FHSIS REPORT for the MONTH: January YEAR: 2021

Name of Barangay: Bikal

Name of BHS: Bikal
Name of Municipality/City: Caramaon
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) (Col. 3) (Col. 4)
10-14 15-19 20-49
1. No. of WRA with unmet need for modern FP 0
Acceptors Current User
Current User Dropout New Acceptors
(Beginning of Month) New Acceptors Other Acceptors (Present Month) (End of Month) (Present Month)
A2. Use of FP Method (Previous Month) (Present Month) (Col.
(Col. 1) (Col. 2) (Col. 5) (Col. 7)
(Col. 3) (Col. 4) 6)
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. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. trimester 0 0 0 0 9. No. of pregnant women screened for syphilis 0

a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0

4. No. of pregnant women for the 2nd or more times given at least 3 doses of Td 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2 Plus)
No. of pregnant women who completed dose of iron with folic acid No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with
5. 0 15. 0
supplementation anemia

Page 1 of 77
 No. of pregnant women who completed doses of calcium carbonate
6. supplementation 0 16. No. of pregnant women screened for gestational diabetes 0

7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. 0 27. No. of postpartum women with Vitamin A supplementation 0
postpartum check-ups

26. No. of postpartum women who completed iron with folic acid supplementation 0

Section C. Child Care and Services

Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition Services for Infants and Children
Infants 6 months old initiated to
23. Newborn initiated on breastfeeding immediately after 0 26. complementary feeding with continues 0 29. Children 12-59 months old given 2 doses 0
birth lasting to 90 minutes of Vitamin A 200,000 I.U
breastfeeding

Infants 6 months old initiated to

Infant 6-11 months old who completed
24. Preterm/LBW infants given iron supplementation 0 27. complementary feeding but no longer or 0 30. MNP supplementation 0
never been breastfed
Infants 6-11 months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. Vitamin A 0 39. ORS with zinc 0

34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0

35. Sick children 12-59 months old seen 0 38. Diarrhea cases 0-59 months old received 0 41. Pneumonia cases 0-59 months completed 0
ORS treatment

Page 2 of 77
 Section E. Infectious Disease Prevention & Control Services
1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. Smear 0
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0

4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0

Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0

Section G. Environmental Health and Sanitation Services

Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
b. No. of HHs with Level II
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)

2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit

3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0

3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Hanoy
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 3) (Col. 4)
1. No. of WRA with unmet need for modern FP Current0User
Current User Acceptors Dropout New Acceptors
(Beginning of Month) New Acceptors Other Acceptors (Present Month) (End of Month) (Present Month)
A2. Use of FP Method (Col.
(Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
(Col. 1)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
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b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
2. No. of pregnant women assessed of their nutritional status during the 1st 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. (Td2 Plus) 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation anemia
6. No. of pregnant women who completed doses of calcium carbonate 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. postpartum check-ups 0 27. No. of postpartum women with Vitamin A supplementation 0
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0

Page 4 of 77
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. 0 29. Children 12-59 months old given 2 doses 0
complementary
Infants 6 monthsfeeding with continues
old initiated to
birth lasting to 90 minutes breastfeeding of Vitamin
Infant 6-11Amonths
200,000 I.Uwho completed
old
24. Preterm/LBW infants given iron supplementation 0 27. complementary feeding but no longer or 0 30. MNP supplementation 0
Infants 6-11breastfed
never been months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. Vitamin A 0 39. ORS with zinc 0
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
35. Sick children 12-59 months old seen 0 38. Diarrhea cases 0-59 months old received 0 41. Pneumonia cases 0-59 months completed 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. 0
Smear
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
Page 5 of 77
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Haponan
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User
Current User Acceptors Dropout (End of Month) New Acceptors
(Beginning of Month) New Acceptors Other Acceptors (Present Month) (Present Month)
A2. Use of FP Method (Col.
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 15-19 20-49 (Col. 4) 10-14 15-19 20-49
Total Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
4. No. of pregnant women for the 2nd or more times given at least 3 doses of Td 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2 Plus)
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation
No. of pregnant women who completed doses of calcium carbonate anemia
6. 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0

