IHIMS Indicators Booklet
IHIMS Indicators Booklet
IHIMS Indicators Booklet
Government of Nepal
Ministry of Health and Populaton
Department of Health Services
Health Management Information Section
Teku, Kathmandu
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CONTENTS
CONTENTS 1
ACRONYMS 2
INTRODUCTION 4
1. Safe Motherhood 6
2. Family Planning 9
3. Female Community Health Volunteers (FCHV) 9
4. Primary Health Care Outreach Services 10
5. Immunization 10
6. Integrated Management of Childhood Illnesses (IMCI) 12
7. Nutrition 14
8. HIV/AIDS 16
9. Tuberculosis 18
10. Epidemiology and Disease Control 19
11. Leprosy 21
12. Curative Services 22
13. Health Facilities 23
Annex 1: List of revised HMIS recording and reporting tools 27
Annex 2: NHSP2 logical framework indicators in HMIS 28
Annex 3: HMIS indicators disaggregated by caste/ethnicity 29
1
ACRONYMS
ABER Annual Blood Examination Rate
AEFI Adverse Events Following Immunization
AES Acute Encephalitic Syndrome
AFP Acute Flaccid Paralysis
ANC Antenatal Care
ANM Auxiliary Nursing Midwife
APH Ante Partum Hemorrhage
API Acute Parasite Incidence
ARI Acute Respiratory Infection
ART Antiretroviral Therapy
ARV Antiretroviral
BC Birthing Centre
BEONC Basic Emergency Obstetric and Neonatal Care
BF Breast Feeding
C/S Caesarean Section
CABA Children Affected By AIDS
CAC Comprehensive Abortion Care
CB‐IMCI Community Based – Integrated Management of Childhood Illnesses
CEONC Comprehensive Emergency Obstetric and Neonatal Care
CMI Clinic Malaria Incidence
COPD Chronic Obstructive Pulmonary Disease
CPR Contraceptive Prevalence Rate
CRD Chronic Respiratory Disease
CYP Couple Years of Protection
DH District Hospital
DHO District Health Office
DPHO District Public Health Office
DPT Diphtheria Pertussis Tetanus
Dr Doctor
DR Drug Resistance
EOC Emergency Obstetric Care
EP Extra Pulmonary
EPI Expanded Program on Immunization
FCHV Female Community Health Volunteer
FHD Family Health Division
FP Family Planning
HC Health Center
Hep B Hepatitis – B
HF Health Facility
Hib Hemophilus Influenza – Type B
HP Health Post
ICD International Classification of Diseases
IDU Intravenous Drug Users
IFA Iron Folic Acid
IMCI Integrated Management of Childhood Illnesses
IUCD Intra Uterine Contraceptive Device
IV Intravenous
JE Japanese Encephalitis
KA Kala‐azar
KATFR Kala‐azar Treatment Failure Rate
LBI Localized Bacterial Infection
MA Medical Abortion
MB Multi Bacillary
2
MCHW Maternal and Child Health Worker
MDR Multi Drug Resistance
MNP Micro‐multi Nutrient Powder
MSC Matri Surakchya Chhakki
MSM Men who have sex with men
MVA Manual Vacuum Aspiration
MWRA Married Women of Reproductive Age
NCASC National Center for AIDS and STDs Control
NGO Non‐Governmental Organization
NHSP2 LF Nepal Health Sector Programme 2 Logical Framework
NHTC National Health Training Center
NRH Nutrition Rehabilitation Home
NSP Needle and Syringe Programme
NT Neonatal Tetanus
NTP National Tuberculosis Program
OC Outcome
OP Output
OPD Out‐Patient Department
OPV Oral Polio Vaccine
ORC Outreach Clinic
ORS Oral Rehydration Solution
ORS Oral Rehydration Solution
OST Opioid Substitution Therapy
OTP Outpatient Therapeutic Center
PAC Post Abortion Care
PAL Practical Approach to Lungs Health
PB Pauci Bacillary
PCV Pneumococcal Conjugate Vaccine
PHC Primary Health Care
PHCC Primary Health Care Centre
PLHIV People Living with Human Immunodeficiency Virus
PMTCT Prevention of Mother‐to‐Child Transmission
PNC Postnatal Care
PPH Postpartum Hemorrhage
PSBI Possible Severe Bacterial Infection
PWID People Who Inject Drugs
RFT Released From Treatment
RHD Regional Health Directorate
SAG Sodium Astivo Gluconate
SAM Severe Acute Malnutrition
SBA Skilled Birth Attendant
SHP Sub Health Post
SPR Slide Positivity Rate
TAD Treatment after Default
TAF Treatment after Failure
Td Tetanus Diphtheria
TT Tetanus Toxoid
VHW Village Health Worker
VVM Vaccine Vial Monitor
WRA Women of Reproductive Age
3
INTRODUCTION
Nepal's health sector needs accurate, comprehensive and disaggregated data to gauge its
performance, identify disparities between social groups and geographic areas, and plan future
interventions. The Health Management Information System (HMIS), based within the Department of
Health Services (DoHS), has played an important role to date in providing health service data.
Realizing the need to strengthen HMIS to meet current demands the Management Information
System (MIS) Section, Management Division, Department of Health Services (DoHS), under the
guidance of Ministry of Health and Population (MoHP), with support from development partners has
revised the HMIS.
The revised HMIS has been designed to:
1. ensure indicators and tools meet the current needs of NHSP2 and the programmes (family
health, child health (including nutrition), epidemics and disease control, HIV/AIDS and STD,
leprosy, tuberculosis, public health laboratory and curative services)
2. integrate vertical reporting systems (Aama programme, emergency obstetric care
monitoring, community based neonatal care programme, nutrition/integrated management
of acute malnutrition, HIV/AIDS and tuberculosis programmes) into HMIS
3. bring HMIS in line with the HSIS National Strategy, in regards to:
enabling selected indicators to be disaggregated by caste/ethnicity
revising the reporting process to enable facility level data reporting
ensuring data from all health facilities across the country including police and army
hospitals, mission hospitals, teaching hospitals and all non‐public facilities are
collected
4. make the tools more user‐friendly
5. ensure the reporting process is efficient and effective to minimise the burden on staff and
any duplication of work
6. ensure the same recording and reporting tools and reporting processes are used in all 75
districts
7. enable electronic data entry at district and hospital level and web‐based reporting to central
level
8. disaggregate hospital mortality and morbidity data by age, sex and cause
9. support use of data for review, planning, monitoring and evaluation at different levels
10. provide evidence to inform strategic and policy level decisions, such as the design of the
sectoral plan
The following process has been followed for revision of HMIS:
Revision of indicators
Revision of recording and reporting forms
Field‐testing of the revised HMIS forms and reporting process
Development of HMIS database – porting the revised HMIS in DHIS2 environment
Strengthening IT system nationwide
Preparation of comprehensive guidelines/manuals
Modular training to staff at all levels of system across 75 districts
Printing and supply of revised tools to all levels of health facilities across the country
Implementation of revised system across 75 districts simultaneously
4
This booklet presents the revised HMIS indicators by programme. There are 13 sections with a total
of 280 indicators. Each indicator is defined with its numerator and denominator. It also explains the
level and type of disaggregation available for each indicator.
