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RCA FORM Monitoring

This document contains an RCA monitoring form used to record immunization data in Barangay Pangil, Amadeo, Cavite. It collects information such as the number of eligible children aged 6-59 months, number vaccinated for MCV and OPV, reasons for non-vaccination, and source of information on measles campaigns. The form is used to monitor immunization coverage and identify areas for improvement by analyzing reasons for non-vaccination and vaccine availability.

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278 views

RCA FORM Monitoring

This document contains an RCA monitoring form used to record immunization data in Barangay Pangil, Amadeo, Cavite. It collects information such as the number of eligible children aged 6-59 months, number vaccinated for MCV and OPV, reasons for non-vaccination, and source of information on measles campaigns. The form is used to monitor immunization coverage and identify areas for improvement by analyzing reasons for non-vaccination and vaccine availability.

Uploaded by

elyss
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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RCA FORM; RCA MONITORING

REGION IV A DATE & TIME OF RCA:


PROVINCE : CAVITE ELIG.POP, forMCV (6-59MOS OLD)
MUNICIPALITY: AMADEO TOTAL No. CHILDREN VACCINATED DURING THE DAY
BARANGAY: PANGIL For MCV______________
SITIO/PUROK For OPV_______________
IMMUNIZATION CONDUCTED
HEALTH CENTER
No of
No of children aged 6- childre No. of No of If unvaccacinated If reason is Source of
No of 59 months n 6- 59 children elig childfren Elig for MCVO/OPV REFUSAL, information on
6 -59 For OPV Elig for for 6- 59 mos for 6-59 mos list reason (refers list reason Measles
NO mo’s MCV/ for MCV for VIT A to the list below* (refer to campaign(refer
Elig. VIT A record only the the list) to the list
For code *record below* record
OPV only the only the code
code
No. No. not No. No. No. No.
given given Give Not give not
n given n give
n

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RESULT:_________________ PASS 0 or 1 misses___________ Fall (2 or more )__________

Dahilan bakit ayaw magpabakuna Reason for parent/ guardian refusal Source of information
1. Religious belief 1. Wala sa bahay ang bata 1. Radio
2. Afraid /takot sa injection 2. Hindi alam na nagbabakuna 2. TV
3. Respondent can’t decide 3. Malayo ang lugar 3. Streamer or tarpuline
4. Ayaw ng sumagot 4. Walang available na bakuna 4.Flyers
5. May dahilang pilosopo 5. Pupunta mamaya o bukas 5.BHW
6. Nagdududa sa kalusugan 7. May sakit ang bata /masama ang pakiramdam 6. Social Media
7. Nabigyan n ang bata 8. Hindi alam 7. others
8. Nagkaroon ng masamang karanasan 9. Other medical reason
Sa nakaraang bakuna

Name of RCA team members

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