ANNEX C

Paranaque City Health Office

Strategic Performance Management System (SPMS)

SECTION PERFORMANCE COMMITMENT AND REVIEW (SPCR)

I, ________(Name)______________________, _____(Designation)________________of the __________(Facility)____________________, commit to deliver and agree to be rated

on the attainment of the following targets in accordance with the indicated measures for the period _________ to __________,2018.

5 – Outstanding
4 – Very Satisfactory
RATING 3 – Satisfactory
Signature
SCALE 2 – Unsatisfactory Date:
1 – Poor

Approved by: Date

Olga Z. Virtusio,M.D., M.P.H

City Health Office
Immediate Supervisor/Department Head

Rating
SUCCESS INDICATORS Individuals Actual
MFO/PAP Accountable Remarks
(TARGETS + MEASURES) Accomplishments
1 2 3 4
Q E T A
Core Mandated Function
1. Maternal Care:
a. Prenatal Services 5 3 1 5 4 3 2 1 Not Applicable
# of Pregnant women with 4 or
more prenatal visits within the 5 Complete ITR Data 5 >130%
rating period without error 4 115-129%
3 Complete ITR data 3 100-114%
with minor errors
TARGET: # 1 Incomplete ITR Data
2 51-99%
1 <50%

100% of Pregnant women who 5 3 1 5 1 5 4 3 2 1

came to the facility for Prenatal
5 Complete ITR Data
Checkup seen and properly without error
attended within ____ mins
3 Complete ITR data
upon admission with minor errors
1 Incomplete ITR Data
5 100%
1 <99%
served w/in
5 ___ mins or less
4 ___ mins
3 ___ mins
2 ___ mins
1 ___ mins or beyond

# of Health Education
sessions conducted during
days of Prenatal Checkup or
on every available opportunity
where pregnant women amass
(i.e. Caravan/Buntis
Congress).
TARGET: #
(N/A IF NO DEFAULTERS)
Defaulter follow-up/tracing
activities conducted vs # of
Defaulters Identified (1:1) for
Maternal Care within the rating
period
TARGET: 1:1
b. Post-Natal
Services
# of Post-partum women who
had at least 2 postpartum
visits after delivery within the
rating period
TARGET: #
100% of Post-partum women
who came in for Post-natal
checkup seen and properly
attended within ____ mins
upon admission
ANNEX C
5 3 1
5 4 3 2 1 Not Applicable
Participant’s List of
5
Attendance with 5 >130%
Pictures AND Post-
Activity Report
4 115-129%
3 Participant’s List of 3 100-114%
Attendance with 2 51-99%
Pictures or Post-
Activity Report
1 <50%
1 With Participant’s List
of Attendance only
5 3 1 5 3 1
5 Complete report and 5 >2:1 or No Defaulters Not Applicable
accounting of 3 1:1
defaulters with 1 1:0
disposition on master
list
3 Complete report of
defaulters master list
submitted
1 Incomplete report of
defaulters
5 3 1 5 4 3 2 1 Not Applicable
5 Complete ITR Data 5 >130%
without error 4 115-129%
3 Complete ITR data
3 100-114%
with minor errors
1 Incomplete ITR Data
2 51-99%
1 <50%
5 3 1 5 1 5 4 3 2 1
served w/in
5 Complete ITR Data 5 100% 5 ___ mins or less
without error 1 <99% 4 ___ mins
3 Complete ITR data 3 ___ mins
with minor errors 2 ___ mins
1 Incomplete ITR Data 1 ___ mins or beyond

