A1

FHSIS REPORT for the MONTH: JANUARY - DECEMBER YEAR: 2023

Name of Barangay: SAN ISIDRO
Name of BHS: BHS SAN SALVADOR
Name of Municipality/City: MATALOM
Name of Province: LEYTE
Projected Population of the Year:
For submission to RHU/MHC
BRGY
Section A. Family Planning Services and Deworming for Women of Reproductive Age
Total for
A1. Modern FP Unmet Need Age
WRA 15-49
Remarks
(Col. 1) (Col. 2) y/o
(Col. 3) (Col. 4)
10-14 y/o 15-19 y/o 20-49 y/o

1. No. of WRA with unmet need for modern FP - Total

A2. Use of FP Method Current Users Acceptors Drop-outs Current Users New Acceptors
(Beginning Month) New Acceptors Other Acceptors (Present Month) (End of Month) (Present Month)
(Previous Month) (Present Month)
(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 5) (Col. 6) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
a. BTL - Total 0 111 111 0 6 6 0 0 0 0 0 0 0 0 0 0
120 120
b. NSV - Total 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. Condom - Total 0 1 143 144 0 0 1 1 0 0 0 0 0 0 0 0
1 1 2 144 146 2 2
d. Pills - Total 0 6 905 911 0 0 15 15 0 0 0 0 0 0 0 0 0
1 1 2 2 6 924 930
d.1 Pills-POP - Total 0 4 208 212 0 0 5 5 0 0 0 0 0 0 0 0 0
1 1 2 2 4 217 221
d.2 Pills-COC - Total 0 2 697 699 0 0 10 10 0 0 0 0 0 0 0 0 0 0 0
2 707 709
e. Injectables (DMPA/POI)-Tot. 0 6 269 699 0 1 2 3 0 0 0 0 0
3 3 1 3 4 6 275 281 2 2
f. Implant - Total 0 0 59 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 61 61
g. IUD (IUD-I and IUD-PP)-Tot. 0 0 290 290 0 3 3 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0
292 292
g.1 IUD-I- Total 0 0 186 186 0 3 3 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0
190 190
g.2 IUD-PP - Total 0 0 104 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
102 102
h. NFP-LAM - Total 0 17 34 51 0 0 22 22 0 0 0 0 0 0 0
16 16 16 67 83 16 1 24 25
i. NFP-BBT - Total 0 0 3 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
j. NFP-CMM - Total 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
k. NFP-STM - Total 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
l. NFP-SDM - Total 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 30 1914 1944 0 1 49 50 0 0 22 22 0 1,9 2,0
1 35 36 30 84 14 30 1 28 29 1
 Section B. Maternal Care and Services
Indicators Age Total Remarks Indicators Age Total Remarks
(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 1) (Col. 2) (Col. 3) (Col. 4)
B1. Prenatal Care
10-14 15-19 20-49 10-14 15-19 20-49
1. No. of pregnant women who 0 22 311 333 6. No. of pregnant women who
gave birth with at least 4 completed doses of calcium 0 15 230 245
prenatal check-ups - Total carbonate supplementation - Total
2. No. of pregnant women 1 25 370 396 7. No. of pregnant women given
0 0 3 3
assessed of their nutritional iodine capsules – Total
status during the 1st tri. - 8. No. of pregnant women given one
dose
0 5 108 113
a. Number of pregnant
women seen in the first 9. No. of pregnant women screened
1 22 328 351 0 1 16 17
trimester who have for syphilis - Total
normal BMI - Total 10. No. of pregnant women tested
b. No. of pregnant women positive
0 0 4 4
seen in the first trimester who 0 21 321 342 11. No. of pregnant women screened for
0 20 241 261
have low BMI - Total
Hepatitis B - Total
c. No. of pregnant 12. No. of pregnant women tested
0 1 23 24
women seen in the 0 0 2 2 positive
first trimester who 13. No. of pregnant women screened for
