NURSE DEPLOYMENT PROJECT (NDP)

MONTHLY ACCOMPLISHMENT
for the month of: ____________

NAME: _____________________________________
AREA OF ASSIGNMENT (name of barangays): __________________________________________________
TOTAL BRGY. POPULATION: _________________________________________________
A. MATERNAL,NEONATAL, CHILD HEALTH AND NUTRITION

INDICATORS
No. of pregnant mothers w/ 4 or more prenatal visits
No. of postpartum mothers w/ 2 or more visits
No. of pregnant mothers delivered in Health Facility
No. of women who delivered at home
No. of Livebirths
Total no. of deliveries
No. teenage pregnancy tracked this month 10-15 years old
No. teenage pregnancy tracked this month 16-19 years old
No. of Livebirths of adolescent mothers (10-19 years old)
No. of deliveries by adolescent mothers(10-15 years old)
No. of deliveries by adolescent mothers(16-19 years old)
No. of newly tracked pregnant women given with MC book
No. of newly tracked pregnant women with a Birth and Emergency Plan
No. of clients enrolled as new acceptors of modern Family Planning
BTL
Vasectomy
Pills
IUD
Injectables (DMPA)
Condom
Implant
NFP-LAM (Lactation Amenorrhea Method)
NFP-CM (Cervical Mucus)
NFP-BBT (Basal Body Temperature)
NFP-STM (Symptothermal Method)
NFP-SDM (Standard Days Method)
No. of current users (end of month) of Family Planning
BTL
Vasectomy
Pills
IUD
Injectables (DMPA)
Condom
Implant
NFP-LAM (Lactation Amenorrhea Method)
NFP-CM (Cervical Mucus)
NFP-BBT (Basal Body Temperature)
NFP-STM (Symptothermal Method)
NFP-SDM (Standard Days Method)
No. of WRA with unmet needs
No. of WRA with unmet needs given counselling
No. of WRA with unmet needs given FP commodities
Percentage of Contraceptive prevalence rate (CPR)
Current users/total population x 0.12325 x 100 %
No. of infants exclusively breastfed until 6th month
No. of children 0-11 months fully immunized

B. SERVICE DELIVERY NETWORK

No. of NHTS families: ______

No. of NHTS households: ______
No. of Health Facilities assessed: ______

INDICATORS
No. of updated family profile (NHTS)
No. of clients referred
No. of clients seen and served

C. BLOOD PROGRAM

INDICATORS
No. of advocacy campaigns conducted
No. of blood letting activity assisted
No. of blood donors
 D. BARANGAY HEALTH BOARD/LOCAL HEALTH BOARD MEETING

INDICATORS
No. of established/ organized/ functional BHB
No. of BHB meetings attended
No. of local ordinances/ resolution passed
Specify what ordinance:

E. TUBERCULOSIS PROGRAM

INDICATORS
No. of TB symptomatic patients who underwent DSSM
No. of smear positive discovered and identified
No. of new smear (+) cases initiated treatment and registered
No. of smear (+) cases cured

F. SCHISTOSOMIASIS PROGRAM

INDICATOR
No. of patients given Praziquantel (Schisto Mass Treatment)

G. HIV/AIDS

INDICATOR
No. of HIV/AIDS advocacy campaigns conducted

H. COMMUNICABLE/INFECTIOUS AND NON-COMMUNICABLE DISEASES

INDICATORS
No. of Asthma patients seen and served
No. of patients with Skin Diseases seen and served
No. of Hypertensive patients seen and served
No. of Diabetic patients seen and served
No. of Mentally-ill patients seen and served
No. of URTI patients served

I. COMMUNITY HEALTH TEAM (CHT)

INDICATORS
No. of CHT/BHW/BNS meeting conducted
No. of CHT/BHW/BNS partners supervised/ monitored
No. of CHT/BHW/BNS reports validated/ analyzed

J. HEALTH EDUCATION

INDICATORS
No. of Mothers class conducted
No. of Family Development Session conducted/ facilitated
No. of Pabasa sa Nutrisyon conducted
No. of USAPAN Session conducted

Submitted by: Noted by:

__________________________ _______________________________
Name & Signature of DOH-NDP Name & Signature of RHM/PHN/MHO

Verified by:

__________________________
Name & Signature of DMO IV
 PUBLIC HEALTH ASSOCIATE (PHA)
MONTHLY ACCOMPLISHMENT
for the month of: ____________

NAME: __________________________________________

I. DATA MANAGEMENT

MONTHLY
INDICATORS
ACCOMPLISHMENT
Collection of Monthly reports(M1) from midwife to PHN
Assist the PHN in consolidation of Monthly reports
Assist in consolidating Quarterly reports(Q1)
Submit monthly/quarterly reports:
HI-5
KP-ROADMAP/ CAS
MNCHN Indicators Form
Expanded Program on Immunization (EPI) Form
Child Injury Prevention Program Form

II. LOGISTICS MANAGEMENT

INVENTORY OF THE FOLLOWING:

Total
Beginning Total balance at
VACCINES stocks of quantity the end of
the month dispensed the
month
OPV
AMR
MMR
PENTAVALENT
BCG
HEPA B
PCV
Praziquantel
TB drugs
COMPACK Drugs:
Anti-hypertensive drugs
Anti-diabetic drugs
FAMILY PLANNING COMMODITIES
Pills
IUD
Injectables (DMPA/CIC)
Condom
Implant
(Note: Report/ give feedback to MHO)

Submitted by: Noted by:

__________________________ _______________________________
Name & Signature of DOH-PHA Name & Signature of RHM/PHN/MHO

Verified by:
__________________________
Name & Signature of DMO IV

NURSE DEPLOYMENT PROJECT

TACLOBAN CITY
VINA KRISHA AUGUSTINE H. ABANILLA, RN