SN Programme No. of indicators %
1 Safe motherhood 36 13.6
2 Family planning 2 0.8
3 Female community health volunteers 10 3.8
4 Primary health care outreach services 4 1.5
5 Immunization 28 10.6
6 Integrated management of childhood illnesses 31 11.7
7 Nutrition 25 9.4
8 HIV/AIDS 24 9.1
9 Tuberculosis 18 6.8
10 Epidemiology and disease control 21 7.9
11 Leprosy 12 4.5
12 Curative services 26 9.8
13 Health facilities 28 10.6
Total 265 100.0
Annexes:
Annex 1: List of revised HMIS recording and reporting tools
Annex 2: NHSP2 logical framework indicators in HMIS
Annex 3: HMIS indicators disaggregated by caste/ethnicity
5
1. Safe Motherhood
Code Indicator Numerator Denominator Multiplier Disaggregation by:
A ANTEPARTUM
1.1 % of pregnant women who had at least one Number of pregnant women who had at least Estimated number of live births 100 Age: <20 yrs, ≥20 years
ANC checkup one ANC checkup
1.2 % of pregnant women who had four ANC Number of pregnant women who had four ANC Estimated number of live births 100
checkups as per protocol (4th, 6th, 8th and checkups as per protocol (4th, 6th, 8th and 9th
9th month) month)
1.3 % of women who received a 180 day supply Number of women who received a 180 day Estimated number of live births 100 Area: Urban, rural
of iron folic acid during pregnancy supply of iron folic acid during pregnancy
1.4 % of pregnant women who received Number of pregnant women who received Estimated number of live births 100
anthelmintics anthelmintics
B DELIVERY
1.5 % of institutional deliveries Number of deliveries conducted in health Estimated number of live births 100 Sector: Govt., non Govt. institutions
facilities Level of facility: Higher level hospitals,
district hospitals, PHCCs, HPs, SHPs
Type of facility: CEONC, BEONC, BC,
Aama programme implementing
facility
Caste/Ethnicity
Area: Urban, rural
1.6 % of births attended by a skilled birth Number of deliveries conducted by a skilled Estimated number of live births 100 Sector: Govt., non Govt.
attendant (SBA) birth attendant (SBA) Place: Institution, home
Area: Urban, rural
1.7 % of births attended by a health worker Number of deliveries conducted by a health Estimated number of live births 100 Sector: Govt. non Govt. institutions
other than SBA worker other than SBA Type of facility: CEONC, BEONC, BC
1.8 % of women who had four ANC checkups as Number of women who had four ANC checkups Estimated number of live birth 100 Sector: Govt., non Govt. institutions
per protocol (4th, 6th, 8th and 9th months) as per protocol (4th, 6th, 8th and 9th months) and Type of facility: CEONC, BEONC, BC,
and delivered in a health facility delivered in a health facility Aama programme implementing
facility
1.9 % of normal deliveries Number of normal deliveries Number of reported deliveries 100 Sector: Govt., not Govt.
Level of facility: Higher level hospitals,
district hospitals, PHCC, HP, SHPs
Type of facility: CEONC, BEONC, BC
1.10 % of assisted (vacuum or forceps) deliveries Number of assisted deliveries Number of reported deliveries 100 Sector: Govt., non Govt. institutions
Level of facility: Higher level hospitals,
6
Code Indicator Numerator Denominator Multiplier Disaggregation by:
district hospitals, PHCC, HP, SHPs
Type: CEONC, BEONC, BC
1.11 % of deliveries by caesarean section Number of caesarean section deliveries Number of reported deliveries 100 Sector: Govt. non‐Govt institutions
Type: Higher level government
hospitals, district hospitals
C POSTPARTUM
1.12 % of postpartum women who received a Number of postpartum women who received a Estimated number of live births 100
PNC checkup within 24 hours of delivery PNC checkup within 24 hours of delivery
1.13 % of women who had three postnatal Number of postpartum women who received Estimated number of live births 100
check‐ups as per protocol (1st within 24 three PNC checkups as per protocol (within 24
hours, 2nd within 72 hours and 3rd hours, on 3rd day and 7th day)
within 7 days of delivery)
1.14 % of postpartum women who received a 45 Number of postpartum women who received a Estimated number of live births 100
day supply of iron folic acid (IFA) 45 day supply of IFA
1.15 % of postpartum women who received Number of postpartum women who received Estimated number of live births 100
Vitamin A supplementation Vitamin A supplementation
D MATERNAL COMPLICATIONS
1.16 Met need for emergency obstetric care Number of women with a direct obstetric Estimated number of women 100 Level of facility: Higher level hospitals,
[% of women with a direct obstetric complication who were treated in a EONC with a direct obstetric district hospitals, PHCC, HP, SHPs
complication who were treated at a EONC (basic or comprehensive) site complication (15% of estimated Type of facility: CEOC, BEOC, BC
(basic or comprehensive) site] number of live birth)
1.17 Number of women treated for Type: APH, PPH
haemorrhage Blood: With and without blood
transfusion
Level of facility: Higher level hospitals,
district hospitals, PHCC, HP, SHPs
1.18 Number of women treated for ectopic
pregnancy
1.19 Number of women treated for prolonged/
obstructed labor
1.20 Number of women treated for ruptured
uterus
1.21 Number of women treated for pre‐
eclampsia
1.22 Number of women treated for eclampsia
1.23 Number of women treated for retained Method: MRP
placenta
7
Code Indicator Numerator Denominator Multiplier Disaggregation by:
1.24 Number of women treated for puerperal
sepsis
1.25 Number of women treated for abortion Type: Surgical, medical
complications Blood: With and without blood
transfusion
1.26 % of women treated for an obstetric Number of women treated for an obstetric Number of women treated for 100
complication who received a blood complication who received a blood transfusion an obstetric complication
transfusion
1.27 Number of blood units used for treating
obstetric complications
1.28 % of births by caesarean section Number of women having given birth by Estimated number of live birth 100
caesarean section
E MATERNAL MORTALITY
1.29 Maternal mortality ratio per 100,000 live Number of maternal deaths in the community Estimated number of live births 100,000 Place: Facility, Community
births and facilities
1.30 Facility maternal mortality ratio per Number of maternal deaths in facilities Number of live births at facilities 100,000
100,000 live births
1.31 Direct obstetric case fatality rate Number of maternal deaths due to direct Number of women treated for 100
obstetric complications in health facilities direct obstetric complications in
health facilities
F NEONATAL
1.32 % of neonates who received a check‐up Number of neonates who received a checkup Estimated number of live births 100
within 24 hours of birth within 24 hours of birth
1.33 % of neonates who received three check‐ Number of neonates who received three Estimated number of live births 100
ups as per PNC protocol (within 24 hours, checkup as per PNC protocol (within 24 hours,
on 3rd day and 7th day) on 3rd day and 7th day)
G ABORTION
1.34 % of pregnancies terminated by induced Number of pregnancies terminated by induced Estimated number of 100 Age: <20 yrs, ≥20 years
procedure at health facility procedure at health facility pregnancies Method: Surgical/Medical
1.35 % of women who received contraceptives Number of women who received Number of women who received 100 Timing: Induced, PAC
after induced abortion (surgical or medical) contraceptives after abortion care at health abortion care at health facility FP method: short‐acting methods,
facility long‐acting methods
Age: <20 yrs, ≥20 years
1.36 % of women of reproductive age (15‐49) Number of women with complications after Number of women of receiving 100 Age: <20 yrs, ≥20 years
with complications from induced abortion receiving induced abortion care at health induced abortion care at health
(surgical and medical) facility facility
8
2. Family Planning
Code Indicator Numerator Denominator Multiplier Disaggregation by:
2.1 Contraceptive prevalence rate (CPR) (modern Number of WRA currently using a modern Estimated number of WRA 100 Age: 15‐19 yrs, 20‐49 yrs
methods) among women of reproductive age method of family planning Area: Urban, rural
(WRA) Method: Condom, pill, injectable,
Implant, IUCD, Sterilization
2.2 % of postpartum mothers using a modern Number of postpartum mothers (who Total number of delivery 100
family planning method (implant, IUCD) delivered within last one year) using a family (Home + Institutional)
