FHSIS REPORT for the YEAR: 2019

A
Name of Barangay: _______________________________
Name of BHS: _______________________________
Name of Municipality/City: Kitcharao

R
Name of Province: Agusan del Norte
Projected Population of the Year: 19,717
For submission to RHU/MHC

Section A. Family Planning Services and Deworming for Women of Reproductive Age
Total for WRA
A1. Modern FP Unmet Need Age
15-49 y/o
(Col. 1) (Col. 2) (Col. 3)
10-14 y/o 15-19 y/o 20-49 y/o
1. No. of WRA with unmet need for modern FP - Total

A2. Use of FP Method Current Users Acceptors Drop-outs Current Users

(Beginning Month) New Acceptors Other Acceptors (Present Month) (End of Month)
(Previous Month) (Present Month)
(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 5) (Col. 6)
10-14 15-19 20-49 10-14 15-19 20-49 10-14 15-19 20-49 10-14 15-19 20-49 10-14 15-19 20-49
Total Total Total Total
y/o y/o y/o y/o y/o y/o y/o y/o y/o y/o y/o y/o y/o y/o y/o
a. BTL - Total
b. NSV - Total
c. Condom - Total
d. Pills (POP & COC) - Total
d.1 Pills-POP - Total
d.2 Pills-COC - Total
e. Injectables (DMPA/CIC)-Tot.
f. Implant - Total
g. IUD (I & PP)-Total
g.1 IUD-I- Total
g.2 IUD-PP - Total
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h. NFP-LAM - Total
i. NFP-BBT - Total
j. NFP-CMM - Total
k. NFP-STM - Total
l. NFP-SDM - Total
m. Total Current Users
 Section B. Maternal Care and Services
Indicators Age Total Remarks Indicators Age Total
(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 1) (Col. 2) (Col. 3)
10-14 15-19 20-49 10-14 15-19 20-49
B1. Prenatal Care

1. No. of pregnant women w/ 6. No. of pregnant women who completed

at least 4 prenatal check- doses of calcium carbonate
ups - Total supplementation - Total
7 121 128 27 27

2. No. of pregnant women 7. No. of pregnant women given

assessed of their nutritional iodine capsules – Total
status during the 1st trimester 8. No. of pregnant women given one dose
-Total of deworming tablet - Total
10 91 101

a. Number of pregnant 9. No. of pregnant women screened for

women seen in the first syphilis - Total
trimester who have normal
BMI - Total 10. No. of pregnant women tested positive
10 91 101 for syphilis - Total
b. No. of pregnant women
seen in the first trimester 11. No. of pregnant women screened for
who have low BMI - Total Hepatitis B - Total
8 61 69
12. No. of pregnant women tested positive
c. No. of pregnant women for Hepatitis B - Total
seen in the first trimester 7 41 48
who have high BMI-Total 13. No. of pregnant women screened for
HIV - Total
1 1
3. No. of pregnant women for 14. No. of pregnant women tested for
the first time given at least 2 CBC or Hgb & Hct count - Total
doses of Td vaccination-Total
5 76 81 24 146 170
15. No. of pregnant women tested for
CBC or Hgb & Hct count diagnosed
4. No. of pregnant women for with anemia - Total
the 2nd or more times given 3 6 17 23
at least 3 doses of Td
 15. No. of pregnant women tested for
4 CBC or Hgb & Hct count diagnosed
4. No. of pregnant women for with anemia - Total
the 2nd or more times given 6 17 23
at least 3 doses of Td 16. No. of pregnant women screened for
vaccination (Td2 Plus) - Total gestational diabetes – Total

16 85 101 1 3 4
No of pregnant women Seen
5. No of Pregnant Women who
completed the dose of iron with
folic acid supplementation-Total
19 128 147 61 368 429
AP Seen (First Visit/Registered)

15 88 103

17. No. of pregnant women tested positive

for gestational diabetes – Total
6 6

18. No. of teenage pregnancy

0 7 7
Indicators Age Total Remarks Indicators Age Total
(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 1) (Col. 2) (Col. 3)
10-14 15-19 20-49 10-14 15-19 20-49
B2. Intrapartum Care and Delivery Outcome
19. No. of deliveries – Total 7 92 99 24. No. of deliveries by health facility
ownership - Total
20. No. of live births – Total
7 92 99 99

