Nutrition Cluster Monthly Reporting Form - Instructions on the reporting process

1. Please report in the next sheet on all nutrition activities your organisation has been engaged in in the previous calendar month (1st-30th/31st)
this includes all regular nutrition activities as well as emergency response nutrition activities
2. Each county your organisation is operational in has to report on a separate form (a separate document)
3. Fill in all the relevant sections (the respective colored areas) of the tool. Leave the other sectors blank. See below for an overview of the sections.
4. You will only need to fill out the white cells with a red border (mostly column E)
5. The sheet "AWG and LOS Calculation Aid" is optional to use - it assists you in calculating the Average Daily Weight Gain and Average Length of Stay
You do not need to do anything with the sheet "admin" and "training"
6. Nomenclature: You need to change the beginning of the file name on four places, as indicated with capital letters.
PARTNER (implementing partner name), COUNTY (county on which reporting), YEAR (reporting year), and MONTH (reporting month)
for example: ACF_Twic_2013_01_nutrition_report_v4.0.xls
7. The reports should be submitted monthly to whom you usually report to, with a copy to nutritionreporting.southsudan@gmail.com
this email address will automatically forward your reports to MoH, WFP, UNICEF, and the Nutrition Cluster
8. Deadline for report submission: 5th of the following month
9. For any questions or assistance that is needed, please do not hesitate to contact the nutrition cluster information manager (for contact details, see website)

Reporting sections overview

General information
Management of Severe Acute Malnutrition - Inpatient
Management of Severe Acute Malnutrition - Outpatient
Targeted Supplementary Feeding Programme
Blanket Supplementary Feeding Programme
Screening and Referral
Micronutrients Supplementation
Deworming
Health Education for Pregnant and Lactating Women
Capacity Development
Supplies
Comments

Detailed instructions for all reporting items

General information
Implementing partner/agency the agency implementing the nutrition services reported on in this form
Reporting month the month in which the nutrition services were implemented as reported on this form
Reporting year the year in which the nutrition services were implemented as reported on this form
Date of report submission (dd-mm-yyyy) the date on which this form is sent to nutritionreporting.southsudan@gmail.com
State the state in which the nutrition services were implemented as reported on this form (choose from drop-down list)

County the county in which the nutrition services were implemented as reported on this form (choose from drop-down list) - note
that each county in which you implement nutrition activities has to be reported on on a separate form
Payam(s) the payam(s) in which the nutrition services were implemented as reported on this form
Number of Stabilization Centers the number of Stabilization Center(s)/ITFC(s) that are reported on in this form
Number of OTPs the number of OTPs that are reported on in this form
Number of community level treatment sites the number of community level treatment sites that are reported on in this form
Number of targeted supplementary feeding sites the number of targeted supplementary feeding sites that are reported on in this form

Name of site(s) by category (SC)
Name of site(s) by category (OTP)
Name of site(s) by category (community level
treatment)
Name of site(s) by category (TSFP)
If implementing Stabilization Center(s)/ITFC(s), please list the name(s) of these site(s)
If implementing OTPs, please list the name(s) of these site(s)
If implementing community level treatment, please list the name(s) of these site(s)
If implementing targeted supplementary feeding site(s), please list the name(s) of these site(s)

Management of Severe Acute Malnutrition - Inpatient

Children 6-59 months
Total end of last month (A) Total children 6-59m at the end of last month, which equals the total at the beginning of this month
New admissions this month (B) Bilateral pitting oedema +++ or Any grade of bilateral pitting oedema with severe wasting or SAM (MUAC <11.5 cm or WHZ <-3 or oedema + or ++)
with medical complications or Relapse after cure
Gender new admissions: male (B1) All new admissions 6-59m as specified above who were male
Gender new admissions: female (B2) All new admissions 6-59m as specified above who were female
Old cases (referral from OTP, returned defaulters, Referred from outpatient care according to action protocol or Returned after defaulting or Moved from other inpatient care site
moved from other SC) (C)
Inpatients stabilized and referred to OTP (E) Condition of child has stabilized, child's appetite has returned, the medical complication is resolving and the child is referred
to outpatient care to continue treatment
Discharged cured (special cases ending treatment) Only special cases of children 6-59m who meet all following discharge criteria: 15 percent weight gain maintained for two
(F1) consecutive days and Oedema free for two consecutive weeks and Child clinically well and alert
Discharged died (F2) Children 6-59m who died while in inpatient care
Discharged defaulted (F3) Children 6-59m who were absent for two days
Discharged non-recovered (F4) Children 6-59m who remained in inpatient care and did not reach discharge criteria after two months in treatment

Other transfers (G) Any other transfers, to other inpatient care or hospital/pediatric ward

Children < 6 months

Total end of last month (A) Total children <6m at the end of last month, which equals the total at the beginning of this month
New admissions this month (B) Bilateral pitting oedema or Visible wasting
Gender new admissions: male (B1) All new admissions <6m as specified above who were male
Gender new admissions: female (B2) All new admissions <6m as specified above who were female
Old cases (returned defaulters, moved from other Returned after defaulting or Moved from other inpatient care site
SC) (C)
Discharged cured (F1) If successful re-lactation and appropriate weight gain maintained (minimum 20 g per day on breastfeeding alone for five
days) and infant clinically well and alert
Discharged died (F2) Children <6m who died while in inpatient care
Discharged defaulted (F3) Children <6m who were absent for two days
Discharged non-recovered (F4) Children <6m who remained in inpatient care and did not reach discharge criteria after two months in treatment
Other transfers (G) Any other transfers, to other inpatient care or hospital/pediatric ward