2. Child Health Services
# of Children Fully Immunized
before their first birthday (FIC)
within the rating period
TARGET: #
100% of Children 0-59 months
brought in (accompanied by
parents/legal guardians) for
immunization and
cleared/deemed healthy to
receive vaccines, given
available
(N/A IF NO DEFAULTERS)
Defaulter follow-up/tracing
activities conducted vs # of
Defaulters Identified (1:1)
within the rating period
TARGET: 1:1
100% of Children who
came/referred to the facility
requiring Vitamin A and Other
Micronutrient supplementation
given available and
appropriate dose of Vitamin
A/Micronutrients within the
rating period
ANNEX C
5 3 1 5 4 3 2 1 Not Applicable
5 Complete ITR Data 5 >130%
without error 4 115-129%
3 Complete ITR data 3 100-114%
with minor errors
1 Incomplete ITR Data
2 51-99%
1 <50%
5 3 1 5 1 5 4 3 2 1
served w/in
5 Complete ITR Data 5 100% 5 ___ mins or less
without error 1 <99% 4 ___ mins
3 Complete ITR data 3 ___ mins
with minor errors 2 ___ mins
1 Incomplete ITR Data 1 ___ mins or beyond
5 3 1 5 3 1 Not Applicable
5 Complete report and 5 >2:1 or No Defaulters
accounting of 3 1:1
defaulters with 1 1:0
disposition on master
list
3 Complete report of
defaulters master list
submitted
1 Incomplete report of
defaulters
5 3 1 5 1
Not Applicable
5 Correct/Appropriate 5 100%
supplement and dose
1 <99%
given with Complete
and correct OPT form
filled up
3 Correct/Appropriate
supplement and dose
given with OPT Form
filled with minor errors
1 Incorrect supplement
or dose given

# of Children 0-59 months
referred by BNS, deemed fit
for deworming, given available
anti-helminthic tablets within
the rating period
TARGET: #
Conduct of Community survey
and massive Operation
Timbang Plus of Children 0-59
months
TARGET: #
Family Planning Services
Contraceptive Prevalence
Rate:
# women of reproductive age
(15‐49 years of age) who are
using (or whose partner is
using) any modern FP method
at a given point in time
100% of clients of reproductive
age who came in requesting/in
need of FP services, given
appropriate FP
commodities/services within
an average of ___ mins upon
admission
ANNEX C
5 3 1 5 4 3 2 1 Not Applicable
5 Correct/Appropriate 5 >130%
supplement and dose
given with Complete
4 115-129%
and correct OPT form 3 100-114%
filled up 2 51-99%
3 Correct/Appropriate 1 <50%
supplement and dose
given with OPT Form
filled with minor errors
1 Incorrect medicine or
dose given
5 3 1 5 4 3 2 1 Not Applicable
5 Complete Data on OPT 5 100%
forms with no errors
4 90-99%
3 Complete Data on OPT
forms with minor errors 3 80-89%
1 Incomplete and Major 2 70-79%
errors on OPT Forms 1 <69%
5 3 1 5 4 3 2 1 Not Applicable
5 Appropriate FP service or 5 >130%
commodity provided with
complete assessment and 4 115-129%
counselling 3 100-114%
Appropriate FP Service or
3
commodity provided with 2 51-99%
counselling but FP Form
has minor/minimal data
1 <50%
missed
1 No counselling
provided
5 3 1 5 1 5 4 3 2 1
served w/in
5 Appropriate FP service or 5 100% 5 ___ mins or less
commodity provided with
complete assessment and
1 99% and below 4 ___ mins
counselling 3 ___ mins
3 Appropriate FP Service or 2 ___ mins
commodity provided with 1 ___ mins or beyond
counselling but FP Form
has minor/minimal data
missed
1 No counselling
provided

# of Health Educations
sessions/Family Development
Sessions conducted to women
of reproductive age within the
rating period
TARGET: #
AFHRS/PHC/Medical
Consultations
100% of Patients who came
in/referred for medical
consultation, AFRHS or
Primary Health Care, seen and
properly attended within ____
mins upon admission
Disease Prevention and
Control
A.1 TB Control and
Prevention Case Detection Rate:
____% TB Cases Detected
within the rating period
A.2 TB Treatment
Success Rate
TB Treatment Success Rate:
____% of Cured and
Completed treatment within
the rating period
ANNEX C
5 4 3 2 1 5 4 3 2 1 Not Applicable
With at least #-#
average number of 5 >130%
participants 4 115-129%
5 #-# participants 3 100-114%
4 #-# participants 2 51-99%
3 #-# participants 1 <50%
2 #-# participants
1 #-# participants
5 4 3 2 1 5 1 5 4 3 2 1
Client Satisfaction served w/in
5 100% 5 ___ mins or less
Survey
1 99% and below 4 ___ mins
5 Excellent 3 ___ mins
4 Very Satisfactory 2 ___ mins
3 Satisfactory 1 ___ mins or beyond
2 Fair
1 Needs Improvement
5 3 1 5 4 3 2 1 Not Applicable
5 Complete NTP 5 >130%
Records/Data without
error
4 115-129%
Complete NTP 3 100-114%
3
Records/Data with 2 51-99%
Minor errors 1 <50%
1 Incomplete NTP
Record/Data
5 3 1 5 4 3 2 1 Not Applicable
5 Complete NTP 5 >130%
Treatment 4 115-129%
Records/Data without
error 3 100-114%
3 Complete NTP 2 51-99%
Treatment
Records/Data with
1 <50%
Minor errors
1 Incomplete NTP
Treatment
Record/Data
 ANNEX C