21. No. of livebirths by birth a. No. of deliveries in public health

97
weight - Total facility-Total
99
a. No. of live births with
b. No. of deliveries in private health
normal birth weight - 2
facility-Total
Total 99
b. No. of live births with
25. No. of non-facility-based deliveries -
low
Total
birth weight - Total
 b. No. of live births with
25. No. of non-facility-based deliveries -
low
Total
birth weight - Total

26. Type of Delivery

c. No. of live births with 7 92 99
unknown birth weight-
Total a. No. of vaginal deliveries – Total
7 86 93

22. No. of deliveries attended by

b. No. of deliveries by cesarean
skilled health professionals -
section – Total
Total
99 6 6
a. No. of deliveries 27. Pregnancy Outcome
attended by a doctor -
Total 21 7 92 99
b. No. of deliveries
attended by a nurse – a. No. of full-term births – Total
Total 7 91 98
c. No. of deliveries
attended by midwives - b. No. of pre-term births – Total
Total 78 1 1

c. No. of fetal deaths - Total

23. No. of health facility-based
deliveries - Total
d. No. of abortion/miscarriage - Total
99

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Indicators Age Total Remarks Indicators Age Total
(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 1) (Col. 2) (Col. 3)
10-14 15-19 20-49 10-14 15-19 20-49
B3. Postpartum and Newborn Care
30. No. of postpartum women with
28. No. of postpartum women Vitamin A supplementation – Total
together with their newborn
who completed at least 2
postpartum check-ups -
Total
53 53 6 44 50

29. No. of postpartum women

who completed iron with
folic acid supplementation -
Total
2 56 58
Section C. Child Care and Services
Indicators Male Female Total Remarks Indicators Male Female Total
(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 5) (Col. 1) (Col. 2) (Col. 3) (Col. 4)
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Newborns/Infants vaccinated with: 2. Fully Immunized Child - Total 74 77 151
* CPAB - Total 3. Completely Immunized Child (13-23 months) -
47 44 91 Total 18 27 45
* BCG - Total 64 55 119 4. School-Based Immunization
* HepB, within 24 hours. - Total 37 43 80 4.1. Total Grade 1 Learners
* DPT-HiB-HepB 1 - Total 84 76 160 - Td, Grade 1 (November) - Total
* DPT-HiB-HepB 2 - Total 82 88 170 - MR, Grade 1 (November) - Total
* DPT-HiB-HepB 3 - Total 103 91 194 4.2. Total Grade 7 Learners
* OPV 1 - Total 70 68 138 - Td, Grade 7 (November) - Total
* OPV 2 - Total 73 71 144 - MR, Grade 7 (November) - Total
* OPV 3 - Total 95 89 184
* IPV - Total 68 84 152
* PCV 1 - Total 73 100 173
* PCV 2 - Total 94 86 180
* PCV 3 - Total 93 97 190
* MCV 1 - Total 74 79 153
* MCV 2 - Total 43 39 82

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Indicators Male Female Total Remarks Indicators Male Female Total
(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 5) (Col. 1) (Col. 2) (Col. 3) (Col. 4)
C2. Nutrition Services for Infants and Children
10. Infants 6-11 mos. old given 1 dose of Vitamin
5. Newborns initiated on breastfeeding imme- A 100,000 I.U. - Total 23 16 39
diately after birth lasting to 90 mins - Total 11. Children 12-59 mos. old Seen
40 49 89 93 69 162
12. Children 0-59 months Seen
6. Preterm infants and/or infants with low birth
supplementation - Total
weight (less than 2500 grams) - Total
0 9 29 38
13. Children 12-23 mos. Seen
Infants 6 months old seen
84 90 174 1 1 2
7. Infants exclusively breastfed until 6th months - 14. Nutritional Status
Total
47 65 112 14.1. Stunted - Total
8. Infants 6 mos. old who have initiated and
14.2. Wasted - Total
received complementary food with continued
breastfeeding - Total
45 6 51 14.2.a. MAM - Total
9. Infants 6 mos. old who have initiated and 14.2.b. SAM - Total
received complementary feeding but has stopped
breastfeeding or has never been breastfed at all - 14.3. Overweight and Obese
Total 14.4. Normal - Total
4 3 7 16 28 44
C3. Deworming Services for Infants, Children and Adolescents
1. Children and Adolescents given 2 doses of b. SAC, 5-9 y/o dewormed (2 doses) - Total
deworming tablet - Total
c. Adolescents, 10-19 y/o dewormed (2
a. PSAC, 1-4 y/o dewormed (2 doses) - doses) - Total
Total
C4. Management of Sick Infants and Children
1. Sick Infants and Children seen - Total 3. Diarrhea cases 0-59 months old seen - Total
45 77 122
3.1. Diarrheal cases 0-59 mos. Old who
1.1. Sick Infant 6-11 mos. old seen - Total received ORS - Total
45 77 122
 3.2. Diarrhea cases 0-59 mos. received ORS
1.2. Sick Children 12-59 mos. old seen - Total with oral zinc drops and syrup - Total

