Health Facilities Feedback Form

Help us improve our service delivery through the 5 A's framework

The 5 A's Framework: Availability, Price, Awareness, Appropriate Product Design, and Product Quality. Your feedback on these areas helps EPSS enhance service delivery.

General Information

Health Facility Name *

Start typing to search for your health facility

Feedback Section – The 5 A's

Availability

What are the Top 10 stocked-out products in your facility?

Search and select up to 10 products (type at least 2 characters)

Price Issue

Which commodities have a higher price compared to other sources based on your findings?

Search and select products with pricing concerns

Awareness

Which products encountered utilization challenges due to lack of awareness or training?

Search and select products needing training or awareness

Appropriate Product Design

Please list products that were not convenient for storage, dispensing or use, purchased from EPSS.

Select Products with Design Issues

Search and select products with design or packaging issues (type at least 2 characters)

Product Quality

Are there any products having quality problems in your facility?

Select Materials with Quality Issues

Search and select materials that have quality problems (type at least 2 characters)

Recommendation Section

General Comments and Recommendations

Maximum 200 characters 200

Your feedback is confidential and secure

Your feedback is confidential and will be used to improve our services.