M1

FHSIS REPORT FOR THE MONTH: MAY YEAR: 2017

NAME OF BRGY: SAMPALOC

NAME OF BHS: BHS SAMPALOC

MUNICIPALITY/CITY OF: TANAY

PROVINCE:

PROJECTED POPULATION OF THE YEAR:

RIZAL
BRGY
FOR SUBMISSION TO RHU

MATERNAL CARE NO.

PREGNANT WOMEN WITH 4 OR MORE PRENATAL VISITS

PREGNANT WOMEN GIVEN 2 DOSES OF TETANUS TOXOID

PREGNANT WOMEN GIVEN TT2 PLUS

PREGNANT WOMEN GIVEN COMPLETE IRON WITH FOLIC ACID SUPPLEMENTATION

POSTPARTUM WOMEN WITH AT LEAST 2 POSTPARTUM VISITS

POSTPARTUM WOMEN GIVEN COMPLETE IRON SUPPLEMENTATION

POSTPARTUM WOMEN GIVEN VITAMIN A SUPPLEMENTATION

POSTPARTUM WOMEN INITIATED BREASTFEEDING WITHIN 1 HOUR AFTER DELIVERY

WOMEN 10-49 YEARS OLD GIVEN IRON SUPPLEMENTATION

DELIVERIES

ACCEPTORS

CURRENT USER NEW ACCEPTORS OF

FAMILY PLANNING METHOD (BEGINNING NEW ACCEPTORS OTHER ACCEPTORS DROPOUT CURRENT USERS
THE PRESENT
(PRESENT MONTH) (END OF MONTH)
MONTH) MONTH

(PREVIOUS MONTH) (PRESENT MONTH)

A. FEMALE STERILIZATION/BTL

B. MALE STERILIZATION/VASECTOMY

C. PILLS

D. IUD (Intrauterine Device)

E. INJECTIBLES (DMPA/CIC)

F. NFP-CM (Cervical Mucus)

G. NFP-BBT (Basal Body Temperature)

H. NFP-STM (Symptothermal Method)

I. NFP-SDM (Standard Days Method)

J. NFP-LAM (lactational Amenorrhea Method)

K. CONDOM

I. IMPLANT

TOTAL 0 0 0 0 0 0
PREGNANT WOMEN GIVEN TETANUS TOXOID 1
PREGNANT WOMEN GIVEN TETANUS TOXOID 2
PREGNANT WOMEN GIVEN TETANUS TOXOID 3
PREGNANT WOMEN GIVEN TETANUS TOXOID 4
PREGNANT WOMEN GIVEN TETANUS TOXOID 5
 CHILD CARE MALE FEMALE TOTAL CHILD CARE MALE FEMALE TOTAL

