Please accomplish AOP Form 1 for 2020, AOP Form 1 for 2021, and AOP Form 1 for 2022

AOP Form 1. SUMMARY OF INVESTMENT COST BY PILLAR AND FUND SOURCE

Region: II - ISABELA
LGU CITY OF ILAGAN - CITY HEALTH OFFICE - 1
AOP CY: 2021

Fund Source (PhP)

(2)
Strategic Pillar % of Pillar to Grand
Grand Total (PhP)
(1) DOH LGU Total
Others
Central Office CHD PLGU C/MLGU BLGU
1. HEALTH SERVICE DELIVERY 99.64
0.00
Health Facility Development
160, 031.08 0.00
Human Resource for Health 11980984.2
11,980,984.20
Commodities
1,189,112,689.44 2,793,047 1,191,905,736.00
Other Technical Assistance
905,280.00 96,000 1,001,280.00
2. FINANCING 2,400,000 0.20
2,400,000.00
3. REGULATION 0.01
97,250.00 97,250.00
4. GOVERNANCE 0.16
1,406,340.00 485,500.00 1,891,840.00

Grand Total (PhP) 11980984.2 1191424309.435 0 5871796.56 0 0 1209277090.195

As a Percentage of Grand Total 0.85596049771611 98.5236815528258 0 0.485562540430924 0 0

(1) F1 Plus Strategic Pillars of:

§ Service Delivery
§ Governance

§ Regulation

§ Financing

(2) Fund Source – which/what office will be able to fund the investment:

§ DOH – Central Office or Centers for Health Development;

§ LGU – Government funds from Local Government Units: PLGU (province), CLGU (city), MLGU (municipality); BLGU (Barangays)
§ Others - Other Fund Sources: from Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs; private and other sectors; and unfunded PPAs
1115659
472665
326010

303195
Please accomplish AOP Form 2 for 2020, AOP Form 2 for 2021, and AOP Form 2 for 2022
For EACH YEAR, please accomplish AOP Form 2 for EACH Strategic Pillar (Service Delivery, Governance, Regulation, Financing)
AOP Form 2. COST ASSUMPTIONS BY PILLAR, PPAS, QUARTER AND FUND SOURCE (AOP MOTHER PLAN)

Region: II - ISABELA Date: ______________

LGU CITY OF ILAGAN - CITY HEALTH OFFICE - 1
AOP CY: 2021

Strategic Pillar: Resource Requirements (PhP) Fund Source (PhP)

HEALTH SERVICE DELIVERY PPA Performance Municipality/ Target (7) (8)
Indicator District Component Name of Health Facility (6)
Program/Project/ (3) City/Barangay (5) DOH LGU
(2) Total Cost
Activities (PPA) (4) Items Description Expense Category Unit Cost Quantity
(Unit Cost x Quantity)
Others
(1) Q1 Q2 Q3 Q4 Total Target CO CHD PLGU C/MLGU BLGU

A. HEALTH FACILITY DEVELOPMENT -ok

2. RHU

CONSTRUCTION OF CITY OF SINGLE

a. Infrastructure district 1 CITY HEALTH OFFICE - 1 0 1 0 0 1 CONSTRUCTION 1,000,000 1 1,000,000 1,000,000
TB DOTS CENTER ILAGAN BUILDING

PROVISION OF 1 CITY HEALTH OFFICE AND 1

district 1 city of ilagan 0 2 0 0 2 DOPPLER EQUIPMENT 5,000 2 10,000
b. Medical Equipment DOPPLER EXTENSION 10,000
PROVISION OF 1 CITY HEALTH OFFICE AND 1
district 1 city of ilagan 2 0 0 0 2 MICROSCOPE EQUIPMENT 37,000 2 74,000
MICROSCOPE EXTENSION 74,000
1 CITY HEALTH OFFICE AND 1
provision of colilert *18 district 1 city of ilagan 2 0 0 0 2 colilert device EQUIPMENT 250,000 2 500,000
EXTENSION 500,000
provision of Chlorine 1 CITY HEALTH OFFICE AND 1
district 1 city of ilagan 2 0 0 0 2 cholorimeter EQUIPMENT 2,500 2 5,000
test device EXTENSION 5,000

1 CITY HEALTH OFFICE AND 1 spray can 12

provsion of spray can district 1 city of ilagan 2 0 0 0 2 EQUIPMENT 14,000 2 28,000
EXTENSION Liters capacity
28,000
TOTAL RHU/CHO - 1,617,000.00 - - - -
2. BHS
MANGCURAM
GUINATAN
SINGLE
a. Infrastructure renovation BHS district 1 city of ilagan STA BARBARA 2 2 2 0 6 RENOVATION 1,000,000 6 6,000,000 6,000,000
BUILDING
CARKKIKAN SUR
CARIKKIKAN NORTE
remote
upgrade on BHS district 1 city of ilagan STA Isabel sur 1 1 upgrade 100,000 1 100,000 100,000
smeering
PROVISION OF
district 1 city of ilagan ALL BARAGAYS ( 35) 9 9 9 8 35 DOPPLER EQUIPMENT 5,000 35 175,000
b. Medical Equipment DOPPLER 175,000
TOTAL BHS\ 6,275,000

Total HEALTH FACILITY DEVELOPMENT 7,892,000

B. HUMAN RESOURCES FOR HEALTH- pls transfer to

Health Workforce template Form 2
DOH Deployed
Salary and
1. Physician HRH Augmentation DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE -1 1 0 0 0 1 PS 1,115,659.20 1 1,115,659.20 1,115,659.20
Benefits
Salary and
HRH Augmentation DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE -1 21 0 0 0 21 PS 472,665 21 9,925,965.00 4,726,650.00
3. Nurse Benefits
Salary and
4. Midwife HRH Augmentation DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE -1 10 0 0 0 10 PS 326,010 10 3,260,100.00 3,260,100.00
Benefits
Salary and
5. Medical Technologist HRH Augmentation DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE -1 2 0 0 0 2 PS 472,665 2 945,330.00 945,330.00
Benefits
Salary and
8. Project Assistant HRH Augmentation DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE -1 1 0 0 0 1 PS 303,195 1 303,195.00 303,195.00
Benefits

LGU-Personnel
Salary and
3. Rural Health Midiwife Plantilia Position DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE -1 5 0 0 0 5 PS 326,010 5 1,630,050
Benefits 1,630,050
HUMAN RESOURCE TOTAL 10,350,934.20 - - 1,630,050.00 - -

A. NATIONAL TUBERCULOSIS PROGRAM ok but

commodities to be transferred to Form 2 Medical Products
(MPVT ) include only in SD template trainings, program review
and advocacy

CITY OF
Category 1 kit (adult) DISTRICT 1 CITY HEALTH OFFICE - 1 90 90 90 80 350 KITS MOOE 1050.21 350 367,574 367,574
ILAGAN
CITY OF
Category 1 kit (Children) FDC DISTRICT 1 CITY HEALTH OFFICE - 1 20 25 20 20 85 KITS MOOE 292.6 85 24,871 24,871
ILAGAN
CITY OF
Purified Protein Derivative (PPD) Sol DISTRICT 1 CITY HEALTH OFFICE - 1 25 25 25 25 100 VIAL MOOE 650 100 65,000 65,000
ILAGAN
CITY OF
Sputum Cups DISTRICT 1 CITY HEALTH OFFICE - 1 500 500 500 0 1500 PIECE MOOE 4 1500 6,000 6,000
ILAGAN
CITY OF
NTP treatment card DISTRICT 1 CITY HEALTH OFFICE - 1 200 235 0 0 435 PIECE PRINTING 5 435 2,175 2,175
ILAGAN
CITY OF
NTP ID Card DISTRICT 1 CITY HEALTH OFFICE - 1 200 235 0 0 435 PIECE PRINTING 5 435 2,175 2,175
ILAGAN
Sub-total NATIONAL TUBERCULOSIS PROGRAM 467,794.50 467,794.50

B. FAMILY HEALTH COMMODITIES to be transferred to

Form 2 Medical Products (MPVT ) include only in SD template
trainings, program review and advocacy

Adolescent Health and Development and WRA

Micronutrient Supplementation

Ferrous salt + Folic Acid tablets (60mg elemental iron + CITY OF

DISTRICT 1 CITY HEALTH OFFICE - 1 2,404 2,404 2,404 2,405 9617 Tablet MOOE 0.74 500,084.00 370,062.16
400ug folic acid per tablet) (Women 10-49 years old) ILAGAN
160,031.08 160031.08

Mental Health Program all commodities to be transferred to

Form 2 Medical Products (MPVT ) include only in SD
template trainings, program review and advocacy

CITY OF
Carbamazepine 200mg/tablet DISTRICT 1 CITY HEALTH OFFICE - 1 5 5 5 - 15 Tablet MOOE 45 5,400 243,000.00
ILAGAN 243,000
CITY OF
Chlorpromazine 200mg/tablet DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1
10 10 5 - 25 Tablet MOOE 45 9,000 405,000.00
405,000
CITY OF
Haloperidol 5mg/tablet DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1
10 5 5 - 20 Tablet MOOE 50 7,200 360,000.00
360,000
CITY OF
Fluphenazine Decanoate 25mg/ml, 10ml DISTRICT 1 CITY HEALTH OFFICE - 1 5 - 15 vial MOOE 1000 5,400 5,400,000.00
ILAGAN 5 5 5,400,000
CITY OF
Olanzapine 10mg/tablet DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1
5 5 5
- 15 Tablet MOOE 40 5,400 216,000.00
216,000
CITY OF
Riperidone 1mg/tab DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1
20 10 10 - 40 Tablet MOOE 40 14,400 576,000.00
576,000
CITY OF
Sertraline 50mg/tablet DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1
10 10 10
- 30 Tablet MOOE 40 10,800 432,000.00
432,000
CITY OF
Fluoxetine 20mg/tablet DISTRICT 1 CITY HEALTH OFFICE - 1 5 - 15 Tablet MOOE 50 5,400 270,000.00
ILAGAN 5 5 270,000
CITY OF
Biperiden 2mg/tablet DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1
10 10 10
- 30 Tablet MOOE 45 10,800 486,000.00
486,000
total
8,388,000.00 -
Safe Motherhood Program to be transferred to Form 2
Medical Products (MPVT ) include only in SD template
trainings, program review and advocacy

Ferrous salt + Folic Acid tablets (60mg elemental iron + CITY OF

DISTRICT 1 CITY HEALTH OFFICE - 1 2,212.00 2,212.00 2,212.00 - 6,636.00 Tablet MOOE 0.74 2,388,960.00 1,767,830.40
400ug folic acid per tablet) ILAGAN 883,915 883,915.20
CITY OF
Calcium Carbonate 500mg tab DISTRICT 1 CITY HEALTH OFFICE - 1 2,212.00 2,212.00 2,212.00 - 6,636.00 Tablet MOOE 3.09 2,388,960.00 7,381,886.40 3,690,943.20 3,690,943.20
ILAGAN

Page 3 of 34
 Strategic Pillar: Resource Requirements (PhP) Fund Source (PhP)
HEALTH SERVICE DELIVERY Municipality/ Target (7) (8)
PPA Performance
District Component Name of Health Facility (6)
Program/Project/ Indicator DOH LGU
(3) City/Barangay (5) Total Cost
Activities (PPA) (2) (4) Items Description Expense Category Unit Cost Quantity Others
(Unit Cost x Quantity)
(1) Q1 Q2 Q3 Q4 Total Target CO CHD PLGU C/MLGU BLGU
CITY OF
Iodized Oil Capsules, 500mg soft gel capsule DISTRICT 1 CITY HEALTH OFFICE - 1 2,212.00 2,212.00 2,212.00 - 6,636.00 Capsule MOOE 41.2 6,636.00 273,403.20
ILAGAN 136,702 136,701.60
CITY OF
Oxytocin 10 IU/mL, 1 mL Ampule DISTRICT 1 CITY HEALTH OFFICE - 1 2,212.00 2,212.00 2,212.00 - 6,636.00 Ampule MOOE 9.89 6,636.00 65,630.04
ILAGAN 65,630.04
CITY OF
Mebendazole 500mg/tab DISTRICT 1 CITY HEALTH OFFICE - 1 2,212.00 2,212.00 2,212.00 - 6,636.00 Tablet MOOE 3 6,636.00 19,908.00
ILAGAN 19,908.00
CITY OF
Magnesium Sulfate 250mg/mL, 20mL ampule DISTRICT 1 CITY HEALTH OFFICE - 1 Ampule MOOE 26.78 50.00 1,339.00
ILAGAN 1,339.00
CITY OF
Dexamethasone 4mg/mL, 2mL vial (as sodium phosphate) DISTRICT 1 CITY HEALTH OFFICE - 1 Vial MOOE 30.99 50.00 1,549.50
ILAGAN 1,549.50
CITY OF
Vitamin A 200,000 IU soft gel capsules DISTRICT 1 CITY HEALTH OFFICE - 1 Capsule MOOE 1.13 6,636.00 7,498.68
ILAGAN 7,498.68
CITY OF
Ampicillin 1g Vial (as sodium salt) DISTRICT 1 CITY HEALTH OFFICE - 1 Vial MOOE 10.8 100.00 1,080.00
ILAGAN 1,080.00
CITY OF
Methyldopa 250mg/tab DISTRICT 1 CITY HEALTH OFFICE - 1 Tablet MOOE 12.36 100.00 1,236.00
ILAGAN 1,236.00
CITY OF
Mother & Baby Booklet DISTRICT 1 CITY HEALTH OFFICE - 1 2,212.00 2,212.00 2,212.00 - 6,636.00 Booklet MOOE 25 6,636.00 165,900.00
ILAGAN 165,900
total
- 3,993,544.80 - 3,925,886.02 - -
Family Planning Program