Page 6 of 77
 a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. postpartum check-ups 0 27. No. of postpartum women with Vitamin A supplementation 0
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
Newborn initiated on breastfeeding immediately after Children 12-59 months old given 2 doses
23. birth lasting to 90 minutes 0 26. complementary
Infants 6 monthsfeeding with continues
old initiated to 0 29. of Vitamin 0
24. Preterm/LBW infants given iron supplementation 0 27. breastfeeding 0 30. Infant 6-11Amonths
200,000 I.Uwho completed
old 0
complementary feeding but no longer or MNP supplementation
Infants 6-11breastfed
never been months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. Vitamin A 0 39. ORS with zinc 0
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
35. Sick children 12-59 months old seen 0 38. Diarrhea cases 0-59 months old received 0 41. Pneumonia cases 0-59 months completed 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. 0
Smear
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0

Page 7 of 77
 Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Maqueda
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP Current0User
Current User Acceptors Dropout New Acceptors
(Beginning of Month) New Acceptors Other Acceptors (Present Month) (End of Month) (Present Month)
A2. Use of FP Method (Col.
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Page 8 of 77
 Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
2. No. of pregnant women assessed of their nutritional status during the 1st 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. (Td2 Plus) 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation anemia
6. No. of pregnant women who completed doses of calcium carbonate 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. postpartum check-ups 0 27. No. of postpartum women with Vitamin A supplementation 0
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. 0 29. Children 12-59 months old given 2 doses 0
complementary
Infants 6 monthsfeeding with continues
old initiated to
birth lasting to 90 minutes breastfeeding feeding but no longer or of Vitamin
Infant 6-11Amonths
200,000 I.Uwho completed
old
24. Preterm/LBW infants given iron supplementation 0 27. complementary 0 30. MNP supplementation 0
Infants 6-11breastfed
never been months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. 0 39. 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
35. Sick children 12-59 months old seen 0 38. Diarrhea cases 0-59 months old received 0 41. Pneumonia cases 0-59 months completed 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services

Page 9 of 77
 E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. Smear 0
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
b. No. of HHs with Level II
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Oroc-Osoc
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User Dropout Current User New Acceptors
New Acceptors Acceptors
Other Acceptors (End of Month)
A2. Use of FP Method (Beginning of Month) (Present Month) (Col. (Present Month)
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
Page 10 of 77
 d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. (Td2 Plus) 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation anemia
6. No. of pregnant women who completed doses of calcium carbonate 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
25. No. postpartum women together with their newborn who completed at least 2 0 27. No. of postpartum women with Vitamin A supplementation 0
postpartum check-ups
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0

Page 11 of 77
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. 0 29. Children 12-59 months old given 2 doses 0
birth lasting to 90 minutes complementary
Infants 6 monthsfeeding with continues
old initiated to of Vitamin
24. Preterm/LBW infants given iron supplementation 0 27. breastfeeding feeding but no longer or
complementary 0 30. Infant 6-11Amonths
200,000 I.Uwho completed
old 0
Infants 6-11breastfed
months given 1 dose of MNP supplementation
Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. never been 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
33. Sick infants 6-11 months old seen 0 36. Sick children 12-59 months old received 0 39. Diarrhea cases 0-59 months old received 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. 0 41. 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
2. No. of deaths due to Rabies 0 4. No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
2. Current smokers 0 6. No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap 0
Smear
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Paniman
Page 12 of 77
 Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User Dropout Current User New Acceptors
New Acceptors Acceptors
Other Acceptors (End of Month)
A2. Use of FP Method (Beginning of Month) (Present Month) (Col. (Present Month)
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. trimester 0 0 0 0 9. No. of pregnant women screened for syphilis 0
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
4. No. of pregnant women for the 2nd or more times given at least 3 doses of Td 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2 Plus)
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation
No. of pregnant women who completed doses of calcium carbonate anemia
6. supplementation 0 16. No. of pregnant women screened for gestational diabetes 0
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0

Page 13 of 77
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
25. No. postpartum women together with their newborn who completed at least 2 0 27. No. of postpartum women with Vitamin A supplementation 0
postpartum check-ups
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. 0 29. Children 12-59 months old given 2 doses 0
birth lasting to 90 minutes complementary
Infants 6 monthsfeeding with continues
old initiated to of Vitamin
24. Preterm/LBW infants given iron supplementation 0 27. breastfeeding
complementary feeding but no longer or 0 30. Infant 6-11Amonths
200,000 I.Uwho completed
old 0
Infants 6-11breastfed
months given 1 dose of MNP supplementation
Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. never been 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. Vitamin A 0 39. ORS with zinc 0
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. 0 41. 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. Smear 0
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0