Other (adolescent, adult, and children ≥ 5 yrs)

Total end of last month (A)
New admissions this month (B)
Gender new admissions: male (B1)
Gender new admissions: female (B2)
Age-groups new admissions: older children 5-9
years (B3)
Age-groups new admissions: adolescents 10-18
years (B4)
Age-groups new admissions: adults > 18 years (B5) All new admissions as specified above under "B" who were >18 years of age
Total ≥ 5 yrs at the end of last month, which equals the total at the beginning of this month
Older Children 5-9 Years: Bilateral pitting oedema or severe wasting
Adolescents 10-18 Years and Adults: Bilateral pitting oedema or severe wasting (acute weight loss) depending on history and
thorough examination to exclude secondary malnutrition
All new admissions ≥ 5 yrs as specified above who were male
All new admissions ≥ 5 yrs as specified above who were female
All new admissions as specified above under "B" who were 5-9 years of age
All new admissions as specified above under "B" who were 10-18 years of age

Old cases (referral from OTP, returned defaulters,
moved from other SC) (C)
Inpatients stabilized and referred to OTP (E)
Discharged cured (special cases ending treatment)
(F1)
Referred from outpatient care or Returned after defaulting or Moved from other inpatient care site
Children 5-9yrs - 15% weight gain maintained for 2 consecutive days and Oedema free for 2 consecutive weeks and Child clinically well and
alert.
Adolescents and adults - who are eating well and have sustained weight gain.
Discharged died (F2) Patients ≥ 5 yrs who died while in inpatient care
Discharged defaulted (F3) Patients ≥ 5 yrs who have defaulted
Discharged non-recovered (F4) Patients ≥ 5 yrs who have been discharged but did not recover
Other transfers (G) Any other transfers, to other inpatient care or hospital/pediatric ward. Adults and adolescents should be referred for
treatment of any other health problem that has been diagnosed prior to discharge.

Management of Severe Acute Malnutrition - Outpatient

Children 6-59 months
Total end of last month (A) Total children 6-59m at the end of last month, which equals the total at the beginning of this month
New admissions this month (B) Bilateral pitting oedema + and ++ or Severe wasting (MUAC < 11.5 cm or WFH < -3 z-score) and 1) Appetite test passed, 2) No medical complication,
3) Child clinically well and alert
Gender new admissions: male (B1) All new admissions 6-59m as specified above who were male
Gender new admissions: female (B2) All new admissions 6-59m as specified above who were female
Old cases (referral from SC, returned defaulters, Referred from inpatient care after stabilization and continue treatment in outpatient care or Returned after defaulting or Moved
moved from other OTP) (C) from other outpatient care site

Discharged cured (E1) 15 percent weight gain maintained for two consecutive visits (of admission weight or weight free of oedema) and Oedema free
for two consecutive visits and Child clinically well and alert
Discharged died (E2) Children 6-59m who died while in outpatient care
Discharged defaulted (E3) Children 6-59m who were absent for three consecutive visits in outpatient care
Discharged non-recovered (E4) Children 6-59m who did not reach discharge criteria after four months in treatment
Referrals to SC (F) Condition of child has deteriorated or child is not responding to treatment (per the action protocol), and child is referred to
inpatient care
Other transfers Transfers to other outpatient care
Average daily weight gain for discharges cured (in see sheet "AWG and LOS calculation" for assistance on how to calculate the Average Daily Weight Gain
grams/kg/day)
Average length of stay for discharges cured (in days) see sheet "AWG and LOS calculation" for assistance on how to calculate the Average Length Of Stay

Other (adolescent, adult, and ≥ 5 years)

Total end of last month (A) Total ≥ 5 years at the end of last month, which equals the total at the beginning of this month
New admissions this month (B)
Gender new admissions: male (B1) All new admissions 6-59m as specified above who were male
Gender new admissions: female (B2) All new admissions 6-59m as specified above who were female
Age-groups new admissions: older children 5-9 All new admissions as specified above under "B" who were 5-9 years of age
years (B3)
Age-groups new admissions: adolescents 10-18 All new admissions as specified above under "B" who were 10-18 years of age
years (B4)
Age-groups new admissions: adults > 18 years (B5) All new admissions as specified above under "B" who were >18 years of age

Old cases (referral from SC, returned defaulters, Referred from inpatient care after stabilization and continue treatment in outpatient care or Returned after defaulting or Moved
moved from other OTP) (C) from other outpatient care site

Discharged cured (E1)

Discharged died (E2) Patients ≥ 5 years who died while in outpatient care
Discharged defaulted (E3) Patients ≥ 5 years who defaulted
Discharged non-recovered (E4) Patients ≥ 5 years who were discharged but did not recover
Referrals to SC (F) Referrals to SC
Other transfers

Targeted Supplementary Feeding Programme

These instructions have been developed in line with the newly developed MAM guidelines, however there may be further changes after piloting of guidelines.
Children 6-59 months
Total end of last month (A) patients carrying forward treatment from the previous month to the current month
New admissions this month (B) children newly joined in the current month
Gender new admissions: male (B1) boys newly joined in the current month
Gender new admissions: female (B2) girls newly joined in the current month
Re-admissions this month (C) children returned to the programme within two months after either cured or defaulted
Discharged cured (E) MUAC ≥125mm for 2 consecutive visits/sessions and 6wks minimum stay in TSFP
Discharged died (F) children died while still registered in the programme
Discharged defaulted (G) children absent for two consecutive sessions within 12 weeks assuming programme is operating every 2 weeks
Referrals (H) children transferred from TSFP to OTP or from TSFP to medical facilities for medical care
Non-respondent (I) Children who do not reach the cure criteria after 12 weeks in the feeding programme. All children who do not reach
discharge criteria within 12 weeks should be referred to a health care provider for appropriate diagnosis.
Average length of stay for discharged cured (in Average LOS is calculated on a sample of cured discharges, as the sum of the individual lenghts of stay divided by the
days) number of cured discharges in the sample.