CITY OF 18.00
Combined Oral contraceptive pills DISTRICT 1 CITY HEALTH OFFICE - 1 2435 2435 2435 2435 9740 Pills MOOE 36,000.00 648,000.00
ILAGAN 648,000
CITY OF 90.00
Progestine only contraceptive pills DISTRICT 1 CITY HEALTH OFFICE - 1 2435 2435 2435 2435 9740 Pills MOOE 2000 180,000.00
ILAGAN 180,000
CITY OF 45.00
Depot Medroxyprogesterone Acetate DISTRICT 1 CITY HEALTH OFFICE - 1 2435 2435 2435 2435 9740 dose/vial/tab etc MOOE 4800 216,000.00
ILAGAN 216,000
CITY OF 22.95
IUD DISTRICT 1 CITY HEALTH OFFICE - 1 2435 2435 2435 2435 9740 Unit MOOE 500 11,475.00
ILAGAN 11,475
CITY OF 109.12
Cycle Beads DISTRICT 1 CITY HEALTH OFFICE - 1 2435 2435 2435 2435 9740 Unit MOOE 9740 1,062,828.80
ILAGAN 1,062,829
CITY OF 6.72
Condom (packs of 3s) DISTRICT 1
ILAGAN CITY HEALTH OFFICE - 1 2435 2435 2435 2435 9740 Pack MOOE 15,000 100,800.00
100,800
CITY OF 1.00
Basal Body Temperature (BBT) Chart DISTRICT 1 CITY HEALTH OFFICE - 1 35 35 Chart MOOE 35 35.00
ILAGAN 35
CITY OF 1.00
Cervical Mucus Method (CMM) Chart DISTRICT 1 CITY HEALTH OFFICE - 1 35 35 Chart MOOE 35 35.00
ILAGAN 35
CITY OF 1.00
Sympto-thermal Method (STM) Chart DISTRICT 1 CITY HEALTH OFFICE - 1 35 35 Chart MOOE 35 35.00
ILAGAN 35
CITY OF 100.00
Thermometer DISTRICT 1 CITY HEALTH OFFICE - 1 35 35 Unit MOOE 35 3,500.00
ILAGAN 3,500
CITY OF 500.00
Progestin-only subdermal implant DISTRICT 1 CITY HEALTH OFFICE - 1 4870 4870 9740 Implant MOOE 300 150,000.00
ILAGAN 150,000
CITY OF 5,488.00
BTL Kits DISTRICT 1 CITY HEALTH OFFICE - 1 200 200 Kit MOOE 200 1,097,600.00
ILAGAN 1,097,600
CITY OF 2,000.00
IUD Insertion Kits DISTRICT 1 CITY HEALTH OFFICE - 1 9740 9740 Kit MOOE 300 600,000.00
ILAGAN 600,000
CITY OF 2,000.00
PPIUD Insertion Kits DISTRICT 1 CITY HEALTH OFFICE - 1 200 200 Kit MOOE 200 400,000.00
ILAGAN 400,000
CITY OF 2,000.00
NSV Kits DISTRICT 1 CITY HEALTH OFFICE - 1 200 200 Kit MOOE 200 400,000.00
ILAGAN 400,000
CITY OF 30.00
Lidocaine hydrochloride 2% in 10mL vials DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 9740 9740 Vial MOOE 300 9,000.00
9,000
CITY OF 50.00
Elastic bandage DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 9740 9740 Bandage MOOE 300 15,000.00
15,000
CITY OF 1.00
Adhesive Bandage (Band-aid) DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 9740 9740 Unit MOOE 300 300.00
300
CITY OF 40.00
Micropore Surgical Tape, 2.5 cm x 5 m (10 patients per roll) DISTRICT 1 CITY HEALTH OFFICE - 1 9740 9740 Roll MOOE 30 1,200.00
ILAGAN 1,200
CITY OF 10.00
Woven sterile gauze, 4 in x 4 in, 12 ply DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 9740 9740 Unit MOOE 50 500.00
500
CITY OF 20.00
Sterile gloves DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 9740 9740 Piece MOOE 1000 20,000.00
20,000
CITY OF 300.00
Clean gloves DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 9740 9740 Piece MOOE 10 3,000.00
3,000
CITY OF 50.00
Epinephrine 1mg/mL ampule DISTRICT 1
ILAGAN CITY HEALTH OFFICE - 1 9740 9740 Ampule MOOE 100 5,000.00
5,000
CITY OF 5.00
syringe 3mL with needle guage 22 DISTRICT 1 CITY HEALTH OFFICE - 1 9740 9740 Piece MOOE 6000 30,000.00
ILAGAN 30,000
CITY OF 40.00
Cotton balls DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 9740 9740 Pack MOOE 150 6,000.00
6,000
CITY OF 3.00
Family Planning Form 1 DISTRICT 1 CITY HEALTH OFFICE - 1 9740 9740 Form MOOE 8000 24,000.00
ILAGAN 24,000
total
- 4,984,308.80 - - - -
Oral Health Program

CITY OF 3,000.00
Fluoride varnish (9 mos old) DISTRICT 1 CITY HEALTH OFFICE - 1 400 400 dose/vial/tab etc MOOE 400 1,200,000.00
ILAGAN 1,200,000
CITY OF 3,000.00
Fluoride varnish (12-59 mos) DISTRICT 1 CITY HEALTH OFFICE - 1 600 600 dose/vial/tab etc MOOE 600 1,800,000.00
ILAGAN 1,800,000
Kiddie Toothbrush with cover and toothpaste with fluoride (6- CITY OF 15.00
DISTRICT 1 CITY HEALTH OFFICE - 1 945 945 dose/vial/tab etc MOOE 945 14,175.00
11 mos) ILAGAN 14,175.00
Kiddie Toothbrush with cover and toothpaste with fluoride CITY OF 15.00
DISTRICT 1 CITY HEALTH OFFICE - 1 7254 7254 dose/vial/tab etc MOOE 7254 108,810.00
(12-59 mos) ILAGAN 108,810.00
CITY OF 200.00
basic oral health instruments (0-11 mos) DISTRICT 1 CITY HEALTH OFFICE - 1 1200 1200 dose/vial/tab etc MOOE 1200 240,000.00
ILAGAN 240,000
CITY OF 200.00
basic oral health instruments (12-59 mos) DISTRICT 1 CITY HEALTH OFFICE - 1 7254 7254 dose/vial/tab etc MOOE 7254 1,450,800.00
ILAGAN 1,450,800
CITY OF 200.00
basic oral health instruments (pregnant women) DISTRICT 1 CITY HEALTH OFFICE - 1 2134 2134 dose/vial/tab etc MOOE 2134 426,800.00
ILAGAN 426,800
CITY OF 200.00
basic oral health instruments (5-9 yo) DISTRICT 1 CITY HEALTH OFFICE - 1 400 400 dose/vial/tab etc MOOE 400 80,000.00
ILAGAN 80,000
CITY OF 200.00
basic oral health instruments (10-19 yo) DISTRICT 1 CITY HEALTH OFFICE - 1 400 400 dose/vial/tab etc MOOE 400 80,000.00
ILAGAN 80,000
CITY OF 200.00
basic oral health instruments (senior citizens) DISTRICT 1 CITY HEALTH OFFICE - 1 2383 2383 dose/vial/tab etc MOOE 2383 476,600.00
ILAGAN 476,600
CITY OF 2,000.00
Glass Ionomer Sealant (0-71months old) DISTRICT 1 CITY HEALTH OFFICE - 1 900 900 dose/vial/tab etc MOOE 900 1,800,000.00
ILAGAN 1,800,000
CITY OF 100.00
Dental kits (0-71months old) DISTRICT 1 CITY HEALTH OFFICE - 1 900 900 dose/vial/tab etc MOOE 900 90,000.00
ILAGAN 90,000
total
- 7,644,200.00 - 122,985.00 - -
Newborn Screening Program
CITY OF 1,500.00
Expanded Newborn Screening Filter Cards DISTRICT 1 CITY HEALTH OFFICE - 1 266 267 267 267 1067 Filter Cards MOOE 1067 1,600,500.00
ILAGAN 1,600,500
CITY OF 2.96
Levothyroxine 25mg/tab DISTRICT 1 CITY HEALTH OFFICE - 1 Tablet MOOE
ILAGAN
CITY OF 13.00
Hydrocortisone 20mg/tab DISTRICT 1 CITY HEALTH OFFICE - 1 Tablet MOOE
ILAGAN
CITY OF 3.00
Sodium Chloride 1gm per tab DISTRICT 1 CITY HEALTH OFFICE - 1 Tablet MOOE
ILAGAN
CITY OF 900.00
Soya Based Milk Formula 800g DISTRICT 1 CITY HEALTH OFFICE - 1 Unit MOOE
ILAGAN
CITY OF 462.00
Lipids 10% 100 ml DISTRICT 1 CITY HEALTH OFFICE - 1 Unit MOOE
ILAGAN
total
- 1,600,500.00 - - - -
Nutrition Program CITY OF
DISTRICT 1 CITY HEALTH OFFICE - 1
ILAGAN
Vitamin A

CITY OF 1.13
100,000 IU (capsule) Infants 6-11 months (GP) DISTRICT 1 CITY HEALTH OFFICE - 1 266 267 267 267 1067 Capsule MOOE 1067 1,205.71
ILAGAN 1,206
CITY OF 1.13
200,000 IU (capsule) children 12-59 months (GP) DISTRICT 1 CITY HEALTH OFFICE - 1 2133 2134 2134 2134 8535 Capsule MOOE 8535 9,644.55
ILAGAN 9,645
CITY OF 1.13
100,000 IU (capsule) *High Risk Infants 6-11 months DISTRICT 1 CITY HEALTH OFFICE - 1 266 267 267 267 1067 Capsule MOOE 1067 1,205.71
ILAGAN 1,206

Page 4 of 34
 Strategic Pillar: Resource Requirements (PhP) Fund Source (PhP)
HEALTH SERVICE DELIVERY Municipality/ Target (7) (8)
PPA Performance
District Component Name of Health Facility (6)
Program/Project/ Indicator DOH LGU
(3) City/Barangay (5) Total Cost
Activities (PPA) (2) (4) Items Description Expense Category Unit Cost Quantity Others
(Unit Cost x Quantity)
(1) Q1 Q2 Q3 Q4 Total Target CO CHD PLGU C/MLGU BLGU
CITY OF 1.13
200,000 IU (capsule) *High Risk Chidlren 12-59 months DISTRICT 1 CITY HEALTH OFFICE - 1 2133 2134 2134 2134 8535 Capsule MOOE 8535 9,644.55
ILAGAN 9,645
Albendazole (deworming tabs)