Page 14 of 77
 Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
b. No. of HHs with Level II
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Tabog
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User Dropout Current User New Acceptors
New Acceptors Acceptors
Other Acceptors (End of Month)
A2. Use of FP Method (Beginning of Month) (Present Month) (Col. (Present Month)
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
Page 15 of 77
 b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2
No. ofPlus)
pregnant women who completed dose of iron with folic acid No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with
5. 0 15. 0
supplementation
No. of pregnant women who completed doses of calcium carbonate anemia
6. supplementation 0 16. No. of pregnant women screened for gestational diabetes 0
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. 0 27. No. of postpartum women with Vitamin A supplementation 0
postpartum check-ups
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition Services for Infants
Infants 6 months old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. complementary 0 29. Children 12-59 months old given 2 doses 0
birth lasting to 90 minutes Infants 6 monthsfeeding with continues
old initiated to of Vitamin
Infant 6-11Amonths
200,000 I.Uwho completed
old
24. Preterm/LBW infants given iron supplementation 0 27. breastfeeding feeding but no longer or
complementary 0 30. 0
Infants 6-11breastfed
never been months given 1 dose of MNP supplementation
Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. 0 39. 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. ORS 0 41. treatment 0
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

Page 16 of 77
1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. Smear 0
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: #REF!
Name of Barangay: Consolidation
Name of BHS: Bikal
Name of Municipality/City: CARAMOAN I
Name of Province: CAMARINES SUR
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User Dropout Current User New Acceptors
New Acceptors Acceptors
Other Acceptors (End of Month)
A2. Use of FP Method (Beginning of Month) (Present Month) (Col. (Present Month)
(Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
(Col. 1)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0

Page 17 of 77
 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
2. No. of pregnant women assessed of their nutritional status during the 1st 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. (Td2 Plus) 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation anemia
6. No. of pregnant women who completed doses of calcium carbonate 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. postpartum check-ups 0 27. No. of postpartum women with Vitamin A supplementation 0
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0

Page 18 of 77
 C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. 0 29. Children 12-59 months old given 2 doses 0
complementary
Infants 6 monthsfeeding with continues
old initiated to
birth lasting to 90 minutes breastfeeding of Vitamin
Infant 6-11Amonths
200,000 I.Uwho completed
old
24. Preterm/LBW infants given iron supplementation 0 27. complementary feeding but no longer or 0 30. 0
Infants 6-11 months given 1 dose of MNP supplementation
Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. never been breastfed 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
33. Sick infants 6-11 months old seen 0 36. Sick children 12-59 months old received 0 39. Diarrhea cases 0-59 months old received 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. 0 41. 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
2. No. of deaths due to Rabies 0 4. No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
2. Current smokers 0 6. No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap 0
Smear
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0

Page 19 of 77
 FHSIS REPORT for the MONTH: FEBRUARY YEAR: 2021
Name of Barangay: Bikal
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) (Col. 3) (Col. 4)
10-14 15-19 20-49
1. No. of WRA with unmet need for modern FP 0
Acceptors Current User
Current User Dropout New Acceptors
(Beginning of Month) New Acceptors Other Acceptors (Present Month) (End of Month) (Present Month)
A2. Use of FP Method (Previous Month) (Present Month) (Col.
(Col. 1) (Col. 2) (Col. 5) (Col. 7)
(Col. 3) (Col. 4) 6)
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. Bilateral Tubal Ligation 9 9 0 0 0 0 0 9 9 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 3 3 0 0 0 0 0 3 3 0
d. Pills-Total 0 0 53 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 53 0 0 0 0
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 53 53 0 0 0 0 0 53 53 0
e Injectables (DMPA/POI) 6 6 0 0 0 0 0 6 6 0
f. Implant 14 14 0 0 0 0 0 14 14 0
0 1 11 0 0 0 0 0 0 0 0 0 1 11 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
12 0 0 0 12 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 1 11 12 0 0 0 0 1 11 12 0
h. NFP-LAM 0 0 1 1 2 2 0 0 -1 -1 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 11 11 0 0 0 0 0 11 11 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 5 5 0 0 0 0 0 5 5 0
m. Total Current Users 0 1 112 113 0 0 0 0 0 0 1 1 0 0 2 2 0 1 111 112 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. trimester 0 0 0 0 9. No. of pregnant women screened for syphilis 0

a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0

4. No. of pregnant women for the 2nd or more times given at least 3 doses of Td 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2 Plus)
No. of pregnant women who completed dose of iron with folic acid No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with
5. 0 15. 0
supplementation anemia