Pregnant and Lactating Mothers

Total end of last month (A) patients carrying forward treatment from the previous month to the current month
New admissions this month (B) PLW newly joined in the current month
Re-admissions this month (C) PLW returned to the programme within two months after either cured or defaulted
Discharged cured (E) PLW fully recovered within 12 weeks in the programme
Discharged died (F) PLW died while still registered in the programme
Discharged defaulted (G) PLW absent for two consecutive sessions within 12 weeks assuming programme is operating every 2 weeks
Referrals (H) PLW transferred from TSFP to OTP or from TSFP to medical facility for medical care
Non-respondent (I) PLW who do not reach the cure criteria after 12 weeks in the feeding programme. All PLW who do not reach discharge
criteria within 12 weeks should be referred to a health care provider for appropriate diagnosis.
Average length of stay for discharged cured (in Average LOS is calculated on a sample of cured discharges, as the sum of the individual lenghts of stay divided by the
days) number of cured discharges in the sample.

Blanket Supplementary Feeding Programme

These instructions have been developed in line with the newly developed MAM guidelines, however there may be further changes after piloting of guidelines.
Children 6-35 months
No. of children 6-35m newly enrolled during the At least 20% of the beneficiaries newly enrolled during the month in BSFP should be measured at each distribution.
month
Male Male beneficiaries 6-35m newly enrolled in BSFP.
Female Female beneficiaries 6-35m newly enrolled in BSFP.
Average number of children 6-35 months attended Average number of children 6-35 months attended distribution this month
distribution this month

Children 6-59 months

No. of children 36-59m newly enrolled during the No. of BSFP beneficiaries 36-59 months newly enrolled during the month.
month
Male Male beneficiaries 36-59m newly enrolled in BSFP.
Female Female beneficiaries 36-59m newly enrolled in BSFP.
Average number of children 6-59 months attended Average number of children 6-59 months attended distribution this month
distribution this month

Pregnant and Lactating Mothers

Number of PLW newly enrolled during the month At least 20% of the beneficiaries newly enrolled during the monthin BSFP should be measured at each distribution.

Screening and Referral

Boys 6-59 months
Number screened total number of boys 6-59m MUAC screened (but exclude any boys screened for Blanket Supplementary Feeding if these
have been reported in the previous section)
Number oedema Bilateral pitting oedema can be verified when thumb pressure applied on top of both feet for 3 seconds leaves a pit
(indentation) in the foot after the thumb is lifted. The pit will remain in both feet for several seconds.
No. of boys 6-59m with red MUAC (<11.5 cm) Number of boys 6-59m with MUAC <11.5 cm (red)
No. of boys 6-59m with yellow MUAC (≥11.5 cm to Number of boys 6-59m with MUAC ≥11.5 cm to <12.5 cm (yellow)
<12.5 cm)
No. of boys 6-59m with green MUAC (≥ 12.5 cm) Number of boys 6-59m with MUAC ≥12.5 cm (green)

Girls 6-59 months

Number screened
Number oedema
No. of girls 6-59m with red MUAC (<11.5 cm)
No. of girls 6-59m with yellow MUAC (≥11.5 cm to
<12.5 cm)
No. of girls 6-59m with green MUAC (≥ 12.5 cm)
total number of girls 6-59m MUAC screened (but exclude any girls screened for Blanket Supplementary Feeding if these
have been reported in the previous section)
Bilateral pitting oedema can be verified when thumb pressure applied on top of both feet for 3 seconds leaves a pit
(indentation) in the foot after the thumb is lifted. The pit will remain in both feet for several seconds.
Number of girls 6-59m with MUAC <11.5 cm (red)
Number of girls 6-59m with MUAC ≥11.5 cm to <12.5 cm (yellow)
Number of girls 6-59m with MUAC ≥12.5 cm (green)

Pregnant and Lactating Mothers

Number screened
No. of PLW with MUAC <21.0 cm
No. of PLW with MUAC ≥21.0 cm to <23.0 cm
No. of PLW with MUAC ≥23.0 cm
Total number of PLW MUAC screened (but exclude any PLW screened for Blanket Supplementary Feeding if these have been
reported in the previous section)
Number of PLW with MUAC <21.0 cm
Number of PLW with MUAC ≥21.0 cm to <23.0 cm
Number of PLW with MUAC ≥23.0 cm

Micronutrients Supplementation
Vitamin A
Children 6-11 months Number of children 6-11m supplemented with vitamin A during the routine inpatient/outpatient treatment. Do Not include
data from campaigns.
Male Number of boys (children 6-11m) supplemented with vitamin A
Female Number of girls (children 6-11m) supplemented with vitamin A

Children 12-59 months Number of children 12-59m supplemented with vitamin A during the routine inpatient/outpatient treatment. Do Not include
data from campaigns.
Male Number of boys (children 12-59m) supplemented with vitamin A
Female Number of girls (children 12-59m) supplemented with vitamin A

Micronutrient Powder supplementation

Children (6- 24 months) supplemented with MNP Number of children (6-24m) supplemented with micronutrient powder
during the month
Male Number of boys (6-24m) supplemented with micronutrient powder
Female Number of girls (6-24m) supplemented with micronutrient powder