CITY OF 1.03
Albendazole 400mg chewable tab - Infants 6-11 months (GP) DISTRICT 1 CITY HEALTH OFFICE - 1 2125 2125 2125 2125 8500 Tablet MOOE 8500 8,755.00
ILAGAN 8,755
Albendazole 400 mg chewable tab - children 12-59 months CITY OF 1.03
DISTRICT 1 CITY HEALTH OFFICE - 1 2125 2125 2125 2125 8500 Tablet MOOE 8500 8,755.00
(GP) ILAGAN
Iron Supplements
39,210.52
CITY OF 18.54
**Drops El 15mg/0.6 ml - LBW infants DISTRICT 1 CITY HEALTH OFFICE - 1 535 533 533 533 2134 Bottle MOOE 25608 474,772.32
ILAGAN 474,772
CITY OF 18.54
**Drops El 15mg/0.6 ml - Infants 6-11 months (anemic) DISTRICT 1 CITY HEALTH OFFICE - 1 Bottle MOOE
ILAGAN
CITY OF 19.84
**Drops El 15mg/0.6 ml - Infants 6-11 months (non anemic) DISTRICT 1 CITY HEALTH OFFICE - 1 300 300 300 45 945 Bottle MOOE 11340 224,985.60
ILAGAN 224,986
CITY OF 21.60
**syrup EI 30mg/5ml - Children 12-23 months (anemic) DISTRICT 1 CITY HEALTH OFFICE - 1 Bottle MOOE
ILAGAN
CITY OF 21.60
**syrup EI 30mg/5ml - Children 12-23 months (non anemic) DISTRICT 1 CITY HEALTH OFFICE - 1 1750 1750 1750 1750 7000 Bottle MOOE 84000 1,814,400.00
ILAGAN 1,814,400
CITY OF 21.60
**syrup EI 30mg/5ml - Children 24-59 months (anemic) DISTRICT 1 CITY HEALTH OFFICE - 1 Bottle MOOE
ILAGAN
CITY OF 21.60
**syrup EI 30mg/5ml - Children 5-9 year old anemic DISTRICT 1 CITY HEALTH OFFICE - 1 Bottle MOOE
ILAGAN
CITY OF 21.60
**syrup EI 30mg/5ml - Children 5-9 year old with malaria DISTRICT 1 CITY HEALTH OFFICE - 1 Bottle MOOE
ILAGAN
**syrup EI 30mg/5ml - Children 5-9 year old with CITY OF 21.60
DISTRICT 1 CITY HEALTH OFFICE - 1 Bottle MOOE
schistosomiases ILAGAN
CITY OF 1.22
**Micronutirient powders - Infants 6-11 months DISTRICT 1 CITY HEALTH OFFICE - 1 300 300 300 45 945 MNP pack MOOE 11340 13,834.80
ILAGAN 13,835
CITY OF 1.22
**Micronutirient powders - Children 12-23 months DISTRICT 1 CITY HEALTH OFFICE - 1 1750 1750 1750 1750 7000 MNP pack MOOE 84000 102,480.00
ILAGAN 102,480
Zinc Supplements

Zinc Drops 27.5 mg/ml ( equiv. to 10 mg elemental Zinc) 15 CITY OF 39.14

DISTRICT 1 CITY HEALTH OFFICE - 1 300 300 300 45 945 Bottle MOOE 11340 443,847.60
ml bottle drops - Infants below 6 months ILAGAN 443,848
Zinc Syrup, 55 mg/ml ( equiv. to 20 mg elemental Zinc) 60 CITY OF 42.23
DISTRICT 1 CITY HEALTH OFFICE - 1 1750 1750 1750 1750 7000 Bottle MOOE 84000 3,547,320.00
ml syrup - Children 6-59 months ILAGAN 1,773,660 1,773,660.00
ORS

CITY OF 5.00
ORS 20.5g sachet - Infants below 6 months DISTRICT 1 CITY HEALTH OFFICE - 1 1500 1500 1000 0 4000 Sachet MOOE 4000 20,000.00
ILAGAN 10,000 10,000.00
CITY OF 5.00
ORS 20.5g sachet - Children 6-59 months DISTRICT 1 CITY HEALTH OFFICE - 1 2500 2500 3000 0 8000 Sachet MOOE 8000 40,000.00
ILAGAN 20,000 20,000.00
total
- 4,908,435.84 - 1,803,660.00 - -
National Immunization Program

BCG Vaccine 147.70

CITY OF
BCG Vaccine 500 mcg/mL vial + 1 mL diluent in ampul x 20 DISTRICT 1 CITY HEALTH OFFICE - 1 535 533 533 533 2134 dose/vial/tab etc MOOE 150 22,155.00
ILAGAN 22,155
dose
Hepatitis B Vaccine (recombinant DNA) CITY OF 1,751.00
DISTRICT 1 CITY HEALTH OFFICE - 1 535 533 533 533 2134 dose/vial/tab etc MOOE 250 437,750.00
10 mL vial, 10 doses ILAGAN 437,750
CITY OF 164.80
Oral Polio Vaccine (20 doses per vial) DISTRICT 1 CITY HEALTH OFFICE - 1 535 533 533 533 2134 dose/vial/tab etc MOOE 345 56,856.00
ILAGAN 56,856
CITY OF 1,050.59
Inactivated Polio Vaccine, 10 doses per vial DISTRICT 1 CITY HEALTH OFFICE - 1 535 533 533 533 2134 dose/vial/tab etc MOOE 250 262,647.50
ILAGAN 262,648
CITY OF 101.66
Pentavalent vaccine DISTRICT 1 CITY HEALTH OFFICE - 1 535 533 533 533 2134 dose/vial/tab etc MOOE 8500 864,110.00
ILAGAN 864,110
CITY OF 824.00
Pneumococcal conjugate vaccine (PCV 13) DISTRICT 1 CITY HEALTH OFFICE - 1 535 533 533 533 2134 dose/vial/tab etc MOOE 8500 7,004,000.00
ILAGAN 7,004,000
CITY OF 335.00
Rota Virus vaccine DISTRICT 1 CITY HEALTH OFFICE - 1 535 533 533 533 2134 dose/vial/tab etc MOOE 2300 770,500.00
ILAGAN 770,500
CITY OF 250.00
Measles-Mumps-Rubella vaccine DISTRICT 1 CITY HEALTH OFFICE - 1 535 533 533 533 2134 dose/vial/tab etc MOOE 1200 300,000.00
ILAGAN 300,000
Measles-Rubella vaccine for School-based Immunization CITY OF 250.00
DISTRICT 1 CITY HEALTH OFFICE - 1 dose/vial/tab etc MOOE 400 100,000.00
Program ILAGAN 100,000
Tetanus-Diphtheria Vaccine for School-based Immunization CITY OF 146.80
DISTRICT 1 CITY HEALTH OFFICE - 1 535 533 533 533 2134 dose/vial/tab etc MOOE 400 58,720.00
Program ILAGAN 58,720
CITY OF 146.80
Tetanus-Diphtheria Vaccine for pregnant women DISTRICT 1 CITY HEALTH OFFICE - 1 535 533 533 533 2134 dose/vial/tab etc MOOE 2547 373,899.60
ILAGAN 373,900
CITY OF 695.25
Quadrivalent Human Papilloma Virus Vaccine DISTRICT 1 CITY HEALTH OFFICE - 1 535 533 533 533 2134 dose/vial/tab etc MOOE 2134 1,483,663.50
ILAGAN 1,483,664
Influenza Polyvalent vaccine, 10 doses per vial CITY OF 1,751.00
DISTRICT 1 CITY HEALTH OFFICE - 1 535 533 533 533 2134 dose/vial/tab etc MOOE 1000 1,751,000.00
ILAGAN 1,751,000
Pneumococcal Polyvalent vaccine CITY OF 352.26
DISTRICT 1 CITY HEALTH OFFICE - 1 535 533 533 533 2134 dose/vial/tab etc MOOE 1000 352,260.00
25 mcg/0.5 mL, 5 doses per vial ILAGAN 352,260
CITY OF 2.60
Autodisable syringe 0.5mL DISTRICT 1 CITY HEALTH OFFICE - 1 250 250 250 250 1000 Unit MOOE 1000 2,600.00
ILAGAN 2,600
CITY OF 1.50
Tuberculin Syringe for BCG DISTRICT 1 CITY HEALTH OFFICE - 1 250 250 250 250 1000 Unit MOOE 1000 1,500.00
ILAGAN 1,500
CITY OF 2.60
Autodisable syringe 0.5mL for senior citizens DISTRICT 1 CITY HEALTH OFFICE - 1 250 250 250 250 1000 Unit MOOE 1000 2,600.00
ILAGAN 2,600
CITY OF 2.60
Autodisable syringe 0.5mL for SBIP DISTRICT 1 CITY HEALTH OFFICE - 1 250 250 250 250 1000 Unit MOOE 1000 2,600.00
ILAGAN 2,600
CITY OF 2.60
Autodisable syringe 0.5mL for HPV DISTRICT 1 CITY HEALTH OFFICE - 1 250 250 250 250 1000 Unit MOOE 1000 2,600.00
ILAGAN 2,600
CITY OF 2.00
Syringe 5cc for reconstitution with G23 needle DISTRICT 1 CITY HEALTH OFFICE - 1 250 250 250 250 1000 Unit MOOE 1000 2,000.00
ILAGAN 2,000
CITY OF 5.00
Vaccination Cards DISTRICT 1 CITY HEALTH OFFICE - 1 250 250 250 250 1000 Cards MOOE 1000 5,000.00
ILAGAN 5,000
CITY OF 5.00
Vaccination Cards for School-based Immunization DISTRICT 1 CITY HEALTH OFFICE - 1 250 250 250 250 1000 Cards MOOE 1000 5,000.00
ILAGAN 5,000
CITY OF 5.00
Vaccination Cards for Senior Citizens DISTRICT 1 CITY HEALTH OFFICE - 1 250 250 250 250 1000 Cards MOOE 1000 5,000.00
ILAGAN 5,000
CITY OF 5.00
Vaccination Cards for HPV DISTRICT 1 CITY HEALTH OFFICE - 1 250 250 250 250 1000 Cards MOOE 1000 5,000.00
ILAGAN 5,000
CITY OF 25.00
Immunization Schedule Posters DISTRICT 1 CITY HEALTH OFFICE - 1 250 250 250 250 1000 Poster MOOE 1000 25,000.00
ILAGAN 25,000
CITY OF 41.92
Epinephrine 1mg/mL ampule for AEFI DISTRICT 1 CITY HEALTH OFFICE - 1 250 250 250 250 1000 Ampule MOOE 1000 41,920.00
ILAGAN 41,920
CITY OF 51.40
Alcohol, Ethyl 70%, 500mL bottle DISTRICT 1 CITY HEALTH OFFICE - 1 250 250 250 250 1000 Bottle MOOE 1000 51,400.00
ILAGAN 51,400
CITY OF 200.00
Cotton Rolls, 400g/ pack DISTRICT 1 CITY HEALTH OFFICE - 1 250 250 250 250 1000 Roll MOOE 1000 200,000.00
ILAGAN 200,000
CITY OF 2,000.00
TCl logbook per Brgy DISTRICT 1 CITY HEALTH OFFICE - 1 35 0 0 0 35 logbook MOOE 35 70,000.00
ILAGAN 70,000
CITY OF 2,000.00
Vaccine Carier DISTRICT 1 CITY HEALTH OFFICE - 1 35 0 0 0 35 Unit MOOE 35 70,000.00
ILAGAN 70,000
total - 14,329,781.60 - - - -

Sub-total FAMILY HEALTH COMMODITIES

Err:522 65652 60777 42681 377260 39,269.46 5,899,619.00 53,887,160.14 - 32,610,526.24 - 12,749,008.32 - -

C. ANTI-RABIES VACCINES
CITY OF
1. Equine Rabies Immunoglobulin 200IU/ml, 5ml/vial DISTRICT 1 CITY HEALTH OFFICE - 1 200 200 100 0 500 Vial ampule 1,550.00 500 775000
ILAGAN 775,000
2. Lyophilized powder 2.5IU/dose + diluent (1ml or CITY OF
DISTRICT 1 CITY HEALTH OFFICE - 1 MOOE
0.5ml(IM, ID)) ILAGAN
CITY OF
2.a. Purified Verocell Rabies Vaccine (PVRV) 0.5ml/vial DISTRICT 1 CITY HEALTH OFFICE - 1 200 200 200 0 600 Vial MOOE 1,300.00 600 780000
ILAGAN 780,000
CITY OF
2.b. Purified Chick Embryo Cell Vaccine (PCECV) 1ml/vial DISTRICT 1 CITY HEALTH OFFICE - 1 200 200 200 0 600 Vial MOOE 1,500.00 600 900000
ILAGAN 900,000
CITY OF
Tetamus toxiod DISTRICT 1 CITY HEALTH OFFICE - 1 200 200 100 0 500 ampule MOOE 50.00 500 25000
ILAGAN 25,000
CITY OF
ATS DISTRICT 1 CITY HEALTH OFFICE - 1 100 100 0 0 200 ampule MOOE 50.00 200 10000
ILAGAN 10,000
CITY OF
Insulin syringe DISTRICT 1 CITY HEALTH OFFICE - 1 piece MOOE 5.00 2000 10000
ILAGAN 10,000
CITY OF
Syringe 3ml G23 DISTRICT 1 CITY HEALTH OFFICE - 1 piece MOOE 5.00 500 2500
ILAGAN 2,500