0 1 24 25
3. No. of pregnant women for HIV - Total
the first time given at least 0 0 2 2 14. No. of pregnant women tested for
0 17 265 282
2 doses of Td vaccination- CBC or Hgb & Hct count - Total
4. No. of pregnant women for 15. No. of pregnant women tested for
nd
the 2 or more times 0 2 201 203 CBC or Hgb & Hct count 0 5 79 84
given at least 3 doses of diagnosed with anemia - Total
16. No. of pregnant women screened for 0 2 45 47
5.Td
No.vaccination
of pregnant(Td2 Plus)who
women gestational diabetes – Total
completed the dose of 17. No. of pregnant women tested
0 21 354 375 positive
0 0 6 6
iron with folic acid
supplementation - Total
B2. Intrapartum Care and Delivery Outcome
18. No. of deliveries – Total 0 5 161 166 20. No. of deliveries attended by skilled 166
19. No. of live births – Total 0 5 161 166 health professionals - Total
a. No. of live births with 162 a. No. of deliveries attended 166
normal birth weight - by a doctor - Total
b. No. of live births with 4 b. No. of deliveries attended by a 0
low birth weight - nurse – Total
c. No. of live births with 0 c. No. of deliveries attended 0
unknown birth weight- by midwives - Total
Indicators Age Tota Remarks Indicators Age Tota Remarks
(Col. 1) (Col. 2) l (Col. (Col. 4) (Col. 1) (Col. 2) l (Col. (Col. 4)
10-14 15-19 20-49 3) 10-14 15-19 20-49 3)
21. No. of health facility- 166 23a. No. of vaginal deliveries – Total 0 5 161 166
based deliveries - Total 23b. No. of deliveries by cesarean 0 0 0 0
a. No. of deliveries in 166 section – Total
public health facility-Total 24a. No. of full-term births – Total 0 4 161 165
b. No. of deliveries in 0 24b. No. of pre-term births – Total 0 0 1 1
private health facility-Tot. 24c. No. of fetal deaths - Total 0 0 0 0
22. No. of non-facility-based 0 24d. No. of abortion/miscarriage - Total 0 0 0 0
deliveries - Total
B3. Postpartum and Newborn Care
25. No. of postpartum 0 5 161 166 27. No. of postpartum women with 1 26 298 325
women together with Vitamin A supplementation – Total
their newborn who
completed at least 2
postpartum check-ups -
Totalof postpartum
26. No. 1 25 266 292
women who completed
iron with folic acid
supplementation - Total
Section C. Child Care and Services
Indicators Male Femal Total Remarks Indicators Male Femal Total Remarks
(Col. 1) (Col. 2) e (Col. 4) (Col. 5) (Col. 1) (Col. 2) e (Col. 4) (Col. 5)
(Col. 3)
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents (Col. 3)
1. CPAB - Total 146 209 355 13. PCV 1 - Total 214 196 410
2. BCG - Total 180 187 367 14. PCV 2 - Total 209 220 429
3. HepB, within 24 hours. - Total 157 177 334 15. PCV 3 - Total 233 206 439
4. DPT-HiB-HepB 1 - Total 214 194 408 16. MCV 1 - Total 217 202 419
5. DPT-HiB-HepB 2 - Total 210 212 422 17. MCV 2 - Total 202 208 410
6. DPT-HiB-HepB 3 - Total 227 202 429 18. FIC - Total 196 206 402
7. OPV 1 - Total 193 188 381 19. CIC - Total 6 2 8
8. OPV 2 - Total 183 174 357 20. Td, Grade 1 (November) - Total 0 0 0
9. OPV 3 - Total 166 154 320 21. MR, Grade 1 (November) - Total 0 0 0
10. IPV 1 - Total 197 183 380 22. Td, Grade 7 (November) - Total 0 0 0
11. IPV 2 (routine)- Total 23. MR, Grade 7 (November) - Total 0 0 0
12. IPV 2 (catch-up)- Total
Indicators Male Femal Total Remarks Indicators Male Femal Total Remarks
(Col. 1) (Col. 2) e (Col. 4) (Col. 5) (Col. 1) (Col. 2) e (Col. 4) (Col. 5)