planning method
3. Female Community Health Volunteers (FCHV)
Code Indicator Numerator Denominator Multiplier Disaggregation by:
A FCHV
3.1 Number of Female Community Health Age: <60, ≥60 years
Volunteers (FCHVs) Area: Urban, rural
3.2 % of mothers group meetings held Number of mothers group meetings held Estimated number of mothers Area: Urban, rural
group meetings
3.3 % of women of reproductive age utilizing Number of women of reproductive age Estimated number of women 100 Area: Urban, rural
FCHV fund ᵃ utilizing FCHV fund of reproductive age
3.4 Amount of money invested from the FCHV Area: Urban, rural
fund
B Programme specific indicators
3.5 % of pregnant women visited by FCHVs Number of pregnant women visited by a FCHV Estimated number of live 100 Area: Urban, rural
births
3.6 % of postpartum women visited by FCHVs Number of postpartum women visited by a Estimated number of live 100 Area: Urban, rural
FCHV births
3.7 Number of oral contraceptive pill cycles Area: Urban, rural
distributed by FCHVs
3.8 Number of condoms distributed by FCHVs Area: Urban, rural
3.9 % of FCHVs who participated in PHC outreach Number of FCHVs who participated in PHC Number of FCHVs 100 Area: Urban, rural
clinics outreach clinics
3.10 Average number of times FCHVs participated Total number of times FCHVs participated in Number of FCHVs Area: Urban, rural
in PHC outreach clinics PHC ORC
9
4. Primary Health Care Outreach Services
Code Indicator Numerator Denominator Multiplier Disaggregation by:
4.1 % of planned primary health care (PHC) Number of PHC outreach clinics conducted Number of PHC outreach 100
outreach clinics conducted clinics planned
4.2 Average number of clients served per PHC Number of clients served at PHC outreach Number of outreach clinics
outreach clinic clinics conducted
4.3 % of women who received a contraceptive Number of women who received a Number of women who 100
injectable at PHC outreach clinic contraceptive injectable at PHC outreach clinic received a contraceptive
injectable at PHC outreach
clinic and health facilities
4.4 % of women who received ANC check‐up at Number of women who received ANC check‐ Number of women who 100
PHC outreach clinic up at PHC outreach clinic received ANC check‐up at PHC
outreach clinic and health
facilities
5. Immunization
Code Indicator Numerator Denominator Multiplier Disaggregation by:
A CHILDREN
5.1 % of children under one year immunized with Number of children under one year Number of children under one
100
BCG immunized with BCG year
5.2 % of children under one year immunized with Number of children under one year Number of children under one 100
DPT‐HepB‐Hib1 immunized with DPT‐HepB‐Hib1 year
5.3 % of children under one year immunized with Number of children under one year Number of children under one 100
DPT‐HepB‐Hib2 immunized with DPT‐HepB‐Hib2 year
5.4 % of children under one year immunized with Number of children under one year Number of children under one 100
DPT‐HepB‐Hib3 immunized with DPT‐HepB‐Hib3 year
5.5 % of children under one year immunized with Number of children under one year Number of children under one 100
Polio 1 immunized with Polio 1 year
5.6 % of children under one year immunized with Number of children under one year Number of children under one 100
Polio 2 immunized with Polio 2 year
5.7 % of children under one year immunized with Number of children under one year Number of children under one 100
Polio 3 immunized with Polio 3 year
5.8 % of children under one year immunized with Number of children under one year Number of children under one 100
PCV 1 immunized with PCV 1 year
5.9 % of children under one year immunized with Number of children under one year Number of children under one 100
PCV 2 immunized with PCV 2 year
10
Code Indicator Numerator Denominator Multiplier Disaggregation by:
5.10 % of children under one year immunized with Number of children under one year Number of children under one 100
PCV 3 immunized with PCV 3 year
5.11 % of one‐year‐old children immunized Number of children under one year immunized Number of children under one Age: 9‐11 months, 12‐23 months
against measles/rubella with measles/rubella year 100 Area: Rural, urban
Caste/Ethnicity
5.12 % of children aged 12‐23 months immunized Number of children aged 12‐23 months Number of children aged 12‐ 100
with JE immunized with JE 23 months
5.13 % of children under one year fully immunized Number of children under one year fully Number of children under one
100
as per NIP schedule (BCG, DPT‐Hep B‐Hib‐3, immunized as per NIP schedule (BCG, DPT‐Hep year
OPV‐3, Measles/Rubella and PCV3) B‐Hib‐3, OPV‐3 and Measles/Rubella, PCV3)
5.14 % of children under one year not immunized Number of children under one year minus Number of children under one
100
against DPT‐Hep B‐Hib3 number of children immunized against DPT‐ year
HepB‐Hib3
5.15 DPT‐HepB‐Hib drop‐out rate Number of children immunized with DPT‐ Number of children
(DPT‐HepB‐Hib 1 vs 3) HepB‐Hib1 minus number of children immunized with DPT‐HepB‐ 100
immunized with DPT‐HepB‐Hib3 Hib1
5.16 Measles/rubella1 dropout rate Number of children immunized with DPT‐ Number of children
(DPT‐HepB‐Hib1 vs measles/rubella 1) HepB‐Hib1 minus number of children immunized with DPT‐HepB‐ 100
immunized with Measles/Rubella 1 Hib1
5.17 % of VDCs/districts with 90% coverage of Number of VDCs/Municipalities/districts with Number of
100
DPTHepBHib3 90% coverage of DPTHepBHib3 VDCs//municipalities/districts
B WASTAGE RATE
5.18 Vaccine wastage rate for of BCG, Measles, Number of doses expended minus number of Number of doses expended for Antigen: BCG, Measles, DPT‐HepB‐Hib,
DPT‐HepB‐Hib, Td, JE, Polio, PCV doses used for BCG, Measles, DPT‐HepB‐Hib, BCG, Measles, DPT‐HepB‐Hib, 100 Td, JE, Polio, PCV
Td, JE, Polio, PCV Td, JE, Polio, PCV
C TITANUS DIPTHERIA
5.19 % of pregnant women who received Td2 Number of pregnant women who received Td2 Estimated number of live 100
births
5.20 % of pregnant women who received Td2+ Number of pregnant women who received Estimated number of live 100
Td2+ births
D IMMUNIZATION CLINICS
5.21 % of planned immunization clinics conducted Number of immunization clinics conducted Number of immunization
100
clinics planned
5.22 % of planned immunization sessions Number of immunization sessions conducted Number of immunization
100
conducted sessions planned
E ADVERSE EVENTS FOLLOWING IMMUNIZATION (AEFI)
11
Code Indicator Numerator Denominator Multiplier Disaggregation by:
5.23 % of adverse events following immunization Number of AEFI cases reported, by antigen Number of children By antigen: BCG,
(AEFI) cases reported, by antigen immunized by antigen 100 DPT‐HepB‐Hib3, OPV‐3 and Measles
By type: Serious and minor
F VACCINE PREVENTABLE DISEASES
5.24 Acute flaccid paralysis (AFP) rate per 100,000 Number of children under 15 years with AFP Number of children under 15
100,000
children under 15 years years
5.25 Neonatal tetanus rate per 1000 live births Number of neonatal tetanus cases Estimated number of live birth 1,000
5.26 Acute encephalitis syndrome (AES) rate per Number of acute encephalitis syndrome cases Total population of high risk
100,000
100,000 population in high risk districts in high risk districts districts
5.27 Measles like illness rate per 100,000 Number of measles like illness cases Total population
100,000
population
5.28 Rubella like illness rate per 100,000 Number of rubella like illness cases Total population
100,000
population
6. Integrated Management of Childhood Illnesses (IMCI)
Code Indicator Numerator Denominator Multiplier Disaggregation by:
A CHILDREN UNDER FIVE YEARS: DIARRHOEA
6.1 Diarrhoea incidence rate among children Number of children under five years with a Estimated number of children 1,000
under five years new case of diarrhoea under five years
6.2 % of children under five years with diarrhea Number of children under five years with Number of children under five 100 Severity of dehydration: some, severe
suffering from dehydration (facility, outreach diarrhea suffering from dehydration (facility, years with diarrhoea (facility,
and community) outreach and community) outreach and community)
6.3 % of children under five years with diarrhea Number of children under five years with Number of children under five 100
suffering from dysentery (blood in stool) diarrhea suffering from dysentery (blood in years with diarrhoea
stool)