Page 5 of 34
 Strategic Pillar: Resource Requirements (PhP) Fund Source (PhP)
HEALTH SERVICE DELIVERY Municipality/ Target (7) (8)
PPA Performance
District Component Name of Health Facility (6)
Program/Project/ Indicator DOH LGU
(3) City/Barangay (5) Total Cost
Activities (PPA) (2) (4) Items Description Expense Category Unit Cost Quantity Others
(Unit Cost x Quantity)
(1) Q1 Q2 Q3 Q4 Total Target CO CHD PLGU C/MLGU BLGU
CITY OF
cotton Rolls 400g DISTRICT 1 CITY HEALTH OFFICE - 1 piece MOOE 200.00 2 400
ILAGAN 400
CITY OF
alcohol, Ethyl 70% 500ml DISTRICT 1 CITY HEALTH OFFICE - 1 piece MOOE 51.40 12 616.8
ILAGAN 617
CITY OF
sterile Guaze 4x4 DISTRICT 1 CITY HEALTH OFFICE - 1 piece MOOE 10.00 200 2000
ILAGAN 2,000
CITY OF
sterile gloves DISTRICT 1 CITY HEALTH OFFICE - 1 piece MOOE 20.00 200 4000
ILAGAN 4,000
CITY OF
cloxacillin 250mg/5ml DISTRICT 1 CITY HEALTH OFFICE - 1 botltle MOOE 13.20 144 1900.8
ILAGAN 1,901
CITY OF
claxacillin 500mg/cap DISTRICT 1 CITY HEALTH OFFICE - 1 capsule MOOE 2.78 1000 2780
ILAGAN 2,780
CITY OF
mefenamic acid 500mg/cap DISTRICT 1 CITY HEALTH OFFICE - 1 capsule MOOE 1.28 1000 1280
ILAGAN 1,280
CITY OF
paracetamol 250mg/5ml DISTRICT 1 CITY HEALTH OFFICE - 1 bottle MOOE 18.93 144 2725.92
ILAGAN 2,726
Sub-total ANTI-RABIES VACCINES 900.00 900.00 600.00 - 2,400.00 4,777.59 7,602.00 2,518,203.52 2,518,203.52 - - - -

D. MEDICINE ACCESS PROGRAM

CITY OF
Amlodipine 5mg, 30’s DISTRICT 1 CITY HEALTH OFFICE - 1 100 100 100 50 350 Treatment Pack MOOE 5.45 4200 22,890
ILAGAN 22,890
CITY OF
Amlodipine 10mg, 30’s DISTRICT 1 CITY HEALTH OFFICE - 1 550 550 550 550 2200 Treatment Pack MOOE 5.77 26400 152,328
ILAGAN 152,328
CITY OF
Losartan, 50mg, 30’s DISTRICT 1 CITY HEALTH OFFICE - 1 725 725 725 725 2900 Treatment Pack MOOE 14.49 34800 504,252
ILAGAN 504,252
CITY OF
Metropolol 50mg DISTRICT 1 CITY HEALTH OFFICE - 1 275 275 275 275 1100 Treatment Pack MOOE 25.93 13200 342,276
ILAGAN 342,276
CITY OF
Metformin 500mg, 90’s DISTRICT 1 CITY HEALTH OFFICE - 1 225 225 225 225 900 Treatment Pack MOOE 25.93 10800 280,044
ILAGAN 280,044
CITY OF
Gliclazide 30 mg tablet 30s DISTRICT 1 CITY HEALTH OFFICE - 1 50 50 50 50 200 Treatment Pack MOOE 29.62 2400 71,088
ILAGAN 71,088
CITY OF
Simvastatin 40mg tablet 30s DISTRICT 1 CITY HEALTH OFFICE - 1 75 75 75 75 300 Treatment Pack MOOE 36.67 3600 132,012
ILAGAN 132,012
Sub-total MEDICINE ACCESS PROGRAM 2,000.00 2,000.00 2,000.00 1,950.00 7,950.00 - - 143.86 95,400.00 1,504,890.00 - 1,504,890.00 - - - -

E. INFECTIOUS DISEASE CONTROL PROGRAM

National Dengue Prevention and Control Program

CITY OF
DISTRICT 1 CITY HEALTH OFFICE - 1 100 100 100 100 400 MOOE 65 400 26000
Dengue NS1 RDT, 25 test/box ILAGAN Test Kit 26000
CITY OF
DISTRICT 1 CITY HEALTH OFFICE - 1 144 144 4500 144 648000 324,000 324,000
"Rapture 10EC" insectivide 1L 12unit/box ILAGAN Unit per liter
Sub total NATIONAL DENGUE CONTROL
PROGRAM 244.00 100.00 100.00 100.00 544.00 - - 4,565.00 544.00 674,000.00 - 350,000.00 - 324,000.00 - -
Leprosy
CITY OF
PB Adult DISTRICT 1 CITY HEALTH OFFICE - 1 2 0 0 0 2 Blister Pack MOOE 29.04 24 696.96
ILAGAN 697
CITY OF
PB Child DISTRICT 1 CITY HEALTH OFFICE - 1 1 0 0 0 1 Blister Pack MOOE 29.04 12 348.48
ILAGAN 348
CITY OF
MB Adult DISTRICT 1 CITY HEALTH OFFICE - 1 2 0 0 0 2 Blister MOOE 73.5 24 1764
ILAGAN 1,764
CITY OF
Bethamethasone Valerate, 1 mg/g (0.1% w/w) 5g tube cream DISTRICT 1 CITY HEALTH OFFICE - 1 7815 7816 0 0 15631 Tubes MOOE 31.2 100 3120
ILAGAN 3,120
CITY OF
Itraconazole 100mg DISTRICT 1 CITY HEALTH OFFICE - 1 7815 7816 0 0 15631 Cap MOOE 14.5 1000 14500
ILAGAN 14,500

Sub-total INFECTIOUS DISEASE CONTROL PROGRAM

15,635.00 15,632.00 - - 31,267.00 - - 177.28 1,160.00 20,429.44 - 20,429.44 - - - -

LABORATORY
CITY OF
HIV/AIDS TESTING KIT DISTRICT 1 CITY HEALTH OFFICE - 1 200 380 200 76,000.00
ILAGAN TESTING KIT MOOE 76,000
CITY OF
Swelab combo pack for CBC DISTRICT 1 CITY HEALTH OFFICE - 1 1 1 8 swelap combo 240882 8 1,927,056.00
ILAGAN pack MOOE 1,927,056.00
Urine Srtrips for urinalysis CITY OF
DISTRICT 1 CITY HEALTH OFFICE - 1 6 6 6 0 18 1800 18 32,400.00
ILAGAN urine strips MOOE 32,400.00
CITY OF
Reagens for Blood chemistry DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 2 2 2500 2 5,000.00
lugol's iodine MOOE 5,000.00
CITY OF
AFB stain DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 2 2 6600 2 13,200.00
AFB stain MOOE 13,200.00
CITY OF
gene xpert cartridge 50/box DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 18 18 18 18 72 918.23 72 66,112.56
cartridge MOOE 66,112.56
CITY OF
syringe 5ml G23 DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 4 4 7 4 28.00
piece MOOE 28.00
CITY OF
cotton roll 400mg DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 2 2 200 2 400.00
piece MOOE 400.00
CITY OF
alcohol 100ml 70% DISTRICT 1 CITY HEALTH OFFICE - 1 5 5 70 5 350.00
ILAGAN piece MOOE 350.00
CITY OF
tourniquet DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 5 5 50 5 250.00
piece MOOE 250.00
CITY OF
microprore 1inch DISTRICT 1 CITY HEALTH OFFICE - 1 2 2 80 2 160.00
ILAGAN piece MOOE 160.00
CITY OF
EDTA tube DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 5 5 1650 5 8,250.00
100/set MOOE 8,250.00
CITY OF
plain tube DISTRICT 1 CITY HEALTH OFFICE - 1 5 5 1800 5 9,000.00
ILAGAN 100/set MOOE 9,000.00
CITY OF
microtainer DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 5 5 1800 5 9,000.00
100/set MOOE 9,000.00
CITY OF
lancet DISTRICT 1
ILAGAN CITY HEALTH OFFICE - 1 5 5 800 5 4,000.00
100/box MOOE 4,000.00
CITY OF
glass slides DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 50 50 298 50 14,900.00
72/box MOOE 14,900.00
CITY OF
applicator sticks DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 5 5 600 5 3,000.00
1000/box MOOE 3,000.00
CITY OF
cover slips DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 50 50 300 50 15,000.00
100/box MOOE 15,000.00
CITY OF
yellow tips DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 5 5 1140 5 5,700.00
100/pack MOOE 5,700.00
CITY OF
blue tips DISTRICT 1
ILAGAN
CITY HEALTH OFFICE - 1 5 5 1140 5 5,700.00
100/pack MOOE 5,700.00
CITY OF
NSS sol'n DISTRICT 1 CITY HEALTH OFFICE - 1 3 3 300 3 900.00
ILAGAN piece MOOE 900.00
CITY OF
wbc diluting fluid DISTRICT 1 CITY HEALTH OFFICE - 1 3 3 780 3 2,340.00
ILAGAN bottle MOOE 2,340.00
CITY OF
HEMA QUICK DISTRICT 1 CITY HEALTH OFFICE - 1 3 3 6600 3 19,800.00
ILAGAN 4/box MOOE 19,800.00
CITY OF
n/10 Hcl DISTRICT 1 CITY HEALTH OFFICE - 1 2 2 950 2 1,900.00
ILAGAN bottle MOOE 1,900.00
CITY OF
tripple distilled water DISTRICT 1 CITY HEALTH OFFICE - 1 2 2 300 2 600.00
ILAGAN bottle MOOE 600.00
SUB TOTAL LABORATORIES 195.00 25.00 24.00 18.00 468.00 - - 271,945.23 468.00 2,221,046.56 - 76,000.00 - 2,145,046.56 - -
C. OTHER TECHNICAL ASSISTANCE (TRAINING,
CAPACITY BUILDING, ETC)
SERVICE DELIVERY
DOH-Funded (CHD) Activities - Service Delivery
Meals,
Training on life saving skills 12 midwives trained DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE - 1 4 4 4 0 12 Accommodation, MOOE 6000 12 72,000.00 42,000.00 30,000.00
venue, kit, TEV

Integrated BEMONC-EINC-LMT-NBS-Postpartum FP Meals,

Integrated Training for Midwives 5 midwives trained DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE - 1 1 2 1 1 5 MOOE 26,000 5 130,000.00 78,000.00 52,000.00
Accommodation,
venue, kit, TEV

Page 6 of 34
 Strategic Pillar: Resource Requirements (PhP) Fund Source (PhP)
HEALTH SERVICE DELIVERY Municipality/ Target (7) (8)
PPA Performance
District Component Name of Health Facility (6)
Program/Project/ Indicator DOH LGU
(3) City/Barangay (5) Total Cost
Activities (PPA) (2) (4) Items Description Expense Category Unit Cost Quantity Others
(Unit Cost x Quantity)
(1) Q1 Q2 Q3 Q4 Total Target CO CHD PLGU C/MLGU BLGU

Integrated BEMONC-EINC-LMT-NBS-Postpartum FP Meals,

Integrated Training for Physician and Nurses 3 nurses trained DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE - 1 1 1 1 0 3 MOOE 26000 3 78,000.00
Accommodation,
venue, kit, TEV 78,000

Integrated FPCBT 1-USAPAN-FPCBT 2 Trainings 5 midwives trained DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE - 1 1 2 1 1 5 Meals, MOOE 7,000 5 35,000.00
Accommodation,
Meals,
venue, kit, TEV
Accommodation, 21,000 14000
training on Cold Chain management 13 midwives trained DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE - 1 3 5 5 0 13 venue, kit, TEV MOOE 2000 13 26,000.00 26,000
Meals,
Integrated IMCI-PIMAM Training 35 midwives DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE - 1 10 11 11 11 44 Accommodation, MOOE 6000 44 264,000.00
9 nurses trained venue, kit, TEV

Training on the Use of the Adolescent Job Aid, Health Meals,

Young Ones and ADEPT DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE - 1 1 1 1 0 3 MOOE 6000 3 18,000.00
Accommodation,
3 nurses trained venue, kit, TEV 18000

Integrated Infectious Diseases Consultation Workshop DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE - 1 2 2 0 0 4 Meals, MOOE 6000 4 24,000.00
1 CHO Accommodation,
3 Nurses venue, kit, TEV 24,000

Training on Nutrition on Disaster DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE - 1 0 3 3 0 6 Meals, MOOE 10000 6 60,000.00
Accommodation,
6 employees trained venue, kit, TEV 60,000

