual number of appendectomies
Annual number of small bowel resection and anastomosis
Annual number of laparatomies for peritonitis

B. Supplies, Support Facility and equipments

Information in this section can be gathered by inventory of resources, interviewing key
personnel like heads at the surgery departments.
Type of facility

Beds in
wards

Required number

Available number

Functional(
not
expired) (1)
Nonfunctional( expired)
(2)

Surgical

Orthopedics beds
Bed for emergency
surgical patients in
outpatient
Duty rooms
Discussion corners

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