NYM Monthly Reporting Summary

1.0 Care & Treatment & ARV Management

Facility Name: _____________________ Month_____________ MFL Code________________ S. County____________________ County________________

< 1 yr 1- 4. 5 -9. 10 - 14 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 -54 55-59 60-64 65 + Grand Key Population Grand
Indicator
M F M F M F M F M F M F M F M F M F M F M F M F M F M F M Total FSW MSM PWID TG Total
Starting ART
Disagregated by Breastfeeding,Preg,TB clients,/FSW/MSM/People in prison& closed settings/PWID and TG to form a subset of Starting ART)
Pregnant
1.1 Starting on ART
Breastfeeding

TB Clients

<200 Cps/ml
CD4'DONE( from No. >200 cps/ml
starting ART)
Not Done CD4

TX _CURR

1.2 Total Current on

Defaulters (0-28 days)
ART TX _CURR (Excluding M.A)
Current on ART(MCH)
Note: Starting on ART and Current on ART numbers MUST always be reconciled with care and treatment section in MOH 731
< 1 yr 1- 4. 5 -9. 10 - 14 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 -54 55-59 60-64 65 + Grand Key Population Grand
Indicator
M F M F M F M F M F M F M F M F M F M F M F M F M F M F M Total FSW MSM PWID TG Total
MMD 1 Months

MMD 2 Months

1.4 Actual number of MMD 3 Month

months ARV drug
dispensed- MOH 367 A MMD 4 Months

MMD 5 Month

MMD 6 Months

< 1 yr 1- 4. 5 -9. 10 - 14 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 -54 55-59 60-64 65 + Grand Key Population Grand

Indicator
M F M F M F M F M F M F M F M F M F M F M F M F M F M F M Total FSW MSM PWID TG Total
1.2 Total Current on Currently on ART TX _CURR
ART
Eligible for Viral Load

1.5 TX_PVLS Viral Load done with results (D)

SUPPRESSED Viral Load (N)
<50 copies/LDL
1.5.1 TX_PVLS Results
50- 199 copies/ml
Disaggregation of Viral
loads done with 200-999 copies/ml
results)
>1000 Copies
 Inflows (Net gain)
< 1 yr 1- 4. 5 -9. 10 - 14 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 -54 55-59 60-64 65 + Grand Key Population Grand
Indicator M F M F M F M F M F M F M F M F M F M F M F M F M F M F M FSW MSM PWID TG
Total Total
TX_CURR (Previous Month/Quarter)
New on ART (Current Month)
Transfer In (TI)
Interuption in Treatment for <3months

1.6 TX_RTT(Returned Interuption inTreatment for 3-5months

to Treatment)
Interuption in Treatment for 6+months

<200 Cps/ml

CD4'DONE( from RTT) >200 cps/ml

Not Eligible for CD4

Patients added due to data Error

Pediatrics graduating to adulthood
Outflows (Net Loss)
IIT >28 days for clients on ART for < 3 months
IIT >28 days for clients on ART for 3-5 months
IIT >28 days for clients on ART for 6+ months
1.7 TX_ML( Mortality
and Loss) Transfer Out (TO)
Refused (Stopped) Treatment
Patients subtracted due to data error
Transition To adulthood this month/Quarter

Deceased
Disaggregations of Cause of Death (Quarterly Net Gain Analysis)
< 1 yr 1- 4. 5 -9. 10 - 14 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 -54 55-59 60-64 65 + Grand Key Population Grand
Indicator
M F M F M F M F M F M F M F M F M F M F M F M F M F M F M Total FSW MSM PWID TG Total
COD- TB
COD- Cancer
1.8 Cause of Death COD-OtherInfectious&ParasiticDisease
COD- Other Diseases
COD- Other Natural Causes
COD- Non Natural Causes
COD- Unknown Causes
Total Gains
Total Losses
Accounting for Expected TX_Current
Patients
Reported TX_Current
Unaccounted for Patients
 LPV/r DTG 10 mg
TLD TLE NVP Other(1st line) Other (2nd line) Other(3rd Line)
LPV/r
Other Adults
1.9 ARV Consumption Reports 40/10 and
30 180 400 400_90 600/TEE 100/25mg 90 COUNT NVP NVP Other Other Other Other Other
90 count (pediatrics) Other (Adult)
count count _30count count count TABS (pediatrics (Adult) (Pediatri (Adult) (Pediatri (Adult) (Pediatri (Pediatric) paediatrics
bottles bottles
bottl bottles bottles bottles bottles (pediatrics ) bottles c, (not bottles c) bottles c) bottles will
accommodate
SC_ARVDISP (# of adult and pediatric ARV bottles [units] dispensed any other
regimens not
listed accros
SC_CURR (# of adult and pediatric ARV bottles [units] remaining at the facility

1.10 MONTHLY PMTCT VL TRACKING TOOL (Females Only)

Agegroups 10-14.15-19.2 24 25-29 30-3435-39 40-44 45-49 50+ Total

TX_Curr _MCH
Pregnant

Breastfeeding

Overall MCH (Preg + Breastfeeding)

Eligible for Viral Load in the last 6 months

Pregnant

Breastfeeding
VL disaggregates

Viral Load
Known positive
Collected
and results New positive
Pregnant available
Virally Known positive
Suppressed
(VL<1000) New positive

Viral Load
Known positive
Collected
and results New positive
Breastfeeding available
Virally Known positive
Suppressed
(VL<1000) New positive

Note: Known positive or New positive is based on the status at ANC1 for the current follow up

Comments:
Reported by: ………………………………… Tel:…………………………………………………. Designation:…………...………………………….