Training on Healthy lifestyle DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE - 1 5 5 0 0 10 Meals, MOOE 14940 10 149,400.00
Accommodation,
10 midwives trained venue, kit, TEV 149,400

Training on Tobacco Cessation DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE - 1 2 0 0 0 2 Meals, MOOE 14940 2 29,880.00
Accommodation,
2 nurses trained venue, kit, TEV 29,880

Training on HIV/AIDS DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE - 1 0 5 0 0 5 Meals, MOOE 16000 5 80,000.00
Accommodation,
5 midwives trained venue, kit, TEV 80,000

Training on HIV proficiency DISTRICT 1 CITY OF ILAGAN CITY HEALTH OFFICE - 1 1 0 0 0 1 Meals, MOOE 5000 1 5,000.00
1 medical technologist Accommodation,
proficient venue, kit, TEV 5,000
SUB TOTAL TRAININGS 31.00 41.00 27.00 13.00 113.00 - - 145,880.00 113.00 971,280.00 - 593,280.00 96,000.00 - - 18,000.00

GRAND TOTAL - SERVICE DELIVERY

Err:522 84,350.00 63,528.00 44,762.00 420,002.00 - - 466,758.42 6,004,906.00 62,264,804.16 10,350,934.20 46,033,123.70 96,000.00 16,848,104.88 - 18,000.00
NOTE: Please use separate sheet for each Strategic Pillar.
(1) Strategic Pillar: Service Delivery, Governance, Regulation, Financing
▪ Projects/Programs/Activities (PPA) - Identified priority strategies/interventions that address health needs and health inequities
▪ Goal – desired outcome for each major PPA
(2) PPA Performance Indicator - Measurable value/performance measurement to evaluate the success of a particular strategy/intervention (such as projects, programs, products and other initiatives)
(3) District - the legislative district where the P/P/A will be applied/conducted. In a province, this excludes the legislative districts covered by the HUC/ICC where they will also be reflected in the latter’s respective plans
(4) Municipality/Component City/Barangay - specific area where the P/P/A will be applied/conducted; indicate if area covers GIDA/IP/Urban poor and other vulnerable population
(5) Name of Health Facility - the exact name of the facility where the PPA will be applied/conducted
(6) Target - Should correspond with PPA Performance Indicator (eg. number, %, rate) for the Quarter indicated
(7) Resource Requirement – Inputs needed for the PPA to be achieved/conducted
§ Items Description - e.g. meals, accommodation, TEV, venue, kit, etc
§ Expense Category: PS, MOOE, CO-Infrastructure/Equipment
§ Unit Cost: Cost to produce/conduct the P/P/A
§ Quantity: Number of the P/P/A to be produced/conducted
§ Total Cost: Unit Cost multiplied by the Quantity of P/P/A to be produced/conducted
(8) Fund Source – which/what office will be able to fund the investment:
§ DOH – Central Office or Centers for Health Development;
§ LGU – Government funds from Local Government Units: PLGU (province), CLGU (city), MLGU (municipality); BLGU (Barangays)
§ Others - Other Fund Sources: from Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs; private and other sectors; and unfunded PPAs

Page 7 of 34
Please accomplish AOP Form 2 for 2020, AOP Form 2 for 2021, and AOP Form 2 for 2022
For EACH YEAR, please accomplish AOP Form 2 for EACH Strategic Pillar (Service Delivery, Governance, Regulation, F
AOP Form 2. COST ASSUMPTIONS BY PILLAR, PPAS, QUARTER AND FUND SOURCE

Region: II - ISABELA
LGU CITY OF ILAGAN - CITY HEALTH OFFICE - 1
AOP CY: 2021
Municipal
Strategic Pillar: PPA ity/
HEALTH FINANCING Name of Target
Performa Compone (6)
District Health
Program/Project/ nce nt
Indicator (3) Facility
Activities (PPA) City/Bara
(5)
(1) (2) ngay Q1 Q2
(4)
CITY
enrolled DISTRICT CITY OF
Mandatory enrolment to PHIC HEALTH 250 250
to PHIC 1 ILAGAN
OFFICE - 1

TOTAL HEALTH FINANCING

vernance, Regulation, Financing)
D FUND SOURCE (AOP MOTHER PLAN)

Resource Requirements (PhP)

Target (7)
(6)
Total Cost
Expense
Total Items Description Unit Cost Quantity (Unit Cost x
Q3 Q4 Category
Target Quantity)

PHIC enrolment
250 250 1000 MOOE 2400 1000 2400000
fee

2,400,000.00
 Date: ______________

Fund Source (PhP)

(8)
DOH LGU
Others
CO CHD PLGU C/MLGU BLGU

2400000

- - - 2,400,000.00 - -
Please accomplish AOP Form 2 for 2020, AOP Form 2 for 2021, and AOP Form 2 for 2022
For EACH YEAR, please accomplish AOP Form 2 for EACH Strategic Pillar (Service Delivery, Governance, Regulation, F
AOP Form 2. COST ASSUMPTIONS BY PILLAR, PPAS, QUARTER AND FUND SOURCE

Region: II - ISABELA
LGU CITY OF ILAGAN - CITY HEALTH OFFICE - 1
AOP CY: 2021

Strategic Pillar: Municipal

HEALTH REGULATION ity/ Targ
PPA Performance Name of (6)
Compone
District Health
Program/Project/ Indicator nt
(3) Facility
Activities (PPA) (2) City/Bara
(5)
ngay Q1
(1)
(4)

Formulation of ordinance regarding

the prohibision and punishment of Ordinace CITY
CITY OF
members formulated and DISTRICT 1 HEALTH 1
ILAGAN
of the community performing abortion established OFFICE - 1
( Pls . transfer to SD template )

CITY OF CITY
Conduct regular monitoring of different DISTRICT 1 HEALTH 10
ILAGAN
health programs to barangays -( pls . regular OFFICE -1
Transfer to Governance ) monitoring done

CITY OF CITY
Conduct annual Program PIR conducted DISTRICT 1 ILAGAN HEALTH 0
Implementation review of all health OFFICE -1
programs ( pls . Transfer to Governance )
Renewal of LTO: ( pls . Transfer to SD
Form 2 new AOP LHS )

CITY
CITY OF
DISTRICT 1 HEALTH
ILAGAN
OFFICE - 1
birthing center 1

CITY
CITY OF HEALTH
DISTRICT 1
ILAGAN OFFICE - 1
laboratory 1
PHIC accreditation:( pls . Transfer to SD
new form LHS )

CITY OF CITY
DISTRICT 1 HEALTH
ILAGAN
OFFICE - 1
MCP 1
 CITY
DISTRICT 1 CITY OF HEALTH
ILAGAN
OFFICE - 1
PCB 1

CITY
CITY OF
DISTRICT 1 HEALTH
ILAGAN
OFFICE - 1
ABTC 1

CITY
CITY OF
DISTRICT 1 HEALTH
ILAGAN
OFFICE - 1
TB-DOTS 1
TOTAL REGULATION
y, Governance, Regulation, Financing)
AND FUND SOURCE (AOP MOTHER PLAN)

Resource Requirements (PhP)

Target (7)
(6)
Items
Expense
Total Descriptio Unit Cost Quantity
Q2 Q3 Q4 Category
Target n

MEALS
0 0 0 1 AND FOOD 750 50 PARTICIPANTS
SNACKS

10 10 5 35 monitorin printing 50 35
g tool

meals and
1 0 0 1 snacks food 700 40

RENEWAL
MOOE 2000 1
FEE
0 0 0 1

RENEWAL
MOOE 20000 1
FEE
0 0 0 1

ACCREDIT
ATION MOOE 2000 1
FEE
0 0 0 1
 ACCREDIT
ATION MOOE 2000 1
FEE
0 0 0 1

ACCREDIT
ATION MOOE 2000 1
FEE
0 0 0 1

ACCREDIT
ATION MOOE 2000 1
FEE
0 0 0 1
31,500 81
 Date: ______________

(PhP) Fund Source (PhP)

(8)
DOH LGU
Total Cost
(Unit Cost x Others
Quantity) CO CHD PLGU C/MLGU BLGU

37,500.00 37,500.00

1,750.00 1,750.00

28,000.00 28,000.00

2,000.00

2000

20,000.00

20000

2,000.00

2000
 2,000.00

2000

2,000.00

2000

2,000.00

2000
97,250.00 - - - 97,250.00 - -
Please accomplish AOP Form 2 for 2020, AOP Form 2 for 2021, and AOP Form 2 for 2022
For EACH YEAR, please accomplish AOP Form 2 for EACH Strategic Pillar (Service Delivery, Governance, Regulation, F
AOP Form 2. COST ASSUMPTIONS BY PILLAR, PPAS, QUARTER AND FUND SOURCE

Region: II - ISABELA
LGU CITY OF ILAGAN - CITY HEALTH OFFICE - 1
AOP CY: 2021

Strategic Pillar:
HEALTH GOVERNANCE Targe
PPA Municipality/ Name of (6)
Performance District Component Health
Program/Project/ Indicator (3) City/Barangay Facility
Activities (PPA) (2) (4) (5)
Q1
(1)

( pls . Transfer to SD Health Promotion

Campaigns New form LHS )

CITY
DISTRICT
Buntis 1 CITY OF ILAGAN HEALTH 0
Conduct annual Buntis Congress Congress OFFICE -1
Celebration conducted

AHDP session CITY

Conduct of parenting education and DISTRICT
conducted to CITY OF ILAGAN HEALTH 10
adolescent sesssion on AHDP 1
35 brgys OFFICE -1

school
CITY
Conduct IEC Facility Hopping activity for all hopping DISTRICT
conducted to CITY OF ILAGAN HEALTH 11
programs 1
8 schools OFFICE -1
around the
city and 35
barangay

( pls . Transfer to MPVT template Form 2

New form LHS )

CITY
equipments DISTRICT
Procurement of Laboratory equipments CITY OF ILAGAN HEALTH 1
procured 1
OFFICE -1
1

CITY
DISTRICT
CITY OF ILAGAN HEALTH
1
materials OFFICE -1
Procurement of latrines/ toilet bowl procured 486
 CITY
DISTRICT CITY OF ILAGAN HEALTH
tech 1
materials OFFICE -1
procurement of Tech materials procured 1
#NAME?
y, Governance, Regulation, Financing)
AND FUND SOURCE (AOP MOTHER PLAN)

Resource Requirements (PhP)

Target (7)
(6)

Items Expense
Total Unit Cost Quantity
Q2 Q3 Q4 Description Category
Target

meals and
1 0 0 1 snacks food 60,000 1

food and
10 10 5 35 meals and 1,000 630
materials
training
materials

TEV travel 12,000 10

11 11 10 43 freebies expense 800 100
flyers materials 40 200

computer capital
1 with printer outlay 40000 1
refrigerator capital
1 6cu.ft outlay 20000 1

485 971 toilet bowl materials 1000 971

 tech
1 laptop materials 50000 1
 Date: ______________

ements (PhP) Fund Source (PhP)

(8)
DOH LGU
Total Cost
(Unit Cost x Quantity) CO CHD PLGU C/MLGU BLGU

60,000.00 60,000.00

630,000.00 630,000.00

120000 120000
80000 80000
8000 8000

40000 40000

20000 20000

971000 485500 485500

 50000 50000
1,891,840.00 1,406,340.00 485,500.00 -
______________

Others
-
Please accomplish AOP Form 3 for 2020, AOP Form 3 for 2021, and AOP Form 3 for 2022
AOP Form 3. SUMMARY OF LGU INVESTMENT NEEDS

Region: II - ISABELA
LGU CITY OF ILAGAN - CITY HEALTH OFFICE - 1
AOP Year: 2021

Cost per Fund Source (PhP)

Categories of Investment Needs (2)
(1) DOH
LGU Others Total
Central Office CHD

1. HEALTH FACILITY DEVELOPMENT (From AOP Form 3.1)

· LGU HOSPITAL
· RURAL HEALTH UNIT/CHO 1,617,000.00 1,617,000.00
· BARANGAY HEALTH STATION - 6,275,000.00 - - 6,275,000.00
Sub-Total HEALTH FACILITY DEVELOPMENT - 7,892,000.00 - - 7,892,000.00

2. HUMAN RESOURCES FOR HEALTH (From AOP Form 3.2)

DOH-DEPLOYED
1. Physician (DTTB) 1,115,659.20 1,115,659.20
3. Nurse II 4,726,650.00 - - 4,726,650.00
4. Midwife II 3,260,100.00 - - 3,260,100.00
5. Medical Technologist II 945,330.00 - - 945,330.00
8. Project Assistant II 303,195.00 - - 303,195.00
LGU PERSONNEL
3. Rural Health Midiwife 1,630,050.00 1,630,050.00
Sub-Total HUMAN RESOURCES FOR HEALTH 10,350,934.20 - 1,630,050.00 - 11,980,984.20