2. Sick Infants and Children who received 4. Pneumonia cases 0-59 mos. old seen - Total
Vitamin A - Total 0
2.1. Sick Infants 6-11 mos. old who received 4.1. Pneumonia cases 0-59 mos. old who
Vitamin A - Total completed treatment - Total

2.2. Sick Children 12-59 mos. old received

Vitamin A - Total
2 7 9
Section D. Oral Care and Services
Indicators Male Female Total Remarks Indicators Male Female Total
(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 5) (Col. 1) (Col. 2) (Col. 3) (Col. 4)
1. Orally fit children 12-59 months old upon oral
examination plus orally fit after rehabilitation - 6. Adolescents who received BOHC - Total
Total

2. Clients 5 years old and above with cases a. Adolescents 10-14 years old who received
of DMFT - Total BOHC - Total

3. Infants 0-11 months old who received BOHC - b. Adolescents 15-19 years old who received
Total BOHC - Total

4. Children 1-4 years old (12-59 mos. old) who 7. Adults 20-59 years old who received BOHC -
received BOHC - Total Total

5. Children 5-9 years old who received BOHC - 8. Senior citizens 60 years old and above who
Total received BOHC - Total

10-14 15-19 20-49

Indicators
y/o y/o y/o

9. Pregnant women who received BOHC - Total

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Section E. Infectious Disease Prevention and Control Services
Indicators Male Female Total Remarks Indicators Male Female Total
(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 5) (Col. 1) (Col. 2) (Col. 3) (Col. 4)
E1. Filariasis Prevention and Control
1. No. of individual examined for lymphatic
filariasis - Total 3. No. of lymphatic filariasis cases examined with
manifestation of either lymhedema, hydrocele and
2. No. of individual examined found positive for elephantiasis - Total
lymphatic filariasis - Total
E2. Schistosomiasis Prevention and Control
1. No. of patients seen - Total 6. No. of confirmed chronic cases - Total
2. No. of suspected cases seen - Total
7. No. of confirmed cases (acute and chronic) -
3. No. of acute clinically diagnosed cases - Total Total

4. No. of confirmed acute cases - Total 8. No. of cases treated - Total

5. No. of chronic clinically diagnosed cases - 9. No. of confirmed chronic cases referred to a
Total hospital facility - Total
E3. Soil Transmitted Helminthiasis Prevention and Control (other age groups reflected under Child Care and Maternal Care)
1. No. of WRA, 20-49 years old, who completed
2 doses of deworming tablet - Total
E4. HIV-AIDS/STI Prevention and Control (reflected under Maternal Care)
E5. Tuberculosis Prevention and Control
3. Number of TB, all forms that are cured and
1. Number of notified TB cases, all forms - Total
completely treated - Total

2. No. of registered bacteriologically confirmed 4. No. of registered bacteriology confirmed drug

drug resistant TB (RR/MDR-TB Cases) - resistant TB Cases (RR/MDR-TB) cured &
Total completed treatment - Total
E6. Malaria Prevention and Control
1. No. of patients with probable/clinically 2. No. of lab-confirmed Malaria deaths - Total
diagnosed Malaria and confirmed case-Total
 • < 5 y/o - Total • < 5 y/o - Total
• ≥ 5 y/o - Total • ≥ 5 y/o - Total
3. No. of confirmed malaria cases in the population
- Total
E7. Leprosy Prevention and Control E8. Rabies Prevention and Control
1. No. of Leprosy cases on treatment during
1. No. of animal bites - Total
reporting period - Total
2. No. of newly detected cases during
2.. No. of deaths due to Rabies - Total
reporting period - Total

Section F. Non-Communicable Disease Prevention and Control Services

Indicators Male Female Total Remarks Indicators Male Female Total

(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 5) (Col. 1) (Col. 2) (Col. 3) (Col. 4)