Iron & folate or Multiple Micronutrients

Pregnant & Lactating Women Number of Pregnant and Lactating Women supplemented with iron & folate or multiple micronutrients

Deworming
No. of children 12-59 months dewormed Number of children 12-59m dewormed during the routine inpatient/outpatient treatment. Do Not include data from
campaigns.
Male Boys dewormed during the month
Female Girls dewormed during the month

Health Education for Pregnant and Lactating Women

Pregnant women attended individual counselling Number of pregnant women attended individual counselling sessions
sessions
Lactating women and caretakers of children <6 Number of lactating women and caretakers of children <6 months attended individual counselling sessions
months attended individual counselling sessions

Lactating women and caretakers of children 6-24 Number of lactating women and caretakers of children 6-24 months attended individual counselling sessions
months attended individual counselling sessions

Number of IYCF groups (including mother support Number of IYCF groups (including mother support groups) operational during reporting month
groups) operational during reporting month

Number of IYCF group sessions held (including
mother support groups)
Number of new admissions to IYCF groups
(including mother support groups)
Male
Female
Average number of people attended IYCF group
session (including mother support groups)
Number of IYCF group sessions held (including mother support groups)
Number of new admissions to IYCF groups (including mother support groups)
Number of men newly admitted to IYCF groups during the month
Number of women newly admitted to IYCF groups during the month
Average number of people attended one IYCF group session (including mother support groups)

Capacity Development
All Training Titles
Type of Training The type of training whether it is New or Refresher
No. of Trainings No. of trainings held
Main category of staff trained The main category of staff that has been trained on this type/topic
From which agency/agencies The agency/agencies of which staff was trained
No. of Days No. of Training Days
Male The number of male persons trained
Female The number of female persons trained
Comments Any comments regarding the training

Supplies
Note: only report on supply items if they are supplied by A) UNICEF, B) WFP, or C) Nutrition section in Ministry of Health
All supply items
Opening Stock at the beginning of the reporting what was in stock at the end of the previous month should equal what was in stock at the beginning of this reporting month
month (A)
Receipts during the reporting month (B) all receipts of this item during the reporting month
Total amount utilized (D) the amount of this item that has been utilized in the reporting month
Losses (E) the amount of losses of this item during the reporting month
Days out of Stock No. of Days out of stock during the month.

Comments
Any comments on programs, gaps or concerns Any comments on programs, gaps or concerns, such as a) Analysis of low performing sites, b) Barriers to access, c) Reasons
for absentees, default, non-response and relapse, d) Common causes of death, and e) Context changes in food security,
WASH, health, and insecurity f) Explaination on days out of stock.
Nutrition Cluster Reporting Form - Version 5.0 (updated March 25, 2014)
General information
Implementing partner/agency
Reporting month
Reporting year
Date of report submission (dd-mm-yyyy)
State Payam(s)
County

Name of site(s) by category (SC, OTP, BSFP, TSFP)

Number of Stabilization Centers (SCs)
Number of Out-Patient Therapeutic Centers (OTPs)
Number of Community level Treatment sites (BSFPs)
Number of Targeted Supplementary feeding sites (TSFPs)