3. COMMODITIES (From AOP Form 3.3)

A. NATIONAL TUBERCULOSIS PROGRAM 467,794.50 467,794.50
B. FAMILY HEALTH COMMODITIES 46,008,802.12 6,012,562.10
Adolescent Health and Development and WRA
Micronutrient Supplementation 160,031.08 160,031.08 320,062.16
mental health program 8,388,000.00 8,388,000.00
Safe Motherhood Program 3,993,544.80 3,925,886.02 7,919,430.82
Family Planning Program 4,984,308.80 4,984,308.80
Oral Health Program 7,644,200.00 122,985.00 7,767,185.00
Newborn Screening Program 1,600,500.00 1,600,500.00
Nutrition Program 4,908,435.84 1,803,660.00 6,712,095.84
National Immunization Program 14,329,781.60 14,329,781.60
C. ANTI-RABIES VACCINES 2,518,203.52 2,518,203.52
D. MEDICINE ACCESS PROGRAM 1,504,890.00 1,504,890.00

E. INFECTIOUS DISEASE CONTROL PROGRAM

20,429.44 20,429.44

F. Laboratories
76,000.00 2,145,046.56 2,221,046.56
F. OTHER HEALTH COMMODITIES TO BE
PROCURED BY LGU
Sub-Total COMMODITIES 96,604,921.70 14,170,170.76 110,775,092.46

4. OTHER TECHNICAL ASSISTANCE (From

AOP Form 3.4)
A. GOVERNANCE 1,285,500.00 485,500.00 1,771,000.00
B. FINANCING 2,400,000.00 2,400,000.00
C. SERVICE DELIVERY 905,280.00 96,000.00 18,000.00 1,019,280.00
D. REGULATION 97,250.00 97,250.00
Sub-Total OTHER TECHNICAL ASSISTANCE 2,190,780.00 3,078,750.00 18,000.00 5,287,530.00

GRAND TOTAL 10,350,934.20 106,687,701.70 18,878,970.76 18,000.00 83,914,242.44

(1) Investment needs include funding requirements of Local Government Units in the following categories:
§ Health Facility Developmentand Water/Sanitation Facilities – LGU investment needs for facilities of health and water/sanitation; values to be culled out from AOP Form 3.1
§ Human Resource for Health - investment needs for the different HRH cadre; values to be culled out from AOP Form 3.2
§ Commodities - investment needs for specific commodities; values to be culled out from AOP Form 3.3
§ Other Technical Assistance - investment needs on capacity-building, advocacy and health promotion, workshops, consultations, monitoring and evaluation, creating and implementing systems and
tools; values to be culled out from AOP Form 3.4
(2) Fund Source – which/what office will be able to fund the investment
§ DOH - from DOH Central Office, Centers for Health Development
§ LGU - Government funds from the Local Government Units: Consolidated from PLGU (province), CLGU (city), MLGU (municipality); BLGU (Barangays)
§ Others - Other Fund Sources: from Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs whether local or national; private and other
sectors; and unfunded PPAs
Please accomplish AOP Form 3.1 for 2020, AOP Form 3.1 for 2021, and AOP Form 3.1 for 2022
Please ensure that the LGU is compliant to the requirements of HFEP Infra/Equipment if the LGU will avail of the HFEP Funds.
For Provincial level, please attach the Health Facility Development Plan to the LIPH 2020-2022 Document.
AOP Form 3.1. LGU INVESTMENT NEEDS FOR HEALTH FACILITY DEVELOPMENT AND WATER/SANITATION FACILITIES

Region: II - ISABELA
LGU CITY OF ILAGAN - CITY HEALTH OFFICE - 1
AOP Year: 2021

Facility Investment Needs (PhP) Cost per Fund Source (PhP)

Municipality/ (6) (7)
Project
District Component City/ Category Name of Facility
Description
(1) Barangay (3) (4) DOH
(5)
(2) Infrastructure Medical Equipment Motor Vehicle Total Cost/ Facility LGU Others
Central Office CHD
NEW
DISTRICT 1 CITY OF ILAGAN RHU TB CENTER ✓ 2,500,000.00 2,500,000.00
CONTRUCTION
BHS MALALAM RENOVATION ✓ 1,000,000.00 1,000,000.00
GUINATAN RENOVATION ✓ 1,000,000.00 1,000,000.00
STA BARBRA RENOVATION ✓ 1,000,000.00 1,000,000.00
MANGCURAM RENOVATION ✓ 1,000,000.00 1,000,000.00
CARIKKIKAN SUR RENOVATION ✓ 1,000,000.00 1,000,000.00
CARIKKIKAN
RENOVATION ✓ 1,000,000.00 1,000,000.00
NORTE
STA ISABEL SUR UPGRADING ✓ 100,000.00 100,000.00
RHU DOPPLER PROVISION ✓ 10,000.00 10,000.00

MICROSCOPE PROVISION ✓ 74,000.00 74,000.00

colilert device PROVISION ✓ 500,000.00 500,000.00

cholorimeter PROVISION ✓ 5,000.00 5,000.00

spray can 12
PROVISION ✓ 28,000.00 28,000.00
Liters capacity
BHS DOPPLER PROVISION ✓ 175,000.00 175,000.00
GRAND TOTAL - 9,392,000.00 - -

(1) District – the legislative district where the facilities are located. In a province, this excludes the legislative districts covered by the HUC/ICC where they will also be reflected in the latter’s respective plans.
(2) Municipality/ Component City/Barangay - specific area where the facilities are located; indicate if area covers GIDA/IP/Urban poor and other vulnerable population
(3) Category – type of facility: Hospital, Rural Health Unit (RHU) and Barangay Health Station (BHS)
(4) Facility – the exact name of the facility
(5) Project Description – EQUIPPING AND INFRA: Completion, New Construction, Expansion, Repair/Renovation
(6) Facility Investment Needs – the specific investment needed for the facility
§ Infrastructure – Completion, New Construction, Expansion, Repair/Renovation
§ Medical Equipment –specific equipment needed for the facility (please attach the Equipment Inventory of the Facility)
§ Motor Vehicle – ambulance, patient transport
§ Total Cost per Facility – total investment for the facility after summation of all required resources
(7) Fund Source – which/what office will be able to fund the investment
§ DOH - from DOH Central Office, Centers for Health Development
§ LGU - Government funds from the Local Government Units: Consolidated from PLGU (province), CLGU (city), MLGU (municipality); BLGU (Barangays)
§ Others - Other Fund Sources: from Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs whether local or national; private and other sectors; and unfunded PPAs
Please accomplish AOP Form 3.2 for 2020, AOP Form 3.2 for 2021, and AOP Form 3.2 for 2022
Please attach Certificate of Plantilla Positions for the RHU/CHO signed by the LGU HRMO
AOP Form 3. 2. LGU INVESTMENT NEEDS FOR HUMAN RESOURCE FOR HEALTH

Region: II - ISABELA
LGU CITY OF ILAGAN - CITY HEALTH OFFICE - 1
AOP Year: 2021

Cost per Fund Source (PhP)

Salaries and (8)
Municipality/ Name of Health
District HRH/Cadre Number Salary Grade Benefits for 12
Component Facility DOH
(1) (4) (5) (6) Months (PhP)
City (2) (3) LGU Others Total
(7) Central Office CHD
DOH-DEPLOYED

CITY OF CITY HEALTH

1 Physician (DTTB) 1 24 1,115,659.20 1,115,659.20
ILAGAN OFFICE - 1

CITY OF CITY HEALTH

1 10 15 472,665 4,726,650.00
ILAGAN OFFICE - 1
Nurse II

CITY OF CITY HEALTH

1 4Midwife II 10 11 326,010 3,260,100.00
ILAGAN OFFICE - 1

CITY OF CITY HEALTH

1 Medical Technologist II 2 15 472,665 945,330.00
ILAGAN OFFICE - 1

CITY OF CITY HEALTH

1 Project Assistant II 1 10 303,195 303,195.00
ILAGAN OFFICE - 1

LGU

CITY OF CITY HEALTH

1 Midwives 5 11 326,010 1,630,050.00
ILAGAN OFFICE - 1

Sub Total DOH-DEPLOYED HRH 11,980,984.20

GRAND TOTAL 11,980,984.20

(1) District – the legislative district where the health facility is located. In a province, this excludes the legislative districts covered by the HUC/ICC where they will also be reflected
in the latter’s respective plans.
(2) Municipality/Component City/Barangay - specific area where the health facility is located; indicate if area covers GIDA/IP/Urban poor and other vulnerable population
(3) Health Facility – the exact name of the facility where the HRH will be deployed
(4) HRH/Cadre - the specific HRH needed/requested
a. Physician (specify) f. Pharmacist k. Other HR Needs
b. Nurse g. Nutritionist-Dietician
c. Midwife h. Public Health Associate
d. Medical Technologist i. Pharmacy Assistants
e. Dentist j. Project Assistants (specify)
(5) Number – quantity or number of HRH needed
(6) Salary Grade - predetermined compensation level for a given position or cadre
(7) Salaries and Benefits – actual monetary compensation of the HR to include allowances and other remunerations
(8) Fund Source – which/what office will be able to fund the investment
§ DOH - from DOH Central Office, Centers for Health Development
§ LGU - Government funds from the Local Government Units: Consolidated from PLGU (province), CLGU (city), MLGU (municipality); BLGU (Barangays)

§ Others - Other Fund Sources: from Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs whether local or national; private and other sectors; and unfunded PPAs
Please accomplish AOP Form 3.3 for 2020, AOP Form 3.3 for 2021, and AOP Form 3.3 for 2022
AOP Form 3.3. LGU INVESTMENT NEEDS FOR COMMODITIES
Region: II - ISABELA
LGU CITY OF ILAGAN - CITY HEALTH OFFICE - 1
AOP Year: 2021

Target
Cost per Fund Source (PhP)
Population
Items / (10)
Name of (5)
Description Estimated Unit
Commodities District Municipality Health Quantity Total (PhP)
(6) Cost (PhP) DOH
(1) (2) (3) Facility (# of infants, SC, (7) (9)
adolescents, (Dosage, Units, (8)
(4) Form) LGU Others
pregnant, WRA
etc) Central Office CHD

B. FAMILY HEALTH COMMODITIES

Adolescent Health and Development and WRA
Micronutrient Supplementation

Ferrous salt + Folic Acid tablets (60mg elemental iron +

Tablet
400ug folic acid per tablet) (Women 10-49 years old)
9,617.00 500,084.00 0.74 370,062.16 160,031.08 160,031.08