Page 20 of 77
 No. of pregnant women who completed doses of calcium carbonate
6. supplementation 0 16. No. of pregnant women screened for gestational diabetes 0

7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. 0 27. No. of postpartum women with Vitamin A supplementation 0 0
postpartum check-ups

26. No. of postpartum women who completed iron with folic acid supplementation 0 0

Section C. Child Care and Services

Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 1 3 4 15. MCV 1 1 2 3
2. CPAB 0 9. OPV 2 1 2 3 16. MCV 2 3 1 4
3. BCG 0 10. OPV 3 2 1 3 17. FIC 2 0 2
4. Hep B, within 24 hours 0 11. IPV 1 2 3 18. CIC 1 1 2
5. DPT-HiB-HepB 1 2 3 5 12. PCV 1 2 3 5 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 1 3 4 13. PCV 2 0 2 2 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 1 1 14. PCV 3 2 1 3 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition Services for Infants and Children
Newborn initiated on breastfeeding immediately after Infants 6 months old initiated to Children 12-59 months old given 2 doses
23. 0 26. complementary feeding with continues 1 1 2 29. 0
birth lasting to 90 minutes breastfeeding of Vitamin A 200,000 I.U
Infants 6 months old initiated to
24. Preterm/LBW infants given iron supplementation 0 27. complementary feeding but no longer or 0 30. Infant 6-11 months old who completed 0
MNP supplementation
never been breastfed
Infants 6-11 months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 1 1 2 28. Vitamin A 100,000 I.U 0 31. MNP supplementation 0
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 385 342 727 b. SAC, 5-9 years old dewormed (2 doses) 106 104 210
a. PSAC, 1-4 years old dewormed (2 doses) 86 59 145 c. Adolescents, 10-19 years old dewormed (2 doses) 193 179 372
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. Vitamin A 0 39. ORS with zinc 0
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0

35. Sick children 12-59 months old seen 0 38. Diarrhea cases 0-59 months old received 0 41. Pneumonia cases 0-59 months completed 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

Page 21 of 77
 E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0

2. No. of deaths due to Rabies 0 4. No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 4 10 14 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
2. Current smokers 4 4 6. No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap 0
Smear
3. Alcohol binge drinkers 2 2 7. No. of women screened for breast mass 0

4. Overweight/Obese 2 2 4 8. No. of women with suspicious breast mass 0

Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0

Section G. Environmental Health and Sanitation Services

Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
b. No. of HHs with Level II
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)

2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit

3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0

3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 1 1 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: FEBRUARY YEAR: 2021
Name of Barangay: Hanoy
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User Dropout Current User New Acceptors
New Acceptors Acceptors
Other Acceptors (End of Month)
A2. Use of FP Method (Beginning of Month) (Present Month) (Col. (Present Month)
(Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
(Col. 1)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 2 2 0 0 0 0 0 2 2 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 2 2 0 0 1 1 0 0 1 1 0
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d. Pills-Total 0 0 15 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 15 0 0 0 0
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 15 15 0 0 0 0 0 15 15 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0 0
f. Implant 8 8 0 0 0 0 0 8 8 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 4 4 0 0 0 0 0 4 4 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 5 5 0 0 0 0 0 5 5 0
m. Total Current Users 0 0 36 36 0 0 0 0 0 0 0 0 0 0 1 1 0 0 35 35 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 3 3 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. trimester 0 0 2 2 9. No. of pregnant women screened for syphilis 0
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 1 1 13. No. of pregnant women screened for HIV 0
4. No. of pregnant women for the 2nd or more times given at least 3 doses of Td 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2 Plus)
5. No. of pregnant women who completed dose of iron with folic acid 3 3 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation
No. of pregnant women who completed doses of calcium carbonate anemia
6. supplementation 3 3 16. No. of pregnant women screened for gestational diabetes 0
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. 0 27. No. of postpartum women with Vitamin A supplementation 0
postpartum check-ups
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 1 1 2 15. MCV 1 2 3 5
2. CPAB 0 9. OPV 2 2 2 4 16. MCV 2 1 1