Management of Severe Acute Malnutrition - Inpatient

Children Total end of last month (A) Automatic calculations children 6-59m
6-59 months Entry categories New admissions this month (B) Total admissions (D=B+C)
Gender new admissions: male (B1) Total exits (H=E+F+G)
Gender new admissions: female (B2) Total at end of month (I=A+D-H)
Old cases (referral from OTP, returned defaulters, moved from other SC) (C)
Exit categories Inpatients stabilized and referred to OTP (E)
Discharged cured (special cases ending treatment) (F1)
Discharged died (F2)
Discharged defaulted (F3)
Discharged non-recovered (F4)
Other transfers (G)
Children Total end of last month (A) Automatic calculations children < 6m
< 6 months Entry categories New admissions this month (B) Total admissions (D=B+C)
Gender new admissions: male (B1) Total exits (H=F+G)
Gender new admissions: female (B2) Total at end of month (I=A+D-H)
Old cases (returned defaulters, moved from other SC) (C)
Exit categories Discharged cured (F1)
Discharged died (F2)
Discharged defaulted (F3)
Discharged non-recovered (F4)
Other transfers (G)
Other Total end of last month (A) Automatic calculations others ≥ 5 years
(adolescent, adult, and Entry categories New admissions this month (B) Total admissions (D=B+C)
children ≥ 5 yrs)
Gender new admissions: male (B1) Total exits (H=E+F+G)
Gender new admissions: female (B2) Total at end of month (I=A+D-H)
Age-groups new admissions: older children 5-9 years (B3)
Age-groups new admissions: adolescents 10-18 years (B4)
Age-groups new admissions: adults > 18 years (B5)
Old cases (referral from OTP, returned defaulters, moved from other SC) (C)
Exit categories Inpatients stabilized and referred to OTP (E)
Discharged cured (special cases ending treatment) (F1)
Discharged died (F2)
Discharged defaulted (F3)
Discharged non-recovered (F4)
Other transfers (G)
Management of Severe Acute Malnutrition - Outpatient
Children Total end of last month (A)
6-59 months Entry categories New admissions this month (B)
Gender new admissions: male (B1)
Gender new admissions: female (B2)
Old cases (referral from SC, returned defaulters, moved from other OTP) (C)
Exit categories Discharged cured (E1)
Discharged died (E2)
Discharged defaulted (E3)
Discharged non-recovered (E4)
Referrals to SC (F)
Other transfers
Average daily weight gain (AWG) for discharges cured (in grams/kg/day)
Average length of stay (LOS) for discharges cured (in days)
Other Total end of last month (A)
(adolescent, adult, and ≥ Entry categories New admissions this month (B)
5 years)
Gender new admissions: male (B1)
Gender new admissions: female (B2)
Age-groups new admissions: older children 5-9 years (B3)
Age-groups new admissions: adolescents 10-18 years (B4)
Age-groups new admissions: adults > 18 years (B5)
Old cases (referral from SC, returned defaulters, moved from other OTP) (C)
Exit categories Discharged cured (E1)
Discharged died (E2)
Discharged defaulted (E3)
Discharged non-recovered (E4)
Referrals to SC (F)
Other transfers
Targeted Supplementary Feeding Programme
Children 6-59 months Total end of last month (A)
Entry categories New admissions this month (B)
Gender new admissions: male (B1)
Gender new admissions: female (B2)
Re-admissions this month (C)
Exit categories Discharged cured (E)
Discharged died (F)
Discharged defaulted (G)
Referrals to TSFP/OTP (H)
Non-respondent (I)
Average length of stay for discharged cured (in days)
Pregnant & Lactating Total end of last month (A)
Women Entry categories New admissions this month (B)
Re-admissions this month (C)
Exit categories Discharged cured (E)
Discharged died (F)
Discharged defaulted (G)
Referrals to TSFP/OTP (H)
Non-respondent (I)
Average length of stay for discharged cured (in days)
Automatic calculations children 6-59m
Total admissions (D=B+C)
Total exits (H=E+F+G)
Total at end of month (I=A+D-H)
Combined in- and outpatient IM-SAM rates
Discharged cured rate (SPHERE min. standards >75%)
Discharged died rate (SPHERE min. standards <10%)
Discharged defaulted rate (SPHERE min. standards <15%)
Discharged non-recovered rate
(SPHERE min. standards > 4g/kg/day)
(SPHERE min. standards < 60 days)
Automatic calculations others ≥ 5 years
Total admissions (D=B+C)
Total exits (H=E+F+G)
Total at end of month (I=A+D-H)
Automatic calculations children 6-59m
Total admissions (D = B+C)
Percentage new admissions male
Percentage new admissions female
Discharges cured rate (SPHERE min. standards >75%)
Discharges died rate (SPHERE min. standards <3%)
Discharges defaulted rate (SPHERE min. standards <15%)
Total exits (J = E+F+G+H+I)
Total at end of month (K = A+D-J)
Automatic calculations PLW
Total admissions (D = B+C)
Discharges cured rate (SPHERE min. standards >75%)
Discharges died rate (SPHERE min. standards <3%)
Discharges defaulted rate (SPHERE min. standards <15%)
Total exits (J = E+F+G+H+I)
Total at end of month (K = A+D-J)
Blanket Supplementary Feeding Programme
Children 6-35 months No. of children 6-35m newly enrolled during the month Automatic calculations children 6-35m
Male % MUAC Red #VALUE!
Female % MUAC Yellow #VALUE!
Average number of children 6-35 months attended distribution this month
Children 6-59 months No. of children 6-59m newly enrolled during the month
Male
Female
Average number of children 6-59 months attended distribution this month
Pregnant&Lactating Women Number of PLW newly enrolled during the month Automatic calculations PLW

Screening and Referral

Boys 6-59 months Screening Number screened Automatic calculations Screening and Referral
(MUAC Number oedema Total no. (boys+girls) screened
measurements)
No. of boys 6-59m with red MUAC (<11.5 cm) Total no. (boys+girls) oedema
No. of boys 6-59m with yellow MUAC (≥11.5 cm to <12.5 cm) Total no. (boys+girls) Red
No. of boys 6-59m with green MUAC (≥ 12.5 cm) Total no. (boys+girls) Yellow
Girls 6-59 months Screening Number screened Total no. (boys+girls) Green
(MUAC Number oedema % of boys+girls oedema
measurements)
No. of girls 6-59m with red MUAC (<11.5 cm) % of boys+girls Red
No. of girls 6-59m with yellow MUAC (≥11.5 cm to <12.5 cm) % of boys+girls Yellow
No. of girls 6-59m with green MUAC (≥ 12.5 cm) % of boys+girls Green
Pregnant & Lactating Screening Number screened Automatic calculations PLW
Women (MUAC No. of PLW with MUAC <21.0 cm % MUAC <21.0 cm
measurements)
No. of PLW with MUAC ≥21.0 cm to <23.0 cm % MUAC ≥21.0 cm to <23.0 cm
No. of PLW with MUAC ≥23.0 cm % MUAC ≥23.0 cm

Micronutrients Supplementation
Children 6-11 months given Vit-A during the month Automatic calculations children 6-11 months
Male % Male
Female % Female
Vitamin A supplementation given to children
Children 12-59 months given Vit-A during the month Automatic calculations children 12-59 months
Male % Male
Female % Female
Children 6- 24 months supplemented with MNP during the month Automatic calculations children 6-24 months
Micronutrient Powder (MNP) given to children
(Micronutrient Powder/ Sprinkle) Male % Male
Female % Female
Iron & folate or Multiple Micronutrients Pregnant & Lactating Women

Deworming
No. of children 12-59 months dewormed Total 12-59m children dewormed during the month Automatic calculations children dwormed
Male % Male
Female % Female

Infant and Young Child Feeding

Pregnant women attended individual counselling sessions
Individual sessions (one- Automatic calculations PLW individual counselling
to-one) Lactating women and caretakers of children <6 months attended individual counselling sessions
Lactating women and caretakers of children 6-24 months attended individual counselling sessions Total
Number of IYCF groups (including mother support groups) operational during reporting month
Number of IYCF group sessions held (including mother support groups)