6.4 % of children under five years with diarrhea Number of children under five years with Number of children under five 100
treated with ORS only (facility, outreach and diarrhea treated with ORS only (facility, years with diarrhoea (facility,
community) outreach and community) outreach and community)
6.5 % of children under five years with diarrhea Number of children under five years with Number of children under five 100 Health facility, CHW, FCHV
treated with zinc and ORS diarrhea treated with ORS and zinc (facility, years with diarrhoea (facility,
outreach and community) outreach and community)
6.6 % of children under five years with diarrhoea Number of children under five years with Number of children under five 100
treated with IV fluid diarrhoea treated with IV fluid years with diarrhoea
6.7 Diarrhoea mortality rate among children Number of deaths due to diarrhoea among Estimated number of children 1,000
under five years (per 1,000) children under five years (facility and under five years
community)
12
Code Indicator Numerator Denominator Multiplier Disaggregation by:
6.8 Diarrhoea case fatality rate among children Number of deaths due to diarrhoea among Number of children under five 1,000
under five years (per 1,000) children under five years occurring at health years with diarrhoea treated at
facilities a health facility
B CHILDREN UNDER FIVE YEARS: ARI
6.9 ARI incidence rate among children under five Number of children under five years with a Estimated number of children 1,000
years (per 1,000) new case of ARI under five years
6.10 Incidence of pneumonia among children Number of new cases of pneumonia Estimated number of children 1,000
under five years (per 1,000) (pneumonia or severe pneumonia, or very under five years
severe pneumonia) among children under five
years
6.11 % of children under five years with ARI Number of children under five years with ARI Number of children under five 100 Severity: Severe pneumonia, very
suffering pneumonia suffering pneumonia years with ARI severe pneumonia
6.12 % of children under five years with Number of children under five years with Number of children under five 100 Antibiotic type: Paediatric cotrim,
pneumonia, who received antibiotics pneumonia, who received antibiotics years with pneumonia Other antibiotics
Place: Health facility, community (FCHV
‐ Cotrim)
6.13 % of children under five years with Number of children under five years with Number of children under five 100
pneumonia counselled for home care pneumonia counselled for home care years with ARI (facility,
management (facility, outreach and management (facility, outreach and outreach and community)
community) community)
6.14 % of children under five years with ARI Number of children under five years with ARI Number of children under five 100 Health facility, CHW, FCHV
managed at a health facility managed at a health facility years with ARI (facility,
outreach and community)
6.15 ARI mortality rate among children under five Number of deaths due to ARI among children Estimated number of children 1,000
years (per 1,000) under five years under five years
6.16 ARI case fatality rate among children under Number of deaths due to ARI at a health Number of children under five 1,000
five years (per 1,000) facility among children under five years years treated for ARI at a
health facility
D CHILDREN UNDER FIVE YEARS: VITAMIN A
6.17 % of children 6‐59 months treated with Number of children 6‐59 months treated with Number of children 6‐59 100
Vitamin A Vitamin A months reported in CB‐IMCI
E CHILDREN UNDER FIVE YEARS: MULTIPLE CLASSIFICATION
6.18 % of multiple illness classification cases Number of multiple illness classification cases Number of cases reported in 100
reported in CB‐IMCI reported in CB‐IMCI CB‐IMCI
F COMMUNITY BASED NEONATAL CARE PROGRAMME (CB‐NCP)
6.19 % of newborns who had skin‐to‐skin contact Number of newborns who had skin‐to‐skin Number of reported live births 100 Place: Facility, Community
immediately after birth contact immediately after birth
13
Code Indicator Numerator Denominator Multiplier Disaggregation by:
6.20 % of newborns who had chlorhexidine Number of newborns who had chlorhexidine Number of reported live births 100 Place: Facility, Community
ointment applied immediately after birth ointment applied immediately after birth
6.21 % of newborns with low birth weight kept in Number of newborns with low birth weight Number of newborns recorded 100
KMC kept in KMC with low birth weight
6.22 % of newborns who initiated breastfeeding Number of newborns who initiated Number of reported live births 100 Place: Facility, Community
within an hour of birth breastfeeding within an hour of birth
6.23 % of infants aged 0‐2 months with possible Number of infants aged 0‐2 months with Number of infants aged 0‐2 100 Age: ≤28 days, 29‐59 days
severe bacterial infection (PSBI) possible severe bacterial infection (PSBI) months reported in CB‐IMCI
6.24 % of infants aged 0‐2 months with PSBI Number of infants aged 0‐2 months with PSBI Number of infants aged 0‐2 100
receiving a first dose of Gentamycin receiving a first dose of Gentamycin months reported with PSBI
6.25 % of infants aged 0‐2 months with PSBI Number of infants aged of 0‐2 months with Number of infants aged 0‐2 100
receiving a complete dose of Gentamycin PSBI receiving a complete dose of Gentamycin months reported with PSBI
6.26 PSBI case fatality rate among infants under Number of newborn deaths due to PSBI at a Number of infants aged 0‐2 1000
one month old (per 1000) health facilities months reported with PSBI
6.27 % of infants aged 0‐2 months with localized Number of infants aged 0‐2 months with Number of infants aged 0‐2 100 Age: ≤28 days, 29‐59 days
bacterial infection (LBI) localized bacterial infection (LBI) months reported in IMCI
6.28 % of infants aged 0‐2 months with Number of infants aged 0‐2 months with Number of infants aged 0‐2 100 Age: ≤28 days, 29‐59 days
hypothermia hypothermia months reported in IMCI
6.29 % of infants aged 0‐2 months with low weight Number of infants aged 0‐2 months with low Number of infants aged 0‐2 100 Age: ≤28 days, 29‐59 days
for age weight for their age months reported in IMCI
6.30 % of infants aged 0‐2 months who had Number of infants aged 0‐2 months who had Number of infants aged 0‐2 100 Age: ≤28 days, 29‐59 days
feeding problems feeding problems months reported in IMCI
G Others
6.31 % of children under five years enrolled in Number of children under five years enrolled Number of children under five 100 Caste/ethnicity
CBIMCI programme in CBIMCI programme years
7. Nutrition
Code Indicator Numerator Denominator Multiplier Disaggregation by:
A GROWTH MONITORING
7.1 % of newborns with low birth weight (<2.5kg) Number of newborns who were weighed less Number of live births at health 100 Place of birth: Health facility, Home
than 2.5 kg facilities and home who were
weighed
7.2 % of children aged 0‐12 months registered for Number of aged 0‐12 months registered for Estimated number of children 100
growth monitoring growth monitoring age 0‐12 months
7.3 Average number of visits among children Sum of number of visits among children aged Number of registered visits for Age: 0‐11 months, 12‐23 months,
aged 0‐24 months registered for growth 0‐24 months registered for growth monitoring children age 0‐24 months Annual
14
Code Indicator Numerator Denominator Multiplier Disaggregation by:
monitoringᵃ registered for growth
monitoring
7.4 % of children aged 0‐24 months registered for Number of children aged 0‐24 months Number of children age 0‐24 100 Severity: Moderate, Severe
growth monitoring who were underweight registered for growth monitoring who were months registered for growth Age: 0‐11 months, 12‐23 months
underweight monitoring Caste/Ethnicity
B INFANT AND YOUNG CHILD FEEDING
7.5 % of newborns who initiated breastfeeding Number newborns who initiated breastfeeding Number of recorded live births 100
within 1 hour of birth within 1 hour of birth
7.6 % of children aged 0‐ 6 months registered for Number of children aged 0‐ 6 months and Number of children age 6‐11 100
growth monitoring, who were exclusively registered for growth monitoring who were months
breastfed for the first six months exclusively breastfed for first 6 months
7.7 % of children aged 6–8 months registered for Number of children aged 6‐8 months Number of children age 6‐11 100
growth monitoring who received solid, semi‐ registered for growth monitoring who received months