5 3 1 5 3 1 Not Applicable
(N/A IF NO DEFAULTERS)
5 Complete report and 5 >2:1 or No Defaulters
# Defaulter follow-up/tracing accounting of 3 1:1
activities conducted vs # of defaulters with 1 1:0
Defaulters Identified (1:1) disposition on master
list
within the rating period
3 Complete report of
TARGET: 1:1 defaulters master list
submitted
1 Incomplete report of
defaulters

5 3 1 5 4 3 2 1 Not Applicable

5 Participant’s list of 5 >130%

# Supervised TB attendance with
Classes/Active Case Finding pictures AND post-
4 115-129%
Conducted within the rating activity report 3 100-114%
period 3 Participant’s list of 2 51-99%
attendance with
TARGET: # pictures OR post-
1 <50%
activity report
1 Participant’s list of
attendance only

B. NCD
Prevention and 5 3 1 5 4 3 2 1 Not Applicable
Control
NCD RISK ASSESSMENT 5 Complete Data on NCD 5 >130%
# Clients risk assessed within Risk Assessment forms
with no errors 4 115-129%
the rating period 3 Complete Data on NCD 3 100-114%
TARGET: # Risk Assessment forms
with minor errors 2 51-99%
1 Incomplete and Major 1 <50%
Errors of Data on NCD
Risk Assessment Forms
# NCD Awareness/Healthy
Lifestyle advocacy activities 5 4 3 2 1 5 4 3 2 1 Not Applicable
conducted within the rating With at least #-#
period average number of 5 >130%
TARGET: # participants 4 115-129%
5 #-# participants with 3 100-114%
pictures AND post 2 51-99%
activity report 1 <50%
4 #-# participants with
pictures or Post-
activity report

Dental Health Services
of children 12-71 months
identified as Orally Fit Children
within the rating period
TARGET: #
# of Pregnant women who
came to the facility given Basic
Oral Health Care
100% of Clients who came in
requiring/in-need of/referred
for dental consultation from all
age groups seen/attended
within ____ mins upon
admission (subject to
availability of dentist, dental
supplies and logistics)
Nutrition Services
# of conducted nutrition
education activity on IYCF in
the facility
TARGET: #
ANNEX C
3 #-# participants with
pictures or Post
activity report
2 #-# participants
1 #-# participants
5 3 1 5 4 3 2 1 Not Applicable
5 Complete IDR Data
without error
5 >130%
3 Complete IDR Data with 4 115-129%
minor errors 3 100-114%
1 Incomplete IDR data or
with Major Errors 2 51-99%
1 <50%
5 3 1 5 4 3 2 1 5 4 3 2 1
served w/in
5 Complete IDR Data 5 >130% 5 ___ mins or less
without error
Complete IDR Data with 4 115-129% 4 ___ mins
3
minor errors 3 ___ mins
3 100-114%
1 Incomplete IDR data or 2 ___ mins
with Major Errors 2 51-99% 1 ___ mins or beyond
1 <50%
5 3 1 5 1 5 4 3 2 1
served w/in
5 Complete IDR Data 5 100% 5 ___ mins or less
without error
1 99% and below 4 ___ mins
3 Complete IDR Data with
minor errors 3 ___ mins
1 Incomplete IDR data or 2 ___ mins
with Major Errors 1 ___ mins or beyond
5 3 1 5 4 3 2 1 Not Applicable
5 Participant’s list of 5 >15 sessions
attendance with
pictures AND post-
4 13-14 sessions
activity report 3 11-12 sessions
3 Participant’s list of 2 9-10 sessions
attendance with 1 <8 sessions
pictures OR post-
activity report
1 Participant’s list of
attendance only
 ANNEX C