Group sessions
 Number of new admissions to IYCF groups (including mother support groups) Automatic calculations group sessions
Group sessions
Male % Male
Female % Female
Average number of people attended IYCF group session (including mother support groups)
Capacity Development
MUAC screening, referral and community Type of Training No. of Trainings
mobilization Main category of staff trained From which agency/agencies
Male No. of Days
Female
Comments
Integrated Management of Acute Malnutrition Type of Training No. of Trainings
(IMAM): SAM/TF (Inpatient) Main category of staff trained From which agency/agencies
Male No. of Days
Female
Comments
Integrated Management of Acute Malnutrition Type of Training No. of Trainings
(IMAM) : SAM/TF (Outpatient) Main category of staff trained From which agency/agencies
Male No. of Days
Female
Comments
Integrated Management of Acute Malnutrition Type of Training No. of Trainings
(IMAM): MAM/TSFP Main category of staff trained From which agency/agencies
Male No. of Days
Female
Comments
Training on IYCF Type of Training No. of Trainings
Main category of staff trained From which agency/agencies
Male No. of Days
Female
Comments
Training on SMART survey Type of Training No. of Trainings
Main category of staff trained From which agency/agencies
Male No. of Days
Female
Comments
Emergency Prepardness & Response Type of Training No. of Trainings
Main category of staff trained From which agency/agencies
Male No. of Days
Female
Comments
Supplies
F100 Opening Stock at the beginning of the reporting month (A) Automatic calculations F100
(sachets) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
Days out of Stock (Please explain in comments section)
F75 Opening Stock at the beginning of the reporting month (A) Automatic calculations F75
(sachets) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
Days out of Stock (Please explain in comments section)
ReSoMol Opening Stock at the beginning of the reporting month (A) Automatic calculations ReSoMol
(sachets) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
Days out of Stock (Please explain in comments section)
Amoxicillin Opening Stock at the beginning of the reporting month (A) Automatic calculations Amoxicillin
(tablets) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
Days out of Stock (Please explain in comments section)
Albendazole or Mebendazole Opening Stock at the beginning of the reporting month (A) Automatic calculations Albendazole or Mebendazole
(tablets) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
Days out of Stock (Please explain in comments section)
RUTF / Plumpy'Nut Opening Stock at the beginning of the reporting month (A) Automatic calculations RUTF/Plumpy'Nut
(sachets) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
Days out of Stock (Please explain in comments section)
Vitamin A Opening Stock at the beginning of the reporting month (A) Automatic calculations Vitamin A (caps 100,000 IU - blue)
(caps 100,000 IU - blue) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
Days out of Stock (Please explain in comments section)
Vitamin A Opening Stock at the beginning of the reporting month (A) Automatic calculations Vitamin A (caps 200,000 IU - red)
(caps 200,000 IU - red) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
Days out of Stock (Please explain in comments section)
Oil Opening Stock at the beginning of the reporting month (A) Automatic calculations Oil
(MT) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
Days out of Stock (Please explain in comments section)
Sugar Opening Stock at the beginning of the reporting month (A) Automatic calculations Sugar
(MT) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
 Days out of Stock (Please explain in comments section)
CSB+ Opening Stock at the beginning of the reporting month (A) Automatic calculations CSB+
(MT) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
Days out of Stock (Please explain in comments section)
CSB++ Opening Stock at the beginning of the reporting month (A) Automatic calculations CSB++
(MT) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
Days out of Stock (Please explain in comments section)
BP-5 or NRG-5 Opening Stock at the beginning of the reporting month (A) Automatic calculations BP-5
(cartons) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
Days out of Stock (Please explain in comments section)
Plumpy'Doz Opening Stock at the beginning of the reporting month (A) Automatic calculations Plumpy'Doz
(cartons) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
Days out of Stock (Please explain in comments section)
RUSF / Plumpy'Sup Opening Stock at the beginning of the reporting month (A) Automatic calculations RUSF / Plumpy'Sup
(cartons) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
Days out of Stock (Please explain in comments section)
Folic Acid Opening Stock at the beginning of the reporting month (A) Automatic calculations Folic Acid
(5mg tablets) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
Days out of Stock (Please explain in comments section)
Iron Folate Opening Stock at the beginning of the reporting month (A) Automatic calculations Iron Folate
(60mg tablets) Receipts during the reporting month (B) Total amount available this month (C = A+B)
Total amount utilized (D) Stock at the end of this month F = C-(D+E)
Losses (E)
Days out of Stock (Please explain in comments section)

Comments
Any comments on
programs, gaps or
concerns
Calculation Aid for Average Daily Weight Gain Calculation results from data entered below
and Average Length Of Stay Average daily weight gain: #DIV/0! g/kg bodyweight/day
only for children 6-59 months who are discharged cured from outpatient therapeutic care Average length of stay: #DIV/0! days

Instructions: Average Daily Weight Gain and Average Length Of Stay are calculated on a randomized sample of cured discharges for kwashiorkor and marasmus.
A reasonable randomized sample of discharged cured cases is 20. If lower numbers have been discharged cured during the period of reporting, take all discharged cured.

