ST & MT

JAN FEB MAR 1st Qtr APR MAY JUN 2nd Qtr JUL AUG SEP
INDICATORS TARGET
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
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
10-14
15-19
20-49
Total
Total
Total
Total
Total
Total
Total
Total
Total
Total
Total
Prenatal Care
1. No. of pregnant women

with at least 4 prenatal
check-ups - Total
· NHTS
· Non-NHTS
assessed of their
nutritional status during the
1st trimester - Total
· NHTS
· Non-NHTS
a. Number of pregnant
women seen in the first
trimester who have
normal BMI - Total
· NHTS
· Non-NHTS
b. No. of pregnant
trimester who have low
BMI - Total
· NHTS
· Non-NHTS
c. No. of pregnant
trimester who have high
BMI - Total
· NHTS
· Non-NHTS
for the first time given 2
.
doses of Td vaccination -
Total
· NHTS
· Non-NHTS
INDICATORS TARGET
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
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
10-14
15-19
20-49
Total
Total
Total
Total
Total
Total
Total
Total
Total
Total
Total
for the 2nd or more times
given at least 3 doses of
Td vaccination (Td2 Plus) -
Total
· NHTS
· Non-NHTS

who completed the dose of
iron with folic acid
supplementation - Total
· NHTS
· Non-NHTS

who completed doses of
calcium carbonate
· NHTS
· Non-NHTS
given iodine capsules –
Total
· NHTS
· Non-NHTS

given one dose of
deworming tablet - Total
· NHTS
· Non-NHTS
screened for syphilis - Total
· NHTS
· Non-NHTS
INDICATORS TARGET
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
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
10-14
15-19
20-49
Total
Total
Total
Total
Total
Total
Total
Total
Total
Total
Total
tested positive for syphilis -
Total
· NHTS
· Non-NHTS
screened for Hepatitis B -
Total
· NHTS
· Non-NHTS
tested positive for Hepatitis
B
· NHTS
· Non-NHTS
screened for HIV - Total
· NHTS
· Non-NHTS
tested for CBC or Hgb&Hct
count - Total
· NHTS
· Non-NHTS
15.No. of pregnant women

tested for CBC or Hgb&Hct
count diagnosed with
anemia - Total
· NHTS
· Non-NHTS

screened for gestational
diabetes – Total
· NHTS
· Non-NHTS
INDICATORS TARGET
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
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
10-14
15-19
20-49
Total
Total
Total
Total
Total
Total
Total
Total
Total
Total
Total
17. No. of pregnant
women tested positive for
gestational diabetes – Total
· NHTS
· Non-NHTS
Intrapartum Care and Delivery Outcome
18. No. of deliveries – Total
· NHTS
· Non-NHTS
19. No. of live births – Total
· NHTS
· Non-NHTS
20. No. of live births by
birth weight - Total
a. No. of live births with
normal birth weight -
Total
· NHTS
· Non-NHTS
b. No. of live births with
low birth weight - Total
· NHTS
· Non-NHTS
c. No. of live births with
unknown birth weight-
Total
· NHTS
· Non-NHTS
21. No. of deliveries

attended by skilled health
professionals - Total
a. No. of deliveries
attended by a doctor -
Total
· NHTS
· Non-NHTS
INDICATORS TARGET
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
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
10-14
15-19
20-49
Total
Total
Total
Total
Total
Total
Total
Total
Total
Total
Total
b. No. of deliveries
attended by a nurse –
Total
· NHTS
· Non-NHTS
c. No. of deliveries
attended by midwives -
Total
· NHTS
· Non-NHTS

attended by non-skilled
health professionals - Total
attended by Hilot/TBA
· NHTS
· Non-NHTS
attended by others
· NHTS
· Non-NHTS
23. No. of health facility-
based deliveries - Total
· NHTS
· Non-NHTS
24. No. of deliveries by
health facility ownership
a. No. of deliveries in
public health facility
· NHTS
· Non-NHTS
b. No. of deliveries in
private health facility
· NHTS
· Non-NHTS
25. No. of non-facility-
· NHTS
· Non-NHTS
INDICATORS TARGET
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
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
10-14
15-19
20-49
Total
Total
Total
Total
Total
Total
Total
Total
Total
Total
Total
26. Type of Delivery
a. No. of vaginal
deliveries – Total
· NHTS
· Non-NHTS
b. No. of deliveries by
CS – Total
· NHTS
· Non-NHTS
27. Pregnancy outcome
a. No. of full-term births
– Total
· NHTS
· Non-NHTS
b. No. of pre-term births
– Total
· NHTS
· Non-NHTS
c. No. of fetal deaths-
Total
· NHTS
· Non-NHTS
d. No. of abortion/
miscarriage - Total
· NHTS
· Non-NHTS
Postpartum and Newborn Care
28. No. of postpartum