solid or soft foods solid, semi‐solid or soft foods
C MICRO‐NUTRIENTS AND ANTIHELMINTHICS
7.8 % of children aged 6‐59 months, who Number of children aged 6‐59 months who Estimated number of children 100 Age: 6‐11 months, 12‐59 months
received Vitamin A supplements received Vitamin A supplementation aged 6‐59 months
7.9 % of children aged 12‐59 months who Number of children aged 12‐59 months who Estimated number of children 100
received antihelminthics received antihelminthics aged 12‐59 months
7.10 % of children aged 6‐23 months, who Number of children aged 6‐23 months, who Estimated number of children 100 Age: 6‐11 months, 12‐17 months, 18‐
received Baal Vita (MNP) received Baal Vita (MNP) age 6‐23 months 23 months
7.11 % of children aged 6‐23 months, who Number of children aged 6‐23 months, who Estimated number of children 100
received all 3 cycles of Baal Vita (MNP) received all 3 cycles of Baal Vita (MNP) age 6‐23 months
7.12 % of adolescents girls aged 10‐19 years who Number of adolescents girls aged 10‐19 years Estimated number of 100 Age: 10‐14 and, 15‐19 years
received iron supplementation for 13 weeks who received iron supplementation for 13 adolescent girls aged 10‐19
weeks years
D MANAGEMENT OF ACUTE MALNUTRION (MAM)
7.13 Number of cases admitted at outpatient
therapeutic centers (OTPs)
7.14 % of cases admitted at OTPs with moderate Number of cases admitted at OTPs with MAM Number of cases admitted at 100
acute malnutrition (MAM) OTPs
7.15 % of cases admitted at OTPs with MAM who Number of cases admitted at OTPs with MAM Number of cases admitted at 100
recovered who recovered OTPs with MAM
7.16 % of cases admitted at OTPs with MAM who Number of cases admitted at OTPs with MAM Number of cases admitted at 100
died who died OTPs with MAM
7.17 % of cases admitted at OTPs with severe Number of cases admitted at OTPs with SAM Number of cases admitted at 100
acute malnutrition (SAM) OTPs
15
Code Indicator Numerator Denominator Multiplier Disaggregation by:
7.18 % of cases admitted at OTPs with SAM who Number of cases admitted at OTPs with SAM Number of cases admitted at 100
recovered who recovered OTPs with SAM
7.19 % of cases admitted at OTPs with SAM who Number of cases admitted at OTPs with SAM Number of cases admitted at 100
died who died OTPs with SAM
7.20 Number of SAM cases admitted at nutrition
rehabilitation homes (NRHs)
7.21 % of cases admitted at NRHs with SAM who Number cases admitted at NRHs with SAM Number of cases admitted at 100
recovered who recovered NRHs with SAM
7.22 % of SAM cases at NRHs who died Number of cases admitted at NRHs with SAM Number of cases admitted at 100
who died NRHs with SAM
E SCHOOL HEALTH AND NUTRITION
7.23 % of public schools that received a first aid kit Number of public schools that received a first Number of public schools 100
box aid kit box
7.24 % of students in grade 1‐10 who received Number of students in grade 1‐10 who Number of students in grade 1‐ 100 Sex: Male, Female
anthelminthic received anthelminthic 10
F FOOD SUPPLEMENT
7.25 % of children aged 6‐23 months who received Number of children aged 6‐23 months who Estimated number of children 100
monthly food supplements received monthly food supplements age 6‐23 months
8. HIV/AIDS
Code Indicators Numerator Denominator Multiplier Disaggregation by:
A HIGH RISK GROUPS
8.1 % of high risk groups who received an HIV test Number of high risk groups who received an Target population High risk group: Sex workers, men who
(e.g. through an outreach service, drop‐in HIV test (e.g. through an outreach service, 100 have sex with men, male labor
centre or sexual health clinic) drop‐in centre or sexual health clinic) migrants, PWIDs
8.2 % of high risk groups who received an HIV test Number of high risk groups who received an Number of high risk groups High risk group: Sex workers, men who
and know their results HIV test and know their results who received an HIV test 100 have sex with men, male labor
migrants, PWIDs
8.3 % of people who inject drugs (PWIDs) Number of people who inject drugs (PWIDs) Estimated number of PWIDs
currently on opioid substitution therapy (OST) currently on opioid substitution therapy 100
Code Indicators Numerator Denominator Multiplier Disaggregation by:
treated for syphilis
8.6 % of people who inject drugs (PWIDs) who Number of people who inject drugs (PWIDs) Estimated number of PWIDs
have been on Opoid Substitution Therapy who have been on OST 100
(OST)
B MOTHER TO CHILD TRANSMISSION
8.7 % of women screened for syphilis at an Number of women who were screened for Estimated number of
100
antenatal care (ANC) check‐up syphilis at an ANC check‐up pregnancies
8.8 % of women screened for syphilis at an ANC Number of women who were screened for Number of women who were
check‐up and tested positive syphilis at an ANC check‐up and tested screened for syphilis at an 100
positive ANC check‐up
8.9 % of women who tested positive for syphilis at Number of women who tested positive for Number of women who
an ANC check‐up and were treated syphilis at an ANC check‐up and were treated tested positive for syphilis at 100
an ANC check‐up
8.10 % of HIV positive pregnant women enrolled in Number of HIV positive pregnant women Estimated number of HIV‐
PMTCT service enrolled in PMTCT service positive pregnant women 100
Code Indicators Numerator Denominator Multiplier Disaggregation by:
antiretroviral therapy and are known to have antiretroviral therapy and are known to have initiated antiretroviral
been on it continuously for at least 36 months been on it continuously for at least 36 months therapy
E TREATMENT AND CARE
8.18 % of people enrolled in HIV care/ treatment Number of people enrolled in HIV care/ Number of people enrolled in Age: 0‐14 years, >14 years
who received cotrimoxazole prophylaxis treatment who received cotrimoxazole HIV care / treatment 100
prophylaxis
8.19 % of people living with HIV currently enrolled Number of people living with HIV currently Estimated number of people Age: 0‐14 years, >14 years
in HIV care, who received opportunistic enrolled in HIV care, who received living with HIV infection 100
infection (OI) services opportunistic infection (OI) services
8.20 % of people living with HIV infection who Number of people living with advanced HIV Estimated number of people Age: 0‐14 years, >14 years
received antiretroviral therapy in accordance infection who received antiretroviral therapy with advanced HIV infection
100
with the nationally approved treatment in accordance with the nationally approved
protocol treatment protocol
8.21 % of people who started antiretroviral therapy Number of people that started antiretroviral Number of people who
and picked up all prescribed antiretroviral therapy and picked up all prescribed started antiretroviral therapy
100
drugs on time for two consecutive drug pick‐ antiretroviral drugs on time for two
ups consecutive drug pick‐ups
F HIV ‐ TB TREATMENT
8.22 % of people enrolled in HIV care who had their Number of people enrolled in HIV care who Number of people enrolled in Age: 0‐14 years, >14 years
TB status assessed and recorded during their had their TB status assessed and recorded HIV care 100
last visit) during their last visit
8.23 % of PLHIV positive TB cases who received Number of people with HIV positive TB cases Estimated number of HIV Age: 0‐14 years, >14 years
treatment for both TB and HIV (antiretroviral who received treatment for both TB and HIV positive TB cases 100
combination therapy) (antiretroviral combination therapy)
8.24 % of people newly enrolled in HIV care who Number of people newly enrolled in HIV care Number of people newly
started treatment for latent TB infection who started (given at least one dose) enrolled in HIV care 100
(isoniazid preventive therapy) treatment of latent TB infection
9. Tuberculosis
Code Indicators Numerator Denominator Multiplier Disaggregation by:
9.1 Case notification rate (New PBC and Relapse Number of new bacteriologically confirmed Estimated population at mid‐ 100,000
TB case) TB cases (New PBC and Relapse TB case) year in defined area (district,
registered in a defined period region, country)
9.2 Case notification rate (all forms of TB cases) Number of all forms of TB Cases (PBC and Estimated population at mid‐ 100,000
PCD and EP) registered in a defined period year in defined area (district,
region, country)
9.3 Case finding rate (%) New bacteriologically confirmed pulmonary Presumptive pulmonary TB 100