Marasmus patients Kwashiorkor patients

number of days Length of stay: number

Type of SAM patient minimum weight after between subsidal of of days between
(choose from weight at admission oedema has subsided oedema and discharge admission and discharge weight Daily weight gain
dropdown list) [kilograms] [kilograms] day [days] discharge [days] [kilograms] [g/kg bodyweight/day]
Discharged Child 1
Discharged Child 2
Discharged Child 3
Discharged Child 4
Discharged Child 5
Discharged Child 6
Discharged Child 7
Discharged Child 8
Discharged Child 9
Discharged Child 10
Discharged Child 11
Discharged Child 12
Discharged Child 13
Discharged Child 14
Discharged Child 15
Discharged Child 16
Discharged Child 17
Discharged Child 18
Discharged Child 19
Discharged Child 20
Partner ReportingMonth ReportingYear ReportSubmissionDate State County #SCs #OTPs
0 0 0 30/Dec/99 0 0 0 0
#CommunityLevelTreatmentSites #TSFPs SAMinpatient6-59mTotBeginMonth
0 0 0
SAMinpatient6-59mNewAdmissions SAMinpatient6-59mNewAdmissionsMale
0 0
SAMinpatient6-59mNewAdmissionsFemaSAMinpatient6-59mOldCases SAMinpatient6-59mReferrals
0 0 0
SAMinpatient6-59mDischargesCured SAMinpatient6-59mDischargesDied
0 0
SAMinpatient6-59mDischargesDefaulted SAMinpatient6-59mDischargesNonRecovered
0 0
SAMinpatient6-59mOtherTransfers SAMinpatient<6mTotBeginMonth
0 0
SAMinpatient<6mNewAdmissions SAMinpatient<6mNewAdmissionsMale
0 0
SAMinpatient<6mNewAdmissionsFemaSAMinpatient<6mOldCases
0 0
SAMinpatient<6mDischargesCured SAMinpatient<6mDischargesDied
0 0
SAMinpatient<6mDischargesDefaulted SAMinpatient<6mDischargesNonRecovered
0 0
SAMinpatient<6mReferrals SAMinpatient>5yTotBeginMonth SAMinpatient>5yNewAdmissions
0 0 0
SAMinpatient>5yNewAdmissionsMale SAMinpatient>5yNewAdmissionsFema
0 0
SAMinpatient>5yNewAdmissionsOlderSAMinpatient>5yNewAdmissionsAdole
0 0
SAMinpatient>5yNewAdmissionsAdultSAMinpatient>5yOldCases SAMinpatient>5yReferrals
0 0 0
SAMinpatient>5yDischargesCured SAMinpatient>5yDischargesDied
0 0
SAMinpatient>5yDischargesDefaulted SAMinpatient>5yDischargesNonRecovered
0 0
SAMinpatient>5yOtherTransfers SAMoutpatient6-59mTotBeginMonth
0 0
SAMoutpatient6-59mNewAdmissions SAMoutpatient6-59mNewAdmissionsMale
0 0
SAMoutpatient6-59mNewAdmissionsFema SAMoutpatient6-59mOldCases
0 0
SAMoutpatient6-59mDischargesCured SAMoutpatient6-59mDischargesDied
0 0
SAMoutpatient6-59mDischargesDefaulted SAMoutpatient6-59mDischargesNonRecovered
0 0
SAMoutpatient6-59mReferrals SAMoutpatient6-59mOtherTransfe
0 0
SAMoutpatient6-59mAvgDailyWeightGain SAMoutpatient6-59mAvgLengthOfStay
0.0 0.0
SAMoutpatient>5yTotBeginMonth SAMoutpatient>5yNewAdmissions
0 0
SAMoutpatient>5yNewAdmissionsMale SAMoutpatient>5yNewAdmissionsFema
0 0
SAMoutpatient>5yNewAdmissionsOlderSAMoutpatient>5yNewAdmissionsAdole
0 0
SAMoutpatient>5yNewAdmissionsAdultSAMoutpatient>5yOldCases
0 0
SAMoutpatient>5yDischargesCured SAMoutpatient>5yDischargesDied
0 0
SAMoutpatient>5yDischargesDefaulted SAMoutpatient>5yDischargesNonRecovered
0 0
SAMoutpatient>5yReferrals SAMoutpatient>5yOtherTransfeTSFP6-59mTotEndOfLastMonth
0 0 0
TSFP6-59mNewAdmissions TSFPmaleNewAdmissions TSFPfemaleNewAdmissions
0 0 0
TSFP6-59mReAdmissions TSFP6-59mDischargesCured TSFP6-59mDischargesDied
0 0 0
TSFP6-59mDischargesDefaulted TSFP6-59mReferrals TSFP6-59mNonRespondent
0 0 0
TSFP6-59mAverageLengthOfSta TSFPplwTotEndOfLastMonth TSFPplwNewAdmissions
0 0 0
TSFPplwReAdmissions TSFPplwDischargesCured TSFPplwDischargesDied
0 0 0
TSFPplwDischargesDefaulted TSFPplwReferrals TSFPplwNonRespondent
0 0 0
TSFPplwAverageLengthOfStay BSFP6-36beneficiaries BSFP6-36beneficiariesmale
0 0 0
BSFP6-36beneficiariesfemale BSFP6-36MUACred BSFP6-36MUACyellow
0 N/A N/A
BSFP6-36MUACgreen BSFP6-36Oedema BSFP36-59beneficiaries
N/A N/A 0
BSFP6-59beneficiariesmale BSFP6-59beneficiariesfemale BSFPplwBeneficiaries
0 0 0
BSFPplwMUACred BSFPplwMUACyellow BSFPplwMUACgreen ScreenAndRefBoysNoSc