women together with their
newborn who completed at
least 2 postpartum check-
ups - Total
· NHTS
· Non-NHTS
women who completed
· NHTS
· Non-NHTS
women with Vitamin A
supplementation – Total
· NHTS
· Non-NHTS
10-14
15-19
20-49
Total 3rd Qtr
10-14
15-19
OCT
20-49
Total
10-14
15-19
NOV
20-49
Total
10-14
15-19
DEC
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
4th Qtr TOTAL
Total
Remarks
10-14
15-19
20-49
Total 3rd Qtr
10-14
15-19
OCT
20-49
Total
10-14
15-19
NOV
20-49
Total
10-14
15-19
DEC
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
4th Qtr TOTAL
Total
Remarks
10-14
15-19
20-49
Total 3rd Qtr
10-14
15-19
OCT
20-49
Total
10-14
15-19
NOV
20-49
Total
10-14
15-19
DEC
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
4th Qtr TOTAL
Total
Remarks
10-14
15-19
20-49
Total 3rd Qtr
10-14
15-19
OCT
20-49
Total
10-14
15-19
NOV
20-49
Total
10-14
15-19
DEC
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
4th Qtr TOTAL
Total
Remarks
10-14
15-19
20-49
Total 3rd Qtr
10-14
15-19
OCT
20-49
Total
10-14
15-19
NOV
20-49
Total
10-14
15-19
DEC
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
4th Qtr TOTAL
Total
Remarks
10-14
15-19
20-49
Total 3rd Qtr
10-14
15-19
OCT
20-49
Total
10-14
15-19
NOV
20-49
Total
10-14
15-19
DEC
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
4th Qtr TOTAL
Total
Remarks
Brgy 1 BRGY.2 ALIM POOK ASIA(M) ASIA(S) BUL. DAU
TARG
INDICATORS
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
10-14
15-19
20-49
10-14
15-19
20-49
10-14
Total
Total
Total
Total
Total
Total
Total
ET
MARCH 2020
Prenatal Care
1. No. of pregnant
women with at least 4
prenatal check-ups -
Total
2. No. of pregnant
women assessed of
their nutritional status
during the 1st trimester
- Total
a. Number of
pregnant women
seen in the first
trimester who have
normal BMI - Total
b. No. of pregnant
women seen in the
first trimester who
have low BMI - Total
c. No. of pregnant
women seen in the
first trimester who
have high BMI - Total
3. No. of pregnant
women for the first time
.
given 2 doses of Td
vaccination - Total
TARG
INDICATORS
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
10-14
15-19
20-49
10-14
15-19
20-49
10-14
Total
Total
Total
Total
Total
Total
Total
ET
4. No. of pregnant
women for the 2nd or
more times given at
least 3 doses of Td
vaccination (Td2 Plus) -
Total
5. No. of pregnant
women who completed
the dose of iron with
folic acid
6. No. of pregnant
women who completed
doses of calcium
carbonate
7. No. of pregnant
women given iodine
capsules – Total
8. No. of pregnant
women given one dose
of deworming tablet -
Total
9. No. of pregnant
women screened for
syphilis - Total
TARG
INDICATORS
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
10-14
15-19
20-49
10-14
15-19
20-49
10-14
Total
Total
Total
Total
Total
Total
Total
ET
10. No. of pregnant

women tested positive
for syphilis - Total
11. No. of pregnant

women screened for
Hepatitis B - Total
12. No. of pregnant

for Hepatitis B
13. No. of pregnant

women screened for
HIV - Total
14. No. of pregnant
women tested for CBC
or Hgb&Hct count -
Total
15.No. of pregnant
women tested for CBC
or Hgb&Hct count
diagnosed with anemia
- Total
16. No. of pregnant
women screened for
gestational diabetes –
Total
TARG
INDICATORS
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
10-14
15-19
20-49
10-14
15-19
20-49
10-14
Total
Total
Total
Total
Total
Total
Total
ET
17. No. of pregnant