TOTAL 370,062.16 160,031.08 160,031.08 - -

Mental Health Program

Carbamazepine 200mg/tablet 15.00 Tablet 5,400.00 45.00 243,000.00 243,000.00
Chlorpromazine 200mg/tablet 25.00 Tablet
9,000.00 45.00 405,000.00 405,000.00
Haloperidol 5mg/tablet 20.00 Tablet 7,200.00 50.00 360,000.00 360,000.00
Fluphenazine Decanoate 25mg/ml, 10ml 15.00 vial 5,400.00 1,000.00 5,400,000.00 5,400,000.00
Olanzapine 10mg/tablet 15.00 Tablet 5,400.00 40.00 216,000.00 216,000.00
Riperidone 1mg/tab 40.00 Tablet 14,400.00 40.00 576,000.00 576,000.00
Sertraline 50mg/tablet 30.00 Tablet 10,800.00 40.00 432,000.00 432,000.00
Fluoxetine 20mg/tablet 15.00 Tablet 5,400.00 50.00 270,000.00 270,000.00
Biperiden 2mg/tablet 30.00 Tablet 10,800.00 45.00 486,000.00 486,000.00
total 8,388,000.00 8,388,000.00 - - -
Safe Motherhood Program
Ferrous salt + Folic Acid tablets (60mg elemental iron + 6,636.00 2,388,960.00 0.74 1,767,830.40 883,915.20 883,915.20
Tablet
400ug folic acid per tablet)
Calcium Carbonate 500mg tab 6,636.00 Tablet 2,388,960.00 3.09 7,381,886.40 3,690,943.20 3,690,943.20
Iodized Oil Capsules, 500mg soft gel capsule 6,636.00 Capsule 6,636.00 41.20 273,403.20 136,701.60 136,701.60
Oxytocin 10 IU/mL, 1 mL Ampule 6,636.00 Ampule 6,636.00 9.89 65,630.04 65,630.04
Mebendazole 500mg/tab 6,636.00 Tablet 6,636.00 3.00 19,908.00 19,908.00
Magnesium Sulfate 250mg/mL, 20mL ampule Ampule 50.00 26.78 1,339.00 1,339.00
Dexamethasone 4mg/mL, 2mL vial (as sodium
Vial
phosphate) 50.00 30.99 1,549.50 1,549.50
Vitamin A 200,000 IU soft gel capsules Capsule 6,636.00 1.13 7,498.68 7,498.68
Ampicillin 1g Vial (as sodium salt) Vial 100.00 10.80 1,080.00 1,080.00
Methyldopa 250mg/tab Tablet 100.00 12.36 1,236.00 1,236.00
Mother & Baby Booklet 6,636.00 Booklet 6,636.00 25.00 165,900.00 165,900.00
total 9,687,261.22 4,877,460.00 4,809,801.22 - -
Family Planning Program
Combined Oral contraceptive pills 9,740.00 Pills 36,000.00 18.00 648,000.00 648,000.00
Progestine only contraceptive pills 9,740.00 Pills 2,000.00 90.00 180,000.00 180,000.00
Depot Medroxyprogesterone Acetate 9,740.00 dose/vial/tab etc 4,800.00 45.00 216,000.00 216,000.00
IUD 9,740.00 Unit 500.00 22.95 11,475.00 11,475.00
Cycle Beads 9,740.00 Unit 9,740.00 109.12 1,062,828.80 1,062,828.80
Condom (packs of 3s) 9,740.00 Pack 15,000.00 6.72 100,800.00 100,800.00
Basal Body Temperature (BBT) Chart Chart 1.00 - -
Cervical Mucus Method (CMM) Chart Chart 1.00 - -
Sympto-thermal Method (STM) Chart Chart 1.00 - -
Thermometer Unit 100.00 - -
Progestin-only subdermal implant 9,740.00 Implant 300.00 500.00 150,000.00 150,000.00
BTL Kits Kit 5,488.00 - -
IUD Insertion Kits 9,740.00 Kit 300.00 2,000.00 600,000.00 600,000.00
PPIUD Insertion Kits Kit 2,000.00 - -
NSV Kits Kit 2,000.00 - -
Lidocaine hydrochloride 2% in 10mL vials 9,740.00 Vial 300.00 30.00 9,000.00 9,000.00
Elastic bandage 9,740.00 Bandage 300.00 50.00 15,000.00 15,000.00
Adhesive Bandage (Band-aid) 9,740.00 Unit 300.00 1.00 300.00 300.00
Micropore Surgical Tape, 2.5 cm x 5 m (10 patients per 9,740.00 30.00 40.00 1,200.00 1,200.00
Roll
roll) 9,740.00 50.00 10.00 500.00 500.00
Woven sterile gauze, 4 in x 4 in, 12 ply Unit
Sterile gloves 9,740.00 Piece 1,000.00 20.00 20,000.00 20,000.00
Clean gloves 9,740.00 Piece 10.00 300.00 3,000.00 3,000.00
 Target
Cost per Fund Source (PhP)
Population
Items / (10)
Name of (5)
Description Estimated Unit
Commodities District Municipality Health Quantity Total (PhP)
(6) Cost (PhP) DOH
(1) (2) (3) Facility (# of infants, SC, (7) (9)
adolescents, (Dosage, Units, (8)
(4) Form) LGU Others
pregnant, WRA
etc) Central Office CHD

Epinephrine 1mg/mL ampule 9,740.00 Ampule 100.00 50.00 5,000.00 5,000.00

syringe 3mL with needle guage 22 9,740.00 Piece 6,000.00 5.00 30,000.00 30,000.00
Cotton balls 9,740.00 Pack 150.00 40.00 6,000.00 6,000.00
Family Planning Form 1 9,740.00 Form 8,000.00 3.00 24,000.00 24,000.00
total 3,083,103.80 3,083,103.80 - - -
Oral Health Program
Fluoride varnish (9 mos old) 400.00 dose/vial/tab etc 400.00 3,000.00 1,200,000.00 1,200,000.00
Fluoride varnish (12-59 mos) 600.00 dose/vial/tab etc 600.00 3,000.00 1,800,000.00 1,800,000.00
cotton buds (9 mos old) 400.00 dose/vial/tab etc 400.00 50.00 20,000.00 20,000.00
cotton buds (12-59 mos) 600.00 dose/vial/tab etc 600.00 50.00 30,000.00 30,000.00
Kiddie Toothbrush with cover and toothpaste with
dose/vial/tab etc
fluoride (6-11 mos) 945.00 945.00 15.00 14,175.00 14,175.00
Kiddie Toothbrush with cover and toothpaste with
dose/vial/tab etc
fluoride (12-59 mos) 7,254.00 7,254.00 15.00 108,810.00 108,810.00
basic oral health instruments (0-11 mos) 1,200.00 dose/vial/tab etc 1,200.00 200.00 240,000.00 240,000.00
basic oral health instruments (12-59 mos) 7,254.00 dose/vial/tab etc 7,254.00 200.00 1,450,800.00 1,450,800.00
basic oral health instruments (pregnant women) 2,134.00 dose/vial/tab etc 2,134.00 200.00 426,800.00 426,800.00
basic oral health instruments (5-9 yo) 400.00 dose/vial/tab etc 400.00 200.00 80,000.00 80,000.00
basic oral health instruments (10-19 yo) 400.00 dose/vial/tab etc 400.00 200.00 80,000.00 80,000.00
basic oral health instruments (senior citizens) 2,383.00 dose/vial/tab etc 2,383.00 200.00 476,600.00 476,600.00
Glass Ionomer Sealant (0-71months old) 900.00 dose/vial/tab etc 900.00 2,000.00 1,800,000.00 1,800,000.00
Dental kits (0-71months old) 900.00 dose/vial/tab etc 900.00 100.00 90,000.00 90,000.00
total 7,817,185.00 7,644,200.00 172,985.00 - -
Newborn Screening Program
Expanded Newborn Screening Filter Cards 1,067.00 Filter Cards 1,067.00 1,500.00 1,600,500.00 1,600,500.00
total 1,600,500.00 1,600,500.00 - - -
Nutrition Program
Vitamin A
100,000 IU (capsule) Infants 6-11 months (GP) 1,067.00 Capsule 2,500.00 1.13 2,825.00 2,825.00
200,000 IU (capsule) children 12-59 months (GP) 8,535.00 Capsule 18,000.00 1.13 20,340.00 20,340.00

100,000 IU (capsule) *High Risk Infants 6-11 months Capsule

2,500.00 1.13 2,825.00 2,825.00

200,000 IU (capsule) *High Risk Chidlren 12-59 months Capsule

15,000.00 1.13 16,950.00 16,950.00
Albendazole (deworming tabs)
Albendazole 400mg chewable tab - Infants 6-11 months
Tablet
(GP) 8,500.00 30,900.00 1.03 31,827.00 31,827.00
Albendazole 400 mg chewable tab - children 12-59
Tablet
months (GP) 1.03
Iron Supplements
**Drops El 15mg/0.6 ml - LBW infants 2,134.00 Bottle 25,608.00 18.54 474,772.32 474,772.32

**Drops El 15mg/0.6 ml - Infants 6-11 months (anemic) Bottle

18.54
**Drops El 15mg/0.6 ml - Infants 6-11 months (non
Bottle
anemic) 945.00 11,340.00 19.84 224,985.60 224,985.60

**syrup EI 30mg/5ml - Children 12-23 months (anemic) Bottle

21.60
**syrup EI 30mg/5ml - Children 12-23 months (non
Bottle
anemic) 7,000.00 84,000.00 21.60 1,814,400.00 1,814,400.00

**syrup EI 30mg/5ml - Children 24-59 months (anemic) Bottle

21.60
**syrup EI 30mg/5ml - Children 5-9 year old anemic Bottle 21.60
**syrup EI 30mg/5ml - Children 5-9 year old with
Bottle
malaria 21.60
**syrup EI 30mg/5ml - Children 5-9 year old with
Bottle
schistosomiases 21.60
**Micronutirient powders - Infants 6-11 months 945.00 MNP pack 11,340.00 1.22 13,834.80 13,834.80
**Micronutirient powders - Children 12-23 months 7,000.00 MNP pack 84,000.00 1.22 102,480.00 102,480.00
Zinc Supplements
Zinc Drops 27.5 mg/ml ( equiv. to 10 mg elemental Zinc)
Bottle
15 ml bottle drops - Infants below 6 months 945.00 11,340.00 39.14 443,847.60 443,847.60
Zinc Syrup, 55 mg/ml ( equiv. to 20 mg elemental Zinc)
Bottle
60 ml syrup - Children 6-59 months 7,000.00 84,000.00 42.23 3,547,320.00 1,773,660.00 1,773,660.00
ORS
 Target
Cost per Fund Source (PhP)
Population
Items / (10)
Name of (5)
Description Estimated Unit
Commodities District Municipality Health Quantity Total (PhP)
(6) Cost (PhP) DOH
(1) (2) (3) Facility (# of infants, SC, (7) (9)
adolescents, (Dosage, Units, (8)
(4) Form) LGU Others
pregnant, WRA
etc) Central Office CHD

ORS 20.5g sachet - Infants below 6 months 4,000.00 Sachet 4,000.00 5.00 20,000.00 10,000.00 10,000.00
ORS 20.5g sachet - Children 6-59 months 8,000.00 Sachet 8,000.00 5.00 40,000.00 20,000.00 20,000.00
total 6,756,407.32 4,952,747.32 1,803,660.00 - -
National Immunization Program
BCG Vaccine
BCG Vaccine 500 mcg/mL vial + 1 mL diluent in ampul dose/vial/tab etc
x 20 dose 2,134.00 150.00 147.70 22,155.00 22,155.00
Hepatitis B Vaccine (recombinant DNA)
dose/vial/tab etc
10 mL vial, 10 doses 2,134.00 250.00 1,751.00 437,750.00 437,750.00
Oral Polio Vaccine (20 doses per vial) 2,134.00 dose/vial/tab etc 345.00 164.80 56,856.00 56,856.00
Inactivated Polio Vaccine, 10 doses per vial 2,134.00 dose/vial/tab etc 250.00 1,050.59 262,647.50 262,647.50
Pentavalent vaccine 2,134.00 dose/vial/tab etc 8,500.00 101.66 864,110.00 864,110.00
Pneumococcal conjugate vaccine (PCV 13) 2,134.00 dose/vial/tab etc 8,500.00 824.00 7,004,000.00 7,004,000.00
Rota Virus vaccine 2,134.00 dose/vial/tab etc 2,300.00 335.00 770,500.00 770,500.00
Measles-Mumps-Rubella vaccine 2,134.00 dose/vial/tab etc 1,200.00 250.00 300,000.00 300,000.00
Measles-Rubella vaccine for School-based Immunization
dose/vial/tab etc
Program 400.00 250.00 100,000.00 100,000.00
Tetanus-Diphtheria Vaccine for School-based
dose/vial/tab etc
Immunization Program 2,134.00 400.00 146.80 58,720.00 58,720.00
Tetanus-Diphtheria Vaccine for pregnant women 2,134.00 dose/vial/tab etc 2,547.00 146.80 373,899.60 373,899.60
Quadrivalent Human Papilloma Virus Vaccine 2,134.00 dose/vial/tab etc 2,134.00 695.25 1,483,663.50 1,031,517,048.38
Influenza Polyvalent vaccine, 10 doses per vial
dose/vial/tab etc
2,134.00 1,000.00 1,751.00 1,751,000.00 1,751,000.00
Pneumococcal Polyvalent vaccine
dose/vial/tab etc
25 mcg/0.5 mL, 5 doses per vial 2,134.00 1,000.00 352.26 352,260.00 352,260.00
Autodisable syringe 0.5mL Unit 1,000.00 2.60 2,600.00 2,600.00
Tuberculin Syringe for BCG Unit 1,000.00 1.50 1,500.00 1,500.00
Autodisable syringe 0.5mL for senior citizens Unit 1,000.00 2.60 2,600.00 2,600.00
Autodisable syringe 0.5mL for SBIP Unit 1,000.00 2.60 2,600.00 2,600.00
Autodisable syringe 0.5mL for HPV Unit 1,000.00 2.60 2,600.00 2,600.00
Syringe 5cc for reconstitution with G23 needle Unit 1,000.00 2.00 2,000.00 2,000.00
Vaccination Cards Cards 1,000.00 5.00 5,000.00 5,000.00
Vaccination Cards for School-based Immunization Cards 1,000.00 5.00 5,000.00 5,000.00
Vaccination Cards for Senior Citizens Cards 1,000.00 5.00 5,000.00 5,000.00
Vaccination Cards for HPV Cards 1,000.00 5.00 5,000.00 5,000.00
Immunization Schedule Posters Poster 1,000.00 25.00 25,000.00 25,000.00
Epinephrine 1mg/mL ampule for AEFI Ampule 1,000.00 41.92 41,920.00 41,920.00
Alcohol, Ethyl 70%, 500mL bottle Bottle 1,000.00 51.40 51,400.00 51,400.00
Cotton Rolls, 400g/ pack Roll 1,000.00 200.00 200,000.00 200,000.00
TCl logbook per Brgy 35.00 logbook 35.00 2,000.00 70,000.00 70,000.00
Vaccine Carier 35.00 Unit 35.00 2,000.00 70,000.00 140,000,000.00
total 14,329,781.60 1,184,293,166.48 - - -
Sub-total FAMILY HEALTH COMMODITIES 14,329,781.60 1,184,293,166.48 - - -