Not Applicable 5 4 3 2 1 Not Applicable

100% of pre-school children 5 100%

seen, referred for micronutrient 4 90-99%
supplementation and 3 80-89%
deworming to the health center 2 70-79%
1 <69%

5 4 3 2 1 5 1 5 4 3 2 1
submitted
5 approved with no 5 100% 5 > 3 days after the
revision (1st
1 99% and below deadline
submission) or
minor revision only 4 1-2 days after the
(1st submission) deadline
4 approved with minor 3 On the day of the
100% of Monthly reports revisions only deadline
submitted to CESU, approved (2nd submission 2 1-2 days before the
on the 1st submission, every 5th 3 approved with major deadline
day of the succeeding month revisions 1 > 3 days before the
(1st submission)
during the rating period 2 approved with major
deadline
revisions (2nd
submission to 3rd
submission)
1 approved with major
revisions (4th
submission)
/ complete rehash or
not approved at all

OTHER INTERVENING TASKS

100% of Monthly reports
Reporting submitted to CESU, approved 5 4 3 2 1 5 1 5 4 3 2 1
on the 1st submission, every 5th submitted
day of the succeeding month 5 approved with no 5 100% 5 > 3 days after the
during the rating period revision (1st 1 99% and below deadline
submission) or
minor revision only 4 1-2 days after the
(1st submission) deadline
4 approved with minor 3 On the day of the
revisions only deadline
(2nd submission 2 1-2 days before the
3 approved with major deadline
revisions 1 > 3 days before the
(1st submission)
deadline
2 approved with major
revisions (2nd
submission to 3rd
submission)
1 approved with major

Conduct of special
events/projects/operation/
thematic campaigns
initiated or coordinated by
health center
Participation in
events/special
operations/activities and
thematic campaigns of
CHO and other
coordinating agencies
Attendance/Tardiness/Pre
sence in the workplace
Learning and
Development
Conduct of special
events/projects/operations/the
matic campaigns initiated or
coordinated by health center
TARGET: #
85-94% Participation in all
events/special
operations/activities and
thematic campaigns of City
Health Office and other
agencies Coordinating with the
CHO
85-94% Present/accounted for
and punctual
Attended at least one (1)
learning and development
program/activity vs Impact
Evaluation on return of
investment (ROI) or learning
application plan which was
submitted on set deadline
ANNEX C
revisions (4th
submission)
/ complete rehash or
not approved at all
5 3 1 5 4 3 2 1 Not Applicable
5 Participant’s list of 5 >130%
attendance with
pictures AND post-
4 115-129%
activity report 3 100-114%
3 Participant’s list of 2 51-99%
attendance with
pictures OR post-
1 <50%
activity report
1 Participant’s list of
attendance only
Not Applicable 5 4 3 2 1 Not Applicable
5 100%
4 95-99%
3 85-94%
2 70-84%
1 <70%
5 1 5 4 3 2 1 5 4 3 2 1
PRESENT PUNCTUAL
5 Accounted for and in 5 100% 5 100%
complete uniform 4 95-99% 4 95-99%
with no validated
incidence of loafing
3 85-94% 3 85-94%
1 Unaccounted for or 2 70-84% 2 70-84%
with validated 1 <70% 1 <70%
incidence of loafing
Not Applicable 5 1 Not Applicable
5 Attended at least 1
1 Not Attended
Total Overall Rating
 ANNEX C

Final Average Rating

Adjectival Rating

Assessed and Reviewed by: Date

Date Date

ENGR. BENIGNO L. RIVERA Reynaldo C. Loon Hon. Edwin L. Olivarez

PMT - Secretariat Head of Agency

Legend: 1 – Quality 2 – Efficiency 3 – Timeliness 4 – Average