IMMUNIZATION GIVEN <YEAR OLD INFANT GIVEN COMPLIMENTARY FOOD FROM 6-8 MONTHS

BCG INFANT FOR NEWBORN SCREENING: REFERRED

W/IN 24HRS : DONE

HEPA B1
>24HRS INFANT 6-11 MONTHS OLD RECEIVED VITAMIN A

1 CHILDREN 12-59 MONTHS OLD RECEIVED VITAMIN A

PENTA 2 INFANT 6-11 MONTHS OLD RECEIVED IRON

3 CHILDREN 12-59 MONTHS OLD RECEIVED IRON

1 INFANT 6-11 MONTHS OLD RECEIVED MNP

OPV 2 CHILDREN 12-23 MONTHS OLD RECEIVED MNP

3 SICK CHILDREN 6-11 MONTHS SEEN

IPV SICK CHILDREN 6-11 MONTHS RECEIVED VITAMIN A

MCV1 (AMV) SICK CHILDREN 12-59 MONTHS SEEN

MCV
MCV2 (MMR) SICK CHILDREN 12-59 MONTHS RECEIVED VITAMIN A

1 CHILDREN 12-59 MOS.OLD GIVEN DEWORMING TABLET/SYRUP

ROTA 2 INFANT 2-5 MOS WITH LOW BIRTH WEIGHT SEEN

3 INFANT 2-5 MOS WITH LBW RECEIVED FULL DOSE IRON

ANEMIC CHILDREN 6-11 MONTHS OLD SEEN

PCV ANEMIC CHILDREN 6-11 MOS RECEIVED FULL DOSE IRON

ANEMIC CHILDREN 12-59 MOS OLD SEEN

FULLY IMMUNIZED CHILD (0-11 MOS) ANEMIC CHILDREN 12-59 MOS OLD RECEIVED FULL DOSE IRON

COMPLETELY IMMUNIZED CHILD (12-23 MOS) DIARRHEA CASES 0-59 MONTHS OLD SEEN

TOTAL LIVEBIRTHS DIARRHEA CASES 0-59 MOS RECEIVED ORS/ORT W/ ZINC

CHILD PROTECTED AT BIRTH (CPAB) PNEUMONIA CASES 0-59 MONTHS OLD

INFANT AGE 6 MONTHS SEEN PNEUMONIA CASES 0-59 MOS OLD COMPLETED TREATMENT

INFANT EXCLUSIVELY BREASTFED UNTIL 6TH MONTH

MALARIA MALE FEMALE TOTAL SCHISTOSOMIASIS MALE FEMALE TOTAL

TOTAL POPULATION NUMBER OF SYMPTOMATIC CASE

POPULATION AT RISK NUMBER OF CASES EXAMINED

ANNUAL PARASITE INCIDENCE NUMBER OF POSITIVE CASES

COMFIRMED MALARIA CASES LOW INTENSITY

<5 YEARS OLD MEDIUM INTENSITY

> 5 YEARS OLD HIGH INTENSITY

PREGNANT NUMBER OF CASES TREATED

CONFIRMED MALARIA CASES NUMBER OF COMPLICATED CASES

BY SPECIES: P. FALCIPARUM NUMBER OF COMPLICATED CASES REFERRED

P. VIVAX
FILARIASIS MALE FEMALE TOTAL
P. OVALE

P. MALARIAE
NO. OF CASES W/ HYDROCELE, LYMPHEDEMA, ELEPHANTIASIS &
CHYLURIA
BY METHOD: SLIDE

RDT NO. OF CASES EXAMINED

MALARIA DEATHS CLINICAL RATE

NUMBER OF LLIN GIVEN NO. OF CASES EXAMINED FOUND POSITIVE FOR MF

AVERAGE MFD
TUBERCULOSIS MALE FEMALE TOTAL
ELIGIBLE POPULATION GIVEN MDA (94.6% OF TP)

1. TB SYMPTOMATICS WHO UNDERWENT DSSM TOTAL POPULATION GIVEN MDA

2. SMEAR POSITIVE DISCOVERED AND IDENTIFIED

LEPROSY MALE FEMALE TOTAL
3. NEW SMEAR (+) CASES INITIATED TX AND REGISTERED

4. NEW SMEAR (+) CASES CURED TOTAL POPULATION

5. SMEAR (+) RETREATMENT CASES CURED TOTAL NO. OF LEPROSY CASES (UNDERGOING TREATMENT)

6. SMEAR (+) RETREATMENT CASES INITIATED TX & REGISTERED NO. OF NEWLY DETECTED LEPROSY CASES

RELAPSE < 15 YEARS OLD

TREATMENT FAILURE GRADE 2 DISABILITY

RETURN AFTER DEFAULT NO. OF LEPROSY CASES CURED

OTHER TYPE OF TB
STI SURVEILLANCE MALE FEMALE TOTAL
7. NUMBER OF SMEAR (+) RETREATMENT CURED

RELAPSE NO. OF PREGNANT WOMEN SEE

TREATMENT FAILURE NO. OF PREGNANT WOMEN TESTED FOR SYPHILIS

RETURN AFTER DEFAULT NO. OF PREGNANT WOMEN POSITIVE FOR SYPHILIS

8. TOTAL NUMBER OF TB CASES (ALL FORMS) INITIATED TREATMENT NO. OF PREGNANT women given penicillin

9. TB ALL FORMS IDENTIFIED

10. CASE DETECTION RATE