For submission to the next administrative level

Section A. Child Care

Indicators

(Col. 1)

Eligible
Population

(Col. 2)

Male

(Col. 3)

Female

(Col. 44)

Total

(Col. 5)

Rate

(Col. 6)

Interpretation

(Col. 7)

Recommendations
or Actions to be Taken

(Col. 8)
A1. Nutritional Status Assessment of Children 0-59 mos. old
1.) Children 0-59 months old seen during the reporting period at health facilities
2.) 0-59 months old with Normal Nutritional Status
3.) 0-59 months old with Overweight/Obese Nutritional Status
4.) 0-59 months old with Stunted Nutritional Status
5.) Wasted-MAM Nutritional Status
5b.) Wasted-SAM Nutritional Status

Section B. Infectious Diseases

Indicators

(Col. 1)

Eligible
Population

(Col. 2)

Male

(Col. 3)

Female

(Col. 44)

Total

(Col. 5)

Rate

(Col. 6)

Interpretation

(Col. 7)

Recommendations
or Actions to be Taken

(Col. 8)
B1. Filariasis Prevention and Control
1.) Children 0-59 months old seen during the reporting period at health facilities
2.) No. of individuals examined found positive for lymphatic filariasis
3.) No. of lymphatic filariasis cases examined with manifestations

Section C. Demographic Data

Indicators

(Col. 1)

LGU-hired

(Col. 2)

DOH-hired

(Col. 3)

Total

(Col. 4)

Ratio to Population

(Col. 5)

Interpretation

(Col. 6)

Recommendations
or Actions to be Taken

(Col. 7)
1.) Number of Barangays
2.) Number of Health Centers - Total
2a.) Main Health Centers
2b.) City Health Centers
2c.) Rural Health Units
3.) Number of Barangay Health Stations
4.) Number of Health Workers - Total
4a.) Physicians/Doctors
4b.) Dentists
4c.) Nurses
4d.) Midwives
4e.) Medical Technologists
4f.) Nutritionists/Dietitians
4g.) Sanitary Engineers
4h.) Sanitary Inspectors
4i.) Active BHWs