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  • Municipality: - Month: - AGE 10-14 15 - 19 Total F M Total Percent F M Total Percent Female Male Maternal Death

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    Alibasher Macalnas
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    This document is a reporting form for adolescent and development health indicators for a provincial or city consolidated accomplishment report by the Department of Health - Autonomous Region in Muslim Mindanao. It collects data on various health metrics for adolescents ages 10-14 and 15-19, including maternal death causes, morbidity rates, sexually transmitted infections, substance use, violence, injuries, suicide, assault/bullying, nutritional status, mental health issues, dental services, consultations, family planning needs, and more. The form requires submission of data by municipality, month, and totals by age group and gender.

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    ARH Data

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    This document is a reporting form for adolescent and development health indicators for a provincial or city consolidated accomplishment report by the Department of Health - Autonomous Region in Muslim Mindanao. It collects data on various health metrics for adolescents ages 10-14 and 15-19, including maternal death causes, morbidity rates, sexually transmitted infections, substance use, violence, injuries, suicide, assault/bullying, nutritional status, mental health issues, dental services, consultations, family planning needs, and more. The form requires submission of data by municipality, month, and totals by age group and gender.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
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    7 views6 pages

    Municipality: - Month: - AGE 10-14 15 - 19 Total F M Total Percent F M Total Percent Female Male Maternal Death

    Uploaded by

    Alibasher Macalnas
    This document is a reporting form for adolescent and development health indicators for a provincial or city consolidated accomplishment report by the Department of Health - Autonomous Region in Muslim Mindanao. It collects data on various health metrics for adolescents ages 10-14 and 15-19, including maternal death causes, morbidity rates, sexually transmitted infections, substance use, violence, injuries, suicide, assault/bullying, nutritional status, mental health issues, dental services, consultations, family planning needs, and more. The form requires submission of data by municipality, month, and totals by age group and gender.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 6

    Reporting form: ADOLESCENT & DEVELOPMENT HEALTH INDICATORS

    Provincial / City Consolidated Accomplishment Department of Health - Autonomous Region in Muslim Mindanao

    Municipality:_______________________
    Month:___________________________

    AGE
    INDICATORS 10-14 15 - 19 TOTAL
    F M TOTAL PERCENT F M TOTAL PERCENT FEMALE MALE
    MATERNAL DEATH:
    hemorrhage
    infections
    unsafe Abortion
    eclampsia
    obstructed labour
    indirect cause:
    malaria
    anemia
    HIV/AIDS
    direct cause:
    cardiovascular disease
    others:
    MORBIDITY:
    diarrheas
    bronchitis
    pneumonias
    influenza
    hypertension
    TB respiratory
    disease of the heart
    malaria
    measles
    Anemia
    Bronchial Asthma
    UTI
    URTI
    STI
    - gonorrhea
    - chlamydia
    - others
    ACCIDENT:
    transportation
    drowning
    others:
    ALCOHOL USE
    TOBACCO USE
    SUBSTANCE USE
    VIOLENCE:
    sexual(rape)
    domestic
    INJURIES:
    intentional
    unintentional
    others:
    SUICIDE:
    thought
    attempted
    ASSAULT/BULLYING
    NUTRITIONAL STATUS:
    underweight
    overweight
    MENTAL HEALTH:
    depression
    anxiety
    mood disorder
    others:
    DENTAL:
    (Basic Oral Health Care)
    oral examination
    oral health education
    counseling
    others:
    NUMBER OF CONSULTATIONS
    AMONG ADOLESCENT:
    early marriage
    single
    early pregnancy
    unwanted pregnancy
    others:
    UNMET NEED FOR FAMILY PLANNING
    - with need but no available method/commodity
    - no trained personnel for the choosen method
    - others

    Submitted by: ___________________________


    Date: ________________________________
    TOTAL
    TOTAL PERCENT

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