for gestational diabetes
– Total
Intrapartum Care and Delivery Outcome

18. No. of deliveries –
Total
19. No. of live births –
Total
20. No. of live births by
birth weight - Total
a. No. of live births
with normal birth
weight - Total
b. No. of live births
with low birth weight -
Total
c. No. of live births
with unknown birth
weight- Total
attended by skilled
health professionals -
Total
attended by a doctor -
Total
TARG
INDICATORS
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
10-14
15-19
20-49
10-14
15-19
20-49
10-14
Total
Total
Total
Total
Total
Total
Total
ET
attended by a nurse –
Total
c. No. of deliveries
attended by midwives
- Total
attended by non-skilled
health professionals -
Total
attended by Hilot/TBA
attended by others
23. No. of health
facility-based deliveries
- Total
24. No. of deliveries by
health facility
ownership
a. No. of deliveries in
public health facility
b. No. of deliveries in
private health facility
25. No. of non-facility-

TARG
INDICATORS
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
10-14
15-19
20-49
10-14
15-19
20-49
10-14
Total
Total
Total
Total
Total
Total
Total
ET
26. Type of Delivery

a. No. of vaginal
deliveries – Total
b. No. of deliveries by
CS – Total
27. Pregnancy outcome
a. No. of full-term
births – Total
b. No. of pre-term
births – Total
c. No. of fetal deaths-
Total
d. No. of abortion/
miscarriage - Total
Postpartum and Newborn Care
women together with
their newborn who
completed at least 2
postpartum check-ups
- Total

women who completed

women with Vitamin A
supplementation – Total
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
DAUG CUL.(M) CUL.(S) SANGKE
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
SAN. R.(M) SAN.R.(M)
Total
10-14
15-19
20-49
BAC.
Total
10-14
15-19
TAL.
20-49
Total
10-14
15-19
20-49
DAM.
Total
10-14
15-19
20-49
TOTAL
Total
rks
Rema
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
BAC.
Total
10-14
15-19
TAL.
20-49
Total
10-14
15-19
20-49
DAM.
Total
10-14
15-19
20-49
TOTAL
Total
rks
Rema
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
BAC.
Total
10-14
15-19
TAL.
20-49
Total
10-14
15-19
20-49
DAM.
Total
10-14
15-19
20-49
TOTAL
Total
rks
Rema
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
BAC.
Total
10-14
15-19
TAL.
20-49
Total
10-14
15-19
20-49
DAM.
Total
10-14
15-19
20-49
TOTAL
Total
rks
Rema
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
BAC.
Total
10-14
15-19
TAL.
20-49
Total
10-14
15-19
20-49
DAM.
Total
10-14
15-19
20-49
TOTAL
Total
rks
Rema
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
Total
10-14
15-19
20-49
BAC.
Total
10-14
15-19
TAL.
20-49
Total
10-14
15-19
20-49
DAM.
Total
10-14
15-19
20-49
TOTAL
Total
rks
Rema

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JAN FEB MAR 1st Qtr APR MAY JUN 2nd Qtr JUL AUG SEP

1. No. of pregnant women

5. No. of pregnant women

6. No. of pregnant women

8. No. of pregnant women

15.No. of pregnant women

16. No. of pregnant women

21. No. of deliveries

22. No. of deliveries

28. No. of postpartum

10. No. of pregnant

11. No. of pregnant

12. No. of pregnant

13. No. of pregnant

17. No. of pregnant

Intrapartum Care and Delivery Outcome

25. No. of non-facility-

26. Type of Delivery

29. No. of postpartum

30. No. of postpartum

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ST &amp; MT

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JAN FEB MAR 1st Qtr APR MAY JUN 2nd Qtr JUL AUG SEP

1. No. of pregnant women

5. No. of pregnant women

6. No. of pregnant women

8. No. of pregnant women

15.No. of pregnant women

16. No. of pregnant women

21. No. of deliveries

22. No. of deliveries

28. No. of postpartum

10. No. of pregnant

11. No. of pregnant

12. No. of pregnant

13. No. of pregnant

17. No. of pregnant

Intrapartum Care and Delivery Outcome

25. No. of non-facility-

26. Type of Delivery

29. No. of postpartum

30. No. of postpartum

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ST & MT