C2. Nutrition Services for Infants and Children (Col. 3) (Col. 3)
24. Newborns initiated on 119 122 241 33. Stunted - Total 0 0 0
25. Preterm/LBW infants given iron 34.a. MAM - Total 0 0 0
16 22 38
supplementation - Total 34.a.1. MAM-admitted in SFT - Total 0 0 0
26. Infants exclusively breastfed until 5th month 34.a.2. MAM-cured in SFT - Total 0 0 0
147 132 279
and 29 days – Total
34.a.3. MAM-defaulted in SFT - Total 0 0 0
27. Infants 6 mos. old initiated to
120 99 219
complementary feeding with continued
breastfeeding - Total
 34.a.4. MAM-died in SFT - Total 0 0 0
28. Infants 6 mos. old initiated to 34 b. SAM - Total 0 0 0
complementary feeding but no longer or 10 8 18
never been breastfed - 34.b.1. SAM-admitted in OTC - Total 0 0 0
Total
29. Infants 6-11 mos. given 1 dose of Vitamin A 388 334 722 34.b.2. SAM-cured in OTC - Total 0 0 0
100,000 I.U. - Total 34.b.3. SAM-defaulted in OTC - Total 0 0 0
30. Children 12-59 mos. old given 2 doses of 964 923 1887 34.b.4. SAM-died in OTC - Total 0 0 0
Vitamin A 200,000 I.U. - Total 35. Overweight and Obese - Total 0 0 0
31. Infant 6-11 months old who completed 9 4 13 36. Normal - Total 0 0 0
MNP supplementation - Total
32. Children 12-23 mos. who completed 4 1 5
MNP supplementation - Total
C3. Deworming Services for Infants, Children and Adolescents
37. 1-19 y/o given 2 doses of deworming drug - 295 238 533 b. SAC, 5-9 y/o dewormed (2 doses) - Total
Total c. Adolescents, 10-19 y/o dewormed (2
a. PSAC, 1-4 y/o dewormed (2 doses) - Total doses) - Total
787 719 1506
C4. Management of Sick Infants and Children
38. Sick Infants 6-11 mos. old seen - Total 3 4 7 42. Diarrhea cases 0-59 months old seen - Total
39. Sick Infants 6-11 mos. old received Vitamin 3 4 7 43. Diarrhea cases 0-59 months old received
A - Total ORS - Total
40. Sick Children 12-59 mos. old seen - Total 1 2 3 44. Diarrhea cases 0-59 mos. received ORS w/
41. Sick Children 12-59 mos. old received 1 2 3 zinc - Total
Vitamin A - Total 45. Pneumonia cases 0-59 mos. old seen - Total
46. Pneumonia cases 0-59 mos. old
completed treatment - Total
Section D. Oral Care and Services
To be submitted Quarterly
Indicators Male Femal Total Remarks Indicators Male Femal Total Remarks
(Col. 1) (Col. 2) e (Col. 4) (Col. 5) (Col. 1) (Col. 2) e (Col. 4) (Col. 5)
(Col. 3) (Col. 3)
1. Orally fit children 12-59 months old upon 6a. Adolescents 10-14 years old who
oral exam plus orally fit after rehab - received BOHC - Total
Total 5 years old and above with
2. Clients 6b. Adolescents 15-19 years old who
cases of DMFT - Total received BOHC - Total
3. Infants 0-11 months old who received 7. Adults 20-59 years old who received
BOHC - Total BOHC - Total
4. Children 1-4 years old who received 8. Senior citizens 60 years old and above
BOHC - Total who received BOHC - Total
5. Children 5-9 years old who received 10-14 15-19 20-49
Indicators Total Remarks
BOHC - Total y/o y/o y/o
9. Pregnant women who received BOHC - Total
 Section E. Infectious Disease Prevention and Control Services
Indicators Male Female Total Remarks Indicators Male Female Total Remarks
(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 5) (Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 5)
E1. Filariasis Prevention and Control (to be reported annually)
E2. Schistosomiasis Prevention and Control
1. No. of patients seen - Total 6. No. of confirmed chronic cases - Total