18
Code Indicators Numerator Denominator Multiplier Disaggregation by:
cases registered in NTP in defined time and cases in specific duration in
area defined area*
9.4 Sputum conversion rate (%) Number of new bacteriologically confirmed Total number of new 100
TB cases who converted to smear negative bacteriologically confirmed
after 2 ( 3 month for retreatment cases] pulmonary cases registered in
month of treatment NTP in defined time and area
9.5 Proportion of PBC cases among new cases All the PBC TB cases in defined time & place All forms of new TB cases in 100
defined time & place
9.6 Loss to follow up rate (%) Number of all type of TB cases who Number of all type of TB cases 100
interrupted treatment for more than 2 registered during the same
consecutive months period
9.7 Death rate (%) Number of all type of TB cases registered for Number of all type of TB cases 100
treatment who died from any cause during registered during the same
treatment period
9.8 Mortality rate Number of all type of TB cases registered for Estimated population at mid‐ 100,000
treatment who died from any cause during year for that defined
treatment population
9.9 Cure rate (%) Number of new bacteriologically confirmed Number of new 100
TB cases who were smear negative in the last bacteriologically confirmed TB
month of treatment and on at least one cases registered during the
previous occasion same period
9.10 Treatment success rate [(Number of new positive cases Number of new 100
(bacteriologically confirmed) who smear bacteriologically confirmed TB
negative in the last month of treatment and cases registered for treatment
on at least one previous occasion) + (Number during the same period
of new positive cases registered who
completed treatment but did not meet the
criteria for cure or failure)]
9.11 Positivity rate Total number of pulmonary TB cases Total no of presumptive TB
bacteriologically confirmed cases examined in the lab in 100
defined time period
Note: * Presumptive pulmonary TB cases (in defined time and place) is estimated by NTC
10. Epidemiology and Disease Control
Code Indicators Numerator Denominator Multiplier Disaggregation by:
A MALARIA
19
Code Indicators Numerator Denominator Multiplier Disaggregation by:
10.1 Annual blood examination rate (ABER) of Number of slides examined in high risk Population in high risk districts 100
malaria in high risk districtsᵃ districts
10.2 Slide positivity rate (SPR) of malaria in high risk Number of positive slides in high risk districts Number of slides examined 100 Level of facility: District Hospital, PHC,
districts HP, SHP
10.3 Malaria annual parasite incidence (per 1,000 Number of positive cases in high risk districts Population in high risk districts 1,000
population in high risk districts) ᵃ (*1000 population)
10.4 Clinical malaria incidence (CMI) in high risk Number of new cases of clinical malaria in Population in high risk districts 1,000
districts high risk districts
10.5 % of P. Falciparum (PF) cases in high risk Number of PF cases in high risk districts Number of positive cases in 100
districts high risk districts
10.6 % of imported cases among positive cases of Number of imported cases Number of positive cases 100
malaria (suspected + confirmed)
10.7 % of malaria cases by target group Number of malaria cases by target group Number of positive cases 100 Age: Children <5
(suspected + confirmed) Sex: Girls, Boys
Client: Pregnant women
10.8 Case fatality rate of malaria Number of deaths due to malaria (suspected Number of positive cases 100 Cases: Suspected, confirmed
and confirmed) (suspected + confirmed)
10.9 % of pregnant women receiving a LLIN from an Number of pregnant women receiving a LLIN Number of pregnant women 100
ANC clinic from an ANC clinic
10.10 % of confirmed cases of uncomplicated malaria Number of confirmed cases of uncomplicated Number of confirmed cases of 100
treated with antimalarials as per national malaria treated with antimalarials as per uncomplicated malaria
guidelines national guidelines
10.11 % of confirmed cases of severe malaria Number of confirmed cases of severe malaria Number of confirmed cases of 100
treated with antimalarials as per national treated with antimalarials as per national severe malaria
guidelines guidelines
10.12 % of blood slide collected that were examined Number of blood slides examined + slide Target for malaria slide 100
and tested positive positive collection
10.13 Number of health facilities designated at Number of health facilities designated as Number of health facilities
sentinel surveillance sites that are functioning sentinel surveillance sites that are functioning designated as sentinel
as sentinel surveillance sitesᵃ as sentinel surveillance sites surveillance sites
B KALA‐AZAR
10.14 Number of kala‐azar cases in at risk districts
10.15 Incidence of kala‐azar (KA) per 10,000 Number of new KA cases in at risk districts Population in at risk districts 10,000
population in at risk districts (*10,000)
10.16 % of kala‐azar cases that were treated by Number of kala‐azar cases treated by SAG in Number of kala‐azar cases in at 100
Sodium Astivo Gluconate (SAG) in at risk at risk districts risk districts
districts
20
Code Indicators Numerator Denominator Multiplier Disaggregation by:
10.17 % of kala‐azar cases that were treated by Number of kala‐azar cases treated by Number of kala‐azar cases in at 100
Fungizone in at risk districts Fungizone in at risk districts risk districts
10.18 Kala‐azar case fatality rate in at risk districts Number of deaths due to kala‐azar in at risk Number of kala‐azar cases in at 100
districts risk districts
10.19 Kala‐azar treatment failure rate (KATFR) in at Number of kala‐azar cases not responding to Number of kala‐azar cases in at 100
risk districts miltefosin/ fungizone in at risk districts risk districts
10.20 Prevalence of Kala‐azar in at risk districts per Number of kala‐azar cases in at risk districts Population in at risk districts 10,000
10,000 population (*10,000)
C LYMPHATIC FILARIASIS
10.21 Prevalence of lymphatic filariasis in at risk Number of cases of lymphatic filariasis in at Population in at risk districts 10,000
districts per 10,000 population risk districts
11. Leprosy
Code Indicators Numerator Denominator Multiplier Disaggregation by:
11.1 New case detection rate of leprosy [Pausi Number of new leprosy cases (PB and MB) Total population 100,000
Besilli (PB) and Multi Besilli (MB)]
11.2 Prevalence of leprosy per 10,000 population Number of leprosy cases (PB and MB) Total population 10,000
11.3 Incidence of leprosy per 10,000 population Number of new leprosy cases (PB and MB) Total population 10,000 Age: <15 years, ≥ 15 years
Sex: Female, male
11.4 % of new leprosy cases presenting with a Number of new leprosy cases (PB and MB) Number of new leprosy cases 100
grade‐2 disability presenting with a grade‐2 disability (PB and MB)
11.5 % of new leprosy cases that are MB Number of new leprosy cases that are MB Number of new leprosy cases 100
(PB and MB)
11.6 Treatment compliance rate for PB cases Number of new PB cases who completed the Number of PB cases who
treatment on time started treatment in the same
batch/year
11.7 Treatment compliance rate for MB cases Number of new MB cases who completed the Number of MB cases who
treatment on time started treatment in the same
batch/year
11.8 % of PB and MB cases who started treatment Number of PB and MB cases who started Number of leprosy cases (PB 100
but defaulted treatment but defaulted and MB)
11.9 % of leprosy cases released from treatment Number of leprosy cases (PB and MB) Number of leprosy cases (PB 100
(RFT) released from treatment and MB)
11.10 % of multi‐drug resistant (MDR) leprosy cases Number of MDR leprosy cases Number of leprosy cases (PB 100
and MB)
11.11 % of relapse cases of leprosy Number of relapse cases of leprosy Number of leprosy cases (PB 100
and MB)
21
Code Indicators Numerator Denominator Multiplier Disaggregation by:
11.12 % of leprosy cases under rehabilitation Number of leprosy cases under rehabilitation Number of leprosy cases (PB 100
and MB)
12. Curative Services
Code Indicators Numerator Denominator Multiplier Disaggregation by:
A OUTPATIENTS
12.1 Number of outpatients Type: New, old
Target group: Ultra poor, Poor, FCHV,
disabled, senior citizen
12.2 % of population utilizing outpatient services Number of new outpatients Total population 100 Sector: Govt., non Govt.