Part 1. Lifestyle Related Diseases (Risk-Assessed Using the PhilPEN protocol) Part 3. Cardiovascular Disease Prevention and Control

1. No. of adults risk-assessed using PhilPEN - 1. No. of newly-identified hypertensive adults -

Total Total

2. Current smokers - Total Part 4. Diabetes Mellitus Prevention and Control

3. Alcohol binge drinkers - Total

1. No. of newly-identified adults with Type 2
Diabetes Mellitus - Total
4. Overweight/Obese - Total

Part 2. Cancer Prevention and Control Part 5. Blindness Prevention Program

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1. No. of adult women screened for Cervical 1. No. of senior citizens screened for visual acuity -
Cancer using VIA/Pap Smear - Total Total

2. No. of senior citizens diagnosed with eye

disease/s - Total

2. No. of adult women found positive or suspect

for Cervical Cancer using VIA or Pap Smear -
Total 3. No. of senior citizens with eye disease/s referred
to an appropriate eye care professional - Total

3. No. of adult women screened for breast mass -

Part 6. Immunization for Senior Citizens
Total

1. No. of senior citizens who received one (1) dose

of PPV - Total
4. No. of adult women with suspicious breast
mass - Total
2. No. of senior citizens who received one (1) dose
of influenza vaccine - Total

Section G. Environmental Health and Sanitation Services

Indicators Total Remarks Indicators Total
(Col. 1) (Col. 2) (Col. 3) (Col. 1) (Col. 2)
1. No. of HHs with access to basic safe water supply - Total
4. No. of HHs using safely managed sanitation services - Total
a. No. of HHs with Level I - Total

b. No. of HHs with Level II - Total

5. No. of industrial establishments issued with sanitary permit - Total
c. No. of HHs with Level III - Total
2. No. of HHs using safely managed drinking water services - Total
6. No. of food establishments issued with sanitary permit - Total
3. No of HHs with basic sanitation facility - Total

a. No. of HH with pour/flush toilet connected to septic tank - Total

7. No. of Barangays Declared ZOD - Total
b. No. of HHs with pour/flush toilet connected to community
sewer/sewerage system or any other approved treatment
system - Total

c. No. of HHs with ventilated improved pit latrine (VIP) - Total

Section H. Mortality Section I. Natality

Indicators Male Female Total Remarks Indicators Male Female Total
(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 5) (Col. 1) (Col. 2) (Col. 3) (Col. 4)
1. Total Deaths 1. Livebirths - Total

2. Maternal Deaths - Total a. Livebirths among 10-14 y/o women-Total

3. Under-five Deaths - Total b. Livebirths among 15-19 y/o women-Total

4. Infant Deaths - Total c. Livebirths among 20-49 y/o women-Total

5. Neonatal Deaths - Total

6. Fetal Deaths - Total

7. Early Neonatal Deaths - Total

8. Perinatal Deaths - Total

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A1
es and Deworming for Women of Reproductive Age
RHU
Remarks

(Col. 4)

Current Users New Acceptors

(End of Month) (Present Month)

(Col. 6) (Col. 7)
10-14 15-19 20-49
Total Total
y/o y/o y/o
15
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Maternal Care and Services

Total Remarks
(Col. 3) (Col. 4)

27

69

48

170

23
 23

429

103

7
Total Remarks
(Col. 3) (Col. 4)

99

97

17
 18

99

93

99

98

1
 Total Remarks
(Col. 3) (Col. 4)

50

C. Child Care and Services

Total Remarks
(Col. 4) (Col. 5)

151

45

19
20
 Total Remarks
(Col. 4) (Col. 5)

39

162

38

44

21
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D. Oral Care and Services

Total Remarks
(Col. 4) (Col. 5)

Total Remarks
Disease Prevention and Control Services
Total Remarks
(Col. 4) (Col. 5)

Maternal Care)

23
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E8. Rabies Prevention and Control

ble Disease Prevention and Control Services

Total Remarks

(Col. 4) (Col. 5)

Part 3. Cardiovascular Disease Prevention and Control

Part 4. Diabetes Mellitus Prevention and Control

Part 5. Blindness Prevention Program

 Part 6. Immunization for Senior Citizens

mental Health and Sanitation Services

Total Remarks
(Col. 2) (Col. 3)

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Section I. Natality
Total Remarks
(Col. 4) (Col. 5)