C. ANTI-RABIES VACCINES
1. Equine Rabies Immunoglobulin 200IU/ml, 5ml/vial 500.00 Vial 500.00 1,550.00 775,000.00 775,000.00
2. Lyophilized powder 2.5IU/dose + diluent (1ml or
0.5ml(IM, ID))
2.a. Purified Verocell Rabies Vaccine (PVRV)
Vial
0.5ml/vial 600.00 600.00 1,300.00 780,000.00 780,000.00
2.b. Purified Chick Embryo Cell Vaccine (PCECV)
1ml/vial 600.00 Vial 600.00 1,500.00 900,000.00 900,000.00
Tetamus toxiod 500.00 ampule 500.00 50.00 25,000.00 25,000.00
ATS 200.00 ampule 200.00 50.00 10,000.00 10,000.00
Insulin syringe piece 2,000.00 5.00 10,000.00 10,000.00
Syringe 3ml G23 piece 500.00 5.00 2,500.00 2,500.00
cotton Rolls 400g piece 2.00 200.00 400.00 400.00
alcohol, Ethyl 70% 500ml piece 12.00 51.40 616.80 616.80
sterile Guaze 4x4 piece 200.00 10.00 2,000.00 2,000.00
sterile gloves piece 200.00 20.00 4,000.00 4,000.00
cloxacillin 250mg/5ml botltle 144.00 13.20 1,900.80 1,900.80
claxacillin 500mg/cap capsule 1,000.00 2.78 2,780.00 2,780.00
mefenamic acid 500mg/cap capsule 1,000.00 1.28 1,280.00 1,280.00
paracetamol 250mg/5ml bottle 144.00 18.93 2,725.92 2,725.92
 Target
Cost per Fund Source (PhP)
Population
Items / (10)
Name of (5)
Description Estimated Unit
Commodities District Municipality Health Quantity Total (PhP)
(6) Cost (PhP) DOH
(1) (2) (3) Facility (# of infants, SC, (7) (9)
adolescents, (Dosage, Units, (8)
(4) Form) LGU Others
pregnant, WRA
etc) Central Office CHD

Sub-total ANTI-RABIES VACCINES 2,518,203.52 2,518,203.52 - - -

D. MEDICINE ACCESS PROGRAM

Amlodipine 5mg, 30’s Treatment Pack
350.00 4,200.00 5.45 22,890.00 22,890.00

Amlodipine 10mg, 30’s Treatment Pack

2,200.00 26,400.00 5.77 152,328.00 152,328.00

Losartan, 50mg, 30’s Treatment Pack

2,900.00 34,800.00 14.49 504,252.00 504,252.00

Metropolol 50mg Treatment Pack

1,100.00 13,200.00 25.93 342,276.00 342,276.00

Metformin 500mg, 90’s Treatment Pack

900.00 10,800.00 25.93 280,044.00 280,044.00

Gliclazide 30 mg tablet 30s Treatment Pack

200.00 2,400.00 29.62 71,088.00 71,088.00

Simvastatin 40mg tablet 30s Treatment Pack

300.00 3,600.00 36.67 132,012.00 132,012.00
Sub-total MEDICINE ACCESS PROGRAM 1,504,890.00 1,504,890.00 - - -

E. INFECTIOUS DISEASE CONTROL PROGRAM

National Dengue Prevention and Control Program

Dengue NS1 RDT, 25 test/box 400.00 Test Kit 400.00 65.00 26,000.00 26,000.00
"Rapture 10EC" insectivide 1L 12unit/box 144.00 Unit per liter 144.00 4,500.00 648,000.00 324,000.00 324,000.00
Sub total NATIONAL DENGUE CONTROL
PROGRAM 544.00 - 544.00 4,565.00 674,000.00 350,000.00 324,000.00
Leprosy
PB Adult 2.00 Blister Pack 24.00 29.04 696.96 696.96
PB Child 1.00 Blister Pack 12.00 29.04 348.48 348.48
MB Adult 2.00 Blister 24.00 73.50 1,764.00 1,764.00
Bethamethasone Valerate, 1 mg/g (0.1% w/w) 5g tube
Tubes
cream 15,631.00 100.00 31.20 3,120.00 3,120.00
Itraconazole 100mg 15,631.00 Cap 1,000.00 14.50 14,500.00 14,500.00
Sub-total INFECTIOUS DISEASE CONTROL
1,368,429.44 720,429.44 648,000.00 - -
PROGRAM
LABORATORY
HIV/AIDS TESTING KIT 200.00 TESTING KIT 200.00 380.00 76,000.00 76,000.00
Swelab combo pack for CBC swelap combo
8.00 pack 8.00 240,882.00 1,927,056.00 1,927,056.00
Urine Srtrips for urinalysis 18.00 urine strips 18.00 1,800.00 32,400.00 32,400.00
Reagens for Blood chemistry 2.00 lugol's iodine 2.00 2,500.00 5,000.00 5,000.00
AFB stain 2.00 AFB stain 2.00 6,600.00 13,200.00 13,200.00
gene xpert cartridge 50/box 72.00 cartridge 72.00 918.23 66,112.56 66,112.56
syringe 5ml G23 4.00 piece 4.00 7.00 28.00 28.00
cotton roll 400mg 2.00 piece 2.00 200.00 400.00 400.00
alcohol 100ml 70% 5.00 5.00 70.00 350.00 350.00
piece
tourniquet 5.00 piece 5.00 50.00 250.00 250.00
microprore 1inch 2.00 piece 2.00 80.00 160.00 160.00
EDTA tube 5.00 100/set 5.00 1,650.00 8,250.00 8,250.00
plain tube 5.00 100/set 5.00 1,800.00 9,000.00 9,000.00
microtainer 5.00 100/set 5.00 1,800.00 9,000.00 9,000.00
lancet 5.00 100/box 5.00 800.00 4,000.00 4,000.00
glass slides 50.00 72/box 50.00 298.00 14,900.00 14,900.00
applicator sticks 5.00 1000/box 5.00 600.00 3,000.00 3,000.00
cover slips 50.00 100/box 50.00 300.00 15,000.00 15,000.00
yellow tips 5.00 100/pack 5.00 1,140.00 5,700.00 5,700.00
blue tips 5.00 100/pack 5.00 1,140.00 5,700.00 5,700.00
NSS sol'n 3.00 piece 3.00 300.00 900.00 900.00
wbc diluting fluid 3.00 bottle 3.00 780.00 2,340.00 2,340.00
HEMA QUICK
3.00 4/box 3.00 6,600.00 19,800.00 19,800.00
n/10 Hcl 2.00 bottle 2.00 950.00 1,900.00 1,900.00
tripple distilled water 2.00 bottle 2.00 300.00 600.00 600.00
SUB TOTAL LABORATORIES 2,221,046.56 76,000.00 2,145,046.56 - -
 Target
Cost per Fund Source (PhP)
Population
Items / (10)
Name of (5)
Description Estimated Unit
Commodities District Municipality Health Quantity Total (PhP)
(6) Cost (PhP) DOH
(1) (2) (3) Facility (# of infants, SC, (7) (9)
adolescents, (Dosage, Units, (8)
(4) Form) LGU Others
pregnant, WRA
etc) Central Office CHD

GRAND TOTAL 21,942,351.12 1,189,112,689.44 2,793,046.56 - -

Please accomplish AOP Form 3.4 for 2020, AOP Form 3.4 for 2021, and AOP Form 3.4 for 2022

AOP Form 3.4. LGU INVESTMENT NEEDS FOR OTHER TECHNICAL ASSISTANCE

Region: II - ISABELA
LGU CITY OF ILAGAN - CITY HEALTH OFFICE - 1
AOP Year: 2021

Cost per Fund Source (PhP)

Municipality/ (3)
Activities Component DOH
(1) City/Barangay
LGU Others Total
(2) Central Office CHD

A. GOVERNANCE
DOH-Funded (CHD) Activities - Governance
Conduct annual Buntis Congress Celebration CITY OF ILAGAN 60000 60000

Conduct of parenting education and adolescent sesssion on AHDP CITY OF ILAGAN 630000 630000

120000
Conduct IEC Facility Hopping activity for all programs CITY OF ILAGAN 80000 0
8000
CITY OF ILAGAN 40000 40000
Procurement of Laboratory equipments
CITY OF ILAGAN 20000 20000

Procurement of latrines/ toilet bowl CITY OF ILAGAN 485500 485500 971000

procurement of Tech materials CITY OF ILAGAN 50000 50000

Sub-total GOVERNANCE 1,285,500 485,500 - 1,771,000

B. FINANCING
DOH-Funded (CHD) Activities - Financing
Mandatory enrolment to PHIC CITY OF ILAGAN 2,400,000.00 2400000

LGU-Funded Activities - Financing - BASED ON SITUATIONAL

AND GAP ANALYSIS
1
2
…. Add more rows if necessary…
Sub-total FINANCING - - - 2,400,000 - 2,400,000

C. SERVICE DELIVERY
DOH-Funded (CHD) Activities - Service Delivery
Training on life saving skills CITY OF ILAGAN 42000 30000 72,000

Integrated BEMONC-EINC-LMT-NBS-Postpartum FP Integrated

CITY OF ILAGAN 78000 52000 130,000
Training for Midwives
3. Integrated BEMONC-EINC-LMT-NBS-Postpartum FP Integrated
CITY OF ILAGAN 78000 78,000
Training for Physician and Nurses
4. Integrated FPCBT 1-USAPAN-FPCBT 2 Trainings CITY OF ILAGAN 21000 14000 35,000
training on Cold Chain management CITY OF ILAGAN 338000 338,000
6. Integrated IMCI-PIMAM Training CITY OF ILAGAN -

7. Training on the Use of the Adolescent Job Aid, Health Young Ones CITY OF ILAGAN -
and ADEPT
8. Integrated Infectious Diseases Consultation Workshop CITY OF ILAGAN 24000 24,000
Training on Nutrition on Disaster CITY OF ILAGAN 60000 60,000
Training on Healthy lifestyle CITY OF ILAGAN 149400 149,400

training on Tobacco Cessation CITY OF ILAGAN 29880 29,880

training on HIV/AIDS CITY OF ILAGAN 80000 80,000

Training on HIV proficiency CITY OF ILAGAN 5000 5,000

Sub-total SERVICE DELIVERY 905,280 96,000 - 1,001,280

D. REGULATION
DOH-Funded (CHD) Activities - Regulation
Formulation of ordinance regarding
the prohibision and punishment of members CITY OF ILAGAN 37,500.00 37500
of the community performing abortion

Conduct regular monitoring of different health programs to barangays CITY OF ILAGAN 1,750.00 1750

Conduct annual Program Implementation review of all health programs CITY OF ILAGAN 28,000.00 28000

Renewal of LTO: 0

birthing center CITY OF ILAGAN 2,000.00 2000

laboratory CITY OF ILAGAN 20,000.00 20000

PHIC accreditation: 0

MCP CITY OF ILAGAN 2,000.00 2000

CITY OF ILAGAN 2000

PCB 2,000.00
ABTC CITY OF ILAGAN 2,000.00 2000

TB-DOTS CITY OF ILAGAN 2,000.00 0 2000

Sub-total REGULATION 97,250.00 97250

GRAND TOTAL - 2,190,780 3,078,750 - 5,269,530

(1) Activities - These include the capacity-building, advocacy and health
a. Governance
promotion, workshops, -consultations,
strengthen leadership
monitoringand management
and evaluation, capacities,
creating and
coordination,
implementing andand
systems support
tools.mechanisms necessary
It is categorized to ensure
according to thefunctional,
4 Pillars of
the F1people-centered
Plus. and participatory health systems
§ GIDA, LIPH/AOP development & M&E, implementation of LGU Scorecard