Level of facility: Higher level, district
hospitals, PHCC, HP, SHP
Type of facility: AFHS facility, other HF
Sex: Female, male
Caste/ethnicity
Target group: Ultra poor, Poor, FCHV,
disabled, senior citizen
Age: 0‐9, 10‐14 Yrs, 15‐19 Yrs, >= 20 Yrs
12.3 Outpatient sex ratio Number of new male outpatients Number of new female Level of facility: Hospitals, PHCC, SHP,
outpatients HP
Target group: Ultra poor, Poor, FCHV,
disabled, senior citizen
12.4 % of outpatients who were referred in Number of new outpatients who were Number of new outpatients 100 Sex: Female, male
referred in
12.5 % of outpatients who were referred out Number of new outpatients who were Number of new outpatients 100 Sex: Female, male
referred out
12.6 % of top ten diseases among outpatients Number of outpatients by top ten diseases Number of new outpatients 100 Ecological zone: Mountain, Hill, Terai
B INPATIENTS
12.7 % population utilising inpatient services at Number of inpatient cases Total population 100 Sector: Govt., non Govt.
hospitals Level of facility: Higher level hospitals,
district hospitals
Sex: Female, male
Target group: Ultra poor, Poor, FCHV,
disabled, senior citizen
Age: 0‐9, 10‐14 Yrs, 15‐19 Yrs, >= 20 Yrs
12.8 Inpatient sex ratio Number of male inpatients Number of female inpatients Sex: Female, male
12.9 % of inpatients who were referred in Number of inpatients who were referred in Number of inpatients 100 Sex: Female, male
22
Code Indicators Numerator Denominator Multiplier Disaggregation by:
12.10 % of inpatients who were referred out Number of inpatients who were referred out Number of inpatients 100
12.11 % of top ten diseases among inpatients Number of inpatients by top ten diseases Number of inpatients 100
12.12 % of top ten diseases among population Number of outpatients by top ten disease Total population 100
12.13 Average length of stay in hospital Total length of stay of discharged patients Number of discharges and Level of hospital: Higher level
deaths government hospital, district hospital
C EMERGENCY SERVICES
12.14 % of population utilising emergency services at Number of people utilizing emergency Total population 100 Level of hospital: Higher level
hospitals (Number at facility level and % at services at hospitals government hospital, district hospital
national level) Sex: Female, male
D HOSPITAL BEDS
12.15 Number of hospital beds per 5,000 population Number of hospital beds Population 5,000 Level of hospital: Higher level
government hospital, district hospital
12.16 Bed occupancy rate Number of inpatient days Number of inpatient beds 100 Level of facility: District, zonal, sub‐
available in hospitals x 365 days regional, regional, central
Ward: Maternity
12.17 Number of maternity beds Annual
12.18 Average length of stay Total inpatients days stay Total number of discharge Level of facility: Higher level hospitals,
district hospitals
12.19 Throughput Number of inpatient admissions Number of inpatient beds Level of facility: Higher level hospitals,
available district hospitals
12.20 Bed turnover interval 365 (days) – Average length of stay x Throughput Level of facility: Higher level hospitals,
Throughput district hospitals
E MORTALITY
12.21 Disease specific case fatality rate Number of deaths, by disease Number of cases of disease 100
registered in the same year
12.22 Hospital death rate, by duration of admission Number of deaths in the hospital, by duration Number of inpatients 100 Duration: Within 48 hours, after 48
of admission hours of admission
F SURGERY
12.23 Infection rate among surgical cases Number of infected surgical cases Number of surgical cases 100
12.24 Surgery related death rate Number of deaths among surgical cases Number of surgical cases 100
H DIAGNOSTIC SERVICES
12.25 Average number of radiographic images per Number of radiographic images/x‐rays Number of days Type: X‐ray, ultrasound, USG, MRI, CT
day Scan
12.26 Average number of laboratory tests per day Number of laboratory tests Number of days
13. Health Facilities
Code Indicator Numerator Denominator Multiplier Disaggregation by:
23
Code Indicator Numerator Denominator Multiplier Disaggregation by:
A CEONC
13.1 % of hospitals that are certified CEONC sitesᵃ Number of hospitals that are certified CEONC Number of hospitals 100 Sector: Govt., non Govt.
sites Level of facility: Higher level hospitals,
district hospitals
13.2 Number of CEONC facilities per 500,000 Number of CEONC facilities Total population 500,000 Ecological zone: Mountain, Hills, Terai
populationᵃ
13.3 % of districts with at least one CEONC public Number of districts with at least one CEONC Number of districts 100
facility ᵃ public facility
13.4 % of districts with at least one public facility Number of districts with at least one public Number of districts 100
providing all CEONC signal functionsᵃ facility providing all CEONC signal functions
B BEONC
13.5 % of district/district level hospitals and PHCCs Number of district/district level hospitals that Number of District and district 100 Level of facility: District/district level
that are certified BEONC sitesᵃ are BEONC level hospitals and PHCCs hospitals, PHCCs
13.6 Number of BEONC facilities per 100,000 Number of BEONC facilities Total population (*100,000) 100,000 Ecological zone: Mountain, Hills, Terai
populationᵃ
13.7 % of PHCCs providing all BEONC signal Number of PHCCs providing all BEONC signal Number of PHCCs 100 Availability: 24/7, not 24/7
functions 24/7ᵃ functions
C BIRTHING CENTRES
13.8 % of PHCCs, health posts and sub‐health posts Number of PHCCs, health posts and sub‐ Number of PHCCs, health posts 100 Level of facility: PHCCs, HPs, SHPs
that are certified birthing centersᵃ health posts that are certified birthing centers and sub‐health posts Availability: 24/7, not 24/7
D SAFE ABORTION SITES
13.9 % of government health facilities that are Number of government health facilities that Number of government health 100 Level of facility: Higher level hospitals,
certified safe abortion sitesᵃ are certified safe abortion sites facilities district hospitals, PHCCs, HPs, SHPs
Method: Surgical, medical
13.10 % of safe abortion (surgical and medical) Number of safe abortion (surgical and Number of safe abortion 100 Level of facility: Higher level hospitals,
sites with long acting family planning medical) sites with long acting family planning (surgical and medical) sites district hospitals, PHCCs, HPs, SHPs
servicesᵃ services Method: Surgical, medical
E PHCCs
13.11 Number of PHCCs per 50,000 populationᵃ Number of PHCCs Population (* 50,000) 50,000
13.12 % of PHCCs with long acting family planning Number of PHCCs with long acting family Number of PHCCs 100
servicesᵃ planning services
F HEALTH POSTS
13.13 Number of HPs per 5,000 populationᵃ Number of HPs Population (*5000) 5,000
13.14 % of health posts with at least five family Number of health posts with at least five Number of health posts 100
planning methodsᵃ family planning methods
13.15 % of health posts with long acting family Number of health posts with long acting Number of health posts 100
planning services ᵃ family planning services
24
Code Indicator Numerator Denominator Multiplier Disaggregation by:
G HEALTH CLINICS
13.16 Number of urban health clinics
13.17 Number of community health clinics
G REPORTING TO HMIS
13.18 % of health facilities (public and private) Number of health facilities (public and Number of health facilities 100 Sector: Govt., non Govt.