2. No. of suspected cases seen - Total 7. No. of confirmed cases (acute and chronic) -
3. No. of acute clinically diagnosed cases - Total Total
4. No. of confirmed acute cases - Total 8. No. of cases treated - Total
5. No. of chronic clinically diagnosed cases - 9. No. of confirmed chronic cases referred to a
Total hospital facility - Total
E3. Soil Transmitted Helminthiasis Prevention and Control (other age groups reflected under Child Care and Maternal Care)
1. No. of WRA, 20-49 years old, who
completed 2 doses of deworming tablet -
E4.Total
HIV-AIDS/STI Prevention and Control (reflected under Maternal Care)
E5. Leprosy Prevention and Control E8. Rabies Prevention and Control
1. No. of Leprosy cases on treatment 1. No. of animal bites - Total
during reporting period - Total
2. No. of newly detected cases 2.. No. of deaths due to Rabies - Total
during reporting period - Total
Section F. Non-Communicable Disease Prevention and Control Services
Indicators Male Female Total Remarks Indicators Male Female Total Remarks
(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 5) (Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 5)
1. No. of adults risk-assessed using 5. No. of adult women screened for
PhilPEN - Total Cervical Cancer using VIA/Pap
2. Current smokers - Total Smear
6. No. - Total
of adult women found positive / suspect
3. Alcohol binge drinkers - Total for Cervical Cancer using VIA or Pap
4. Overweight/Obese - Total Smear - Total
Indicators Male Female Total Remarks Indicators Male Female Total Remarks
(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 5) (Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 5)
7. No. of adult women screened for breast mass 11. No. of senior citizens screened for
- Total visual acuity - Total
8. No. of adult women with suspicious 12. No. of senior citizens diagnosed with
breast mass - Total eye disease/s - Total
9. No. of newly-identified hypertensive 13. No. of senior citizens who received one (1)
adults - Total dose of PPV - Total
10. No. of newly-identified adults with Type 2 14. No. of senior citizens who received one
DM- Total (1) dose of influenza vaccine - Total
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
(Col. 1) (Col. 2) (Col. 3) (Col. 1) (Col. 2) (Col. 3)
1. No. of HHs with access to basic safe water supply - Total 2. No of HHs with basic sanitation facility - Total
a. No. of HHs with Level I - Total a. No. of HH with pour/flush toilet connected to septic tank - Total
b. No. of HHs with Level II - Total b. No. of HHs with pour/flush toilet connected to community
c. No. of HHs with Level III - Total sewer/sewerage system or any other approved treatment
 system - Total
c. No. of HHs with ventilated improved pit latrine (VIP) - Total
3. No. of industrial establishments issued with sanitary permit -
Section H. Mortality Total Section I. Natality
Indicators Male Femal Total Remarks Indicators Male Femal Total Remarks
(Col. 1) (Col. e (Col. 4) (Col. 5) (Col. 1) (Col. 2) e (Col. 4) (Col. 5)
1. Total Deaths 2) (Col. (Col. 3)
1. Livebirths - Total CB
2. Maternal Deaths - Total a. Livebirths among 15-19 y/o women-Tot. R:
3. Under-five Deaths - Total AB
4. Infant Deaths - Total
5. Neonatal Deaths - Total
6. Fetal Deaths - Total
7. Early Neonatal Deaths - Total
8. Perinatal Deaths - Total

Prepared by:

CLAIR ANN D. VELOSO, RN

FHSIS Coordinator