N/A N/A N/A 0
ScreenAndRefBoysOed ScreenAndRefBoysMUAScreenAndRefBoysMUAScreenAndRefBoysMUA
0 0 0 0
ScreenAndRefBoysRefO ScreenAndRefBoysRefT ScreenAndRefGirlsNoSc ScreenAndRefGirlsOed
N/A N/A 0 0
ScreenAndRefGirlsMUA ScreenAndRefGirlsMUA ScreenAndRefGirlsMUA ScreenAndRefGirlsRefO
0 0 0 N/A
ScreenAndRefGirlsRefT ScreenAndRefPLWNoSc ScreenAndRefPLWMUACScreenAndRefPLWMUAC
N/A 0 0 0
ScreenAndRefPLWMUA ScreenAndRefPLWRefO ScreenAndRefPLWRefTSMicronutrientsVitA6-11
0 N/A N/A 0
MicronutrientsVitA6-11 MicronutrientsVitA6-11 MicronutrientsVitA12-5 MicronutrientsVitA12-
0 0 0 0
MicronutrientsVitA12-5 MNNPbeneficiaries MNNPbeneficiariesmaleMNNPbeneficiariesfema
0 0 0 0
MicronutrientsIronFolatePLW Deworming12-59 Deworming12-59male
0 0 0
Deworming12-59female HealthEducationPLWiycf Mothersupportgroupsestb
0 N/A N/A
IYCFPWindivid IYCFLW0-5individ IYCFLW6-24individ
0 0 0
IYCFgroupoperational IYCFgroupsessions IYCFnewadmissionstotal
0 0 0
IYCFnewadmissionsmen IYCFnewadmissionswomen Averagepergroupsession
0 0 0
SuppliesF100OpeningStock SuppliesF100Receipts SuppliesF100Utilised SuppliesF100Losses
0 0 0 0
SuppliesF100DOS SuppliesF75OpeningStock SuppliesF75Receipts SuppliesF75Utilised
0 0 0 0
SuppliesF75Losses SuppliesF75DOS SuppliesReSoMolOpeningStock SuppliesReSoMolReceipts
0 0 0 0
SuppliesReSoMolUtilised SuppliesReSoMolLosses SuppliesReSoMolDOS
0 0 0
SuppliesAmoxicillinOpeningStock SuppliesAmoxicillinReceipts SuppliesAmoxicillinUtilised
0 0 0
SuppliesAmoxicillinLosses SuppliesAmoxicillinDOS SuppliesAbendazoleOpeningStock
0 0 0
SuppliesAbendazoleReceipts SuppliesAbendazoleUtilised SuppliesAbendazoleLosses
0 0 0
SuppliesAbendazoleDOS SuppliesPlumpyNutOpeningStock SuppliesPlumpyNutReceipts
0 0 0
SuppliesPlumpyNutUtilised SuppliesPlumpyNutLosses SuppliesPlumpyNutDOS
0 0 0
SuppliesVitaminA100OpeningStock SuppliesVitaminA100Receipts SuppliesVitaminA100Utilised
0 0 0
SuppliesVitaminA100Losses SuppliesVitaminA100DOS SuppliesVitaminA200OpeningStock
0 0 0
SuppliesVitaminA200Receipts SuppliesVitaminA200Utilised SuppliesVitaminA200Losses
0 0 0
SuppliesVitaminA200DOS SuppliesOilOpeningStock SuppliesOilReceipts SuppliesOilUtilised
0 0.000 0.000 0.000
SuppliesOilLosses SuppliesOilDOS SuppliesSugarOpeningStock SuppliesSugarReceipts
0.000 0 0.000 0.000
SuppliesSugarUtilised SuppliesSugarLosses SuppliesSugarDOS SuppliesCSB1pOpeningS
0.000 0.000 0 0.000
SuppliesCSB1pReceipts SuppliesCSB1pUtilised SuppliesCSB1pLosses SuppliesCSB1pDOS
0.000 0.000 0.000 0
SuppliesCSB2pOpeningSSuppliesCSB2pReceipts SuppliesCSB2pUtilised SuppliesCSB2pLosses
0.000 0.000 0.000 0.000
SuppliesCSB2pDOS SuppliesBP5OpeningStock SuppliesBP5Receipts SuppliesBP5Utilised
0 0.00 0.00 0.00
SuppliesBP5Losses SuppliesBP5DOS SuppliesPlumpyDozOpeningStock
0.00 0 0.00
SuppliesPlumpyDozReceipts SuppliesPlumpyDozUtilised SuppliesPlumpyDozLosses
0.00 0.00 0.00
SuppliesPlumpyDozDOS SuppliesPlumpySupOpeningSt SuppliesPlumpySupReceipts
0 0.00 0.00
SuppliesPlumpySupUtilised SuppliesPlumpySupLosses SuppliesPlumpySupDOS
0.00 0.00 0
SuppliesFolicAcidOpeningStock SuppliesFolicAcidReceipts SuppliesFolicAcidUtilised
0 0 0
SuppliesFolicAcidLosses SuppliesFolicAcidDOS SuppliesIronFolateOpeningStock
0 0 0
SuppliesIronFolateReceipts SuppliesIronFolateUtilised SuppliesIronFolateLosses
0 0 0
SuppliesIronFolateDOS
0
 ReportingY State County Training1No Training1staff Training1Male
PartnerReportingMonth
0 0 0 0 0 00 0
Training1Female Training1Days Training2No Training2staff Training2Male Training2Female
0 0 00 0 0
Training2Days Training3No Training3staff Training3Male Training3Female Training3Days
0 00 0 0 0
Training4No Training4staff Training4Male Training4Female Training4Days Training5No
00 0 0 0 0
Training5staff Training5Male Training5Female Training5Days Training6No Training6staff
0 0 0 0 00
Training6Male Training6Female Training6Days Training7No Training7staff Training7Male
0 0 0 00 0
Training7Female Training7Days
0 0