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18 / 24

Yes                                                    No

If No, why?

Supervisory checklist for

Vaccination outreach services

A/ Service delivery

-Service availability

Yes                                                    No

If No, why?

Is the service done outside the centre?-

Yes                                                    No

If No, why

Are there child immunization service delivered?-

Yes                                                    No

If No, why?

-Regularity of the visits (service delivery visits)

Yes                                                    No

If No, why?

-Availability of feedback from the visits.

Yes                                                    No

If No, why?

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