reporting to HMIS (by type or level) private) reporting to HMIS (public and private) Level of facility: Higher level, district
hospitals, PHCCs, HPs, SHPs
13.19 % of tertiary and secondary hospitals (public Number of tertiary and secondary hospitals Number of tertiary and 100 Level of facility: Tertiary, secondary
and private) implementing ICD 10 and implementing ICD 10 and reporting coded secondary hospitals
reporting coded information to HMIS information to HMIS
13.20 % of health information systems implementing Number of health information systems Number of health information 100
(using) uniform standard codes implementing (using) uniform standard codes systems
H LABORATORY
13.21 % of health facilities with a laboratoryᵃ Number of health facilities with a laboratory Number of health facilities, by 100 Availability: 24/7, not 24/7
level Level of facility: District Hospital, PHCC
I FAMILY PLANNING SERVICES
13.22 % of health facilities providing IUCD services, Number of health facilities providing IUCD Number of health facilities 100 Type of facility: SHPs, HPs, PHCCs and
by type of facility services district clinics
13.23 % of health facilities providing Implant Number of health facilities providing Implant Number of health facilities 100 Type of facility: SHPs, HPs, PHCCs and
services, by type of facility services district clinics
J HIV/AIDS
13.24 % of health facilities that provide HIV testing Number of health facilities that provide HIV Number of health facilities 100 Service: Testing and counseling
and counseling servicesᵃ testing and counseling services Level of facilities: Higher level, district
hospitals, PHCC, HP, SHP
13.25 % of health facilities that provide PMTCT Number of health facilities that provide Number of health facilities 100 Level of facilities: Higher level, district
servicesᵃ PMTCT services hospitals, PHCC, HP, SHP
13.26 % of health facilities that provide ART servicesᵃ Number of health facilities that provide ART Number of health facilities 100 Level of facilities: Higher level, district
services hospitals, PHCC, HP, SHP
13.27 % of health facilities dispensing antiretroviral Number of health facilities dispensing Number of health facilities 100 Level of facilities: Higher level, district
therapy that experienced a stock‐out of at antiretroviral therapy that experienced a dispensing antiretroviral hospitals, PHCC, HP, SHP
least one required antiretroviral drug stock‐out of at least one required therapy
antiretroviral drug
K Adolescence sexual and reproductive health services
13.28 % of health facilities with adolescent friendly Number of health facilities with adolescent Number of health facilities 100 Sector: Govt., non govt.
servicesᵃ friendly services Level of facility: Higher level govt.
hospitals, district hospitals, PHCCs, HPs,
SHPs
25
Note:
Indicators shaded in orange color are NHSP2 Log Frame indicators.
a = Indicators to be reported annually
26
Annex 1: List of revised HMIS recording and reporting tools
SN HMIS No HMIS Tools
1 Common Tools
1 1.1 Master Register
2 1.2 Health Service Card
3 1.3 Outpatient Register
4 1.4 Referral/Transfer Slip
5 1.5 Defaulter/Discontinuation Tracing Slip
6 1.6 Open Tally Sheet
2 Infant and Child Health
7 2.1 Child Health Card
8 2.2 Immunization Register
9 2.3 Nutrition Register
10 2.4 IMCI Register
11 2.5 IMAM Child Health Card
12 2.6 IMAM Register
13 2.7 IMAM Register – Hospital
3 Family Health
14 3.1 FP Face sheet
15 3.2 Pills, Depo Service Register
16 3.3 IUCD/Implant Service Register
17 3.4 Sterilization Register
18 3.5 Maternal and Newborn Health Card
19 3.6 Maternal and Newborn Health Service Register
20 3.7 Safe Abortion Service Register
4 Community Services
21 4.1 ORC Register
22 4.2 FCHV Service Register
23 4.3 Vitamin A Register
5 Malaria, Kalazaar and Leprosy
24 5.1 Malaria, Kalazaar & Leprosy Sample Collection Form
25 5.2 Malaria, Kalazaar & Leprosy Laboratory Register
26 5.3 Malaria and Kalazaar Treatment Register
27 5.4 Leprosy Examination and Treatment Card
28 5.5 Leprosy Treatment Register
6 Tuberculosis
29 6.1 Sputum Sample Collection Form
30 6.2 Tuberculosis Laboratory Register
31 6.3 Tuberculosis Treatment Card (Health Facility)
32 6.4 Tuberculosis Treatment Card (Patient)
33 6.5 Tuberculosis Treatment Register
34 6.6 PAL: Smoking Cessation Register
35 6.7 DR Tuberculosis Laboratory Register
36 6.8 DR Tuberculosis Treatment Register
7 HIV/AIDS and STI
37 7.1 HIV Testing and Counseling Register
38 7.2 Sexually Transmitted Infection (STI) Treatment Register
39 7.3 Prevention of Mother‐To‐Child Transmission (PMTCT) Of HIV (PMTCT) Service Register
27
SN HMIS No HMIS Tools
40 7.4 HIV Treatment and Care Register
41 7.5 HIV Patient Treatment Card
42 7.6 Opioid Substitution Therapy (OST) Register
8 Hospital
43 8.1 Admission Register
44 8.2 Discharge Register
45 8.3 Emergency Service Register
9 Monthly Reporting Form
46 9.1 FCHV Reporting Form
47 9.2 ORC Reporting Form
48 9.3 PHCC, HP and SHP Reporting Form
49 9.4 Public Hospital Reporting Form
50 9.5 Private and NGO Health Facility Reporting Form
Annex 2: NHSP2 logical framework indicators in HMIS
The following 35 indicators in the NHSP‐2 logical framework are monitored by revised HMIS:
NHSP‐2
Logical framework Indicators
LF Code
G8 Malaria annual parasite incidence (per 1000 population)
P3 % of one‐year‐old children immunized against measles
P4 % of children aged 6‐59 months that have received vitamin A supplements
P7 Contraceptive Prevalence Rate ‐ modern methods (%)
P8 % of pregnant women attending at least four ANC visits
P9 % of pregnant women receiving IFA tablets or syrup during their last pregnancy
P10 % of deliveries conducted by a skilled birth attendant
P11 % of women who had three postnatal check‐ups as per protocol (1st within 24 hours of delivery, 2nd within
72 hours of delivery and 3rd within 7 days of delivery, as % of expected live births)
P12 % of women of reproductive age (15 ‐ 49) with complications from safe abortion (surgical and medical)
P13 Prevalence rate of Leprosy (%)
P14 Obstetric direct case fatality rate (%)
OC1.2 % population utilising outpatient services at SHP, HP, PHCC and district hospitals ‐ disaggregated by sex and
caste/ethnicity
OC1.3 % population utilising inpatient services at district hospitals (all level of hospitals)
OC1.4 % population utilising emergency services at district hospitals (all level of hospitals)
OC1.5 Met need for emergency obstetric care (%)
OC1.6 % of deliveries by Caesarean Section
OC1.7 Tuberculosis treatment success rates (%)
OC2.1 % of children under 5 with diarrhoea treated with Zinc and ORS
OC2.2 % of children under 5 with pneumonia, who received antibiotics
OC2.4 % of institutional deliveries
OC2.5 % of women who received contraceptives after safe abortion (surgical or medical)
OC2.7 Tuberculosis case detection rate (%)
OP1.1 % of women utilizing FCHV fund (among women of reproductive age)
OP3.4 Number of Female Community Health Volunteers (FCHVs)
OP4.2 Number of HPs per 5,000 population
OP4.3 Number of PHCCs per 50,000 population
OP4.4 Number of district hospital beds per 5,000 population
OP4.5 % of districts with at least one public facility providing all CEONC signal functions
28
NHSP‐2
Logical framework Indicators
LF Code
OP4.6 % of PHCCs providing all BEONC signal functions
OP4.7 % of health posts with birthing centre
OP4.8 % of safe abortion (surgical and medical) sites with long acting family planning services
OP4.9 % of health posts with at least five family planning methods
OP6.2 % of health information systems implementing (using) uniform standard codes
OP6.3 % of tertiary and secondary hospital (public and private) implementing ICD 10 and reporting coded
information to health information system
OP6.4 % of health facilities (public and private) reporting to national health information system (by type or level)
Annex 3: HMIS indicators disaggregated by caste/ethnicity
Indicators
1 % of fully immunized children
2 % of underweight children below 2 years
3 % of children enrolled in IMCI
4 % of institutional deliveries
5 % of abortion cases
6 % of outpatients utilizing health services
7 % of inpatients utilizing health services
8 % of HIV positive cases
9 % of Leprosy patients
10 % of Tuberculosis patients
11 % of gender based violence cases registered in health facility
29
HMIS Publications
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