Data Collection Form 3 allows collection of all the data needed from public and private health facilities to calculate process indicators PR33 and 35 and outcome indicator OT9 (see page 46). A form should be filled in in each health facility visited.

1. Collecting data for process indicator PR33:

• The monitoring unit should provide data collectors with the list of manuals, formularies, etc. which can be taken into account for the calculation of this indicator.

• Ask selected prescribers the following question:

"Could you show us a copy of the national or regional formulary, or any manual containing objective and independent information on drugs?"

• Observe if the formulary is immediately visible on the prescriber's desk (1), elsewhere in the office (2) or not available (3). Fill in the box with 1, 2 or 3.

• Please write the title and author of the document:
_______________________________________________________________
_______________________________________________________________

2. Collecting data for process indicator PR35:

• Ask selected prescribers the following question:

"Have you attended at least one training session where problems related to the rational use of drugs were discussed in the past year?"

1 = yes, 2 = no

A training session is defined as any meeting, workshop, seminar, etc. in which problems related to the rational use of drugs are discussed. Only training sessions organized by the public sector (i.e. ministry of health) and/or non-profit institutions and/or professional organizations (i.e. medical associations) should be considered. Any meeting organized/supported by the pharmaceutical industry cannot be considered as a training session.

3. Collecting data for outcome indicator OT9:

• Copy the first 5 prescriptions seen for children under 5 years old with diarrhoea, in column 1.

• Column 2 can be filled in during the survey or after by the monitoring unit.