Page 23 of 77
3. BCG 0 10. OPV 3 0 17. FIC 1 1
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 2 2 4 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 1 1 2 13. PCV 2 2 2 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition Services for Infants and Children
Infants 6 months old initiated to
Newborn initiated on breastfeeding immediately after Children 12-59 months old given 2 doses
23. birth lasting to 90 minutes 0 26. complementary feeding with continues 0 29. of Vitamin A 200,000 I.U 0
breastfeeding
Infants 6 months old initiated to Infant 6-11 months old who completed
24. Preterm/LBW infants given iron supplementation 0 27. complementary feeding but no longer or 0 30. 0
never been breastfed MNP supplementation
25. Infants exclusively breastfed until 6th month 0 28. Infants 6-11 months given 1 dose of 0 31. Children 12-23 months who completed 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 113 108 221 b. SAC, 5-9 years old dewormed (2 doses) 22 26 48
a. PSAC, 1-4 years old dewormed (2 doses) 16 22 38 c. Adolescents, 10-19 years old dewormed (2 doses) 75 60 135
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. Vitamin A 0 39. ORS with zinc 0
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
35. Sick children 12-59 months old seen 0 38. Diarrhea cases 0-59 months old received 0 41. Pneumonia cases 0-59 months completed 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 1 1

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. 0
Smear
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

Page 24 of 77
2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: FEBRUARY YEAR: 2021
Name of Barangay: Haponan
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 3) (Col. 4)
1. No. of WRA with unmet need for modern FP Current0User
Current User Acceptors Dropout New Acceptors
(Beginning of Month) New Acceptors Other Acceptors (Present Month) (End of Month) (Present Month)
A2. Use of FP Method (Col.
(Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
(Col. 1)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 15-19 20-49 (Col. 4) 10-14 15-19 20-49
Total Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-Total 0 1 14 15 0 0 0 0 0 0 0 0 0 0 0 0 0 1 14 15 0 0 0 0
d.1 Pills-POP 1 1 2 0 0 0 0 1 1 2 0
d.2 Pills-COC 13 13 0 0 0 0 0 13 13 0
e Injectables (DMPA/POI) 2 2 0 0 1 1 0 0 1 1 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 12 12 0 2 2 3 3 0 0 11 11 1 1
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 1 28 29 0 0 0 0 0 0 2 2 0 0 4 4 0 1 26 27 0 0 1 1
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 1 1 8. No. of pregnant women given one dose of deworming tablet 1 1
2. No. of pregnant women assessed of their nutritional status during the 1st 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. (Td2 Plus) 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
5. No. of pregnant women who completed dose of iron with folic acid 2 2 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation anemia
6. No. of pregnant women who completed doses of calcium carbonate 2 2 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome

Page 25 of 77
18. No. of deliveries 3 3 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 3 3 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 3 3 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 3 3
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 3 3
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 3 3
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. postpartum check-ups 3 3 27. No. of postpartum women with Vitamin A supplementation 3 3
26. No. of postpartum women who completed iron with folic acid supplementation 3 3
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 2 1 3 8. OPV 1 1 0 1 15. MCV 1 0 1 1
2. CPAB 1 0 1 9. OPV 2 1 0 1 16. MCV 2 2 0 2
3. BCG 0 10. OPV 3 1 1 2 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 1 0 1 18. CIC 2 0 2
5. DPT-HiB-HepB 1 0 12. PCV 1 1 0 1 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 1 0 1 13. PCV 2 2 0 2 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 1 1 2 14. PCV 3 1 0 1 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition Services for Infants and Children
Newborn initiated on breastfeeding immediately after Infants 6 months old initiated to Children 12-59 months old given 2 doses
23. 0 26. complementary feeding with continues 1 2 3 29. 0
birth lasting to 90 minutes breastfeeding of Vitamin A 200,000 I.U
Infants 6 months old initiated to
24. Preterm/LBW infants given iron supplementation 0 27. complementary feeding but no longer or 1 1 30. Infant 6-11 months old who completed 0
MNP supplementation
never been breastfed
Infants 6-11 months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 2 1 3 28. Vitamin A 100,000 I.U 0 31. MNP supplementation 0
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 192 158 350 b. SAC, 5-9 years old dewormed (2 doses) 56 49 105
a. PSAC, 1-4 years old dewormed (2 doses) 36 29 65 c. Adolescents, 10-19 years old dewormed (2 doses) 100 80 180
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. 0 39. 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. ORS 0 41. treatment 0
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 9 11 20 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
2. Current smokers 3 0 3 6. No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap 0
Smear
3. Alcohol binge drinkers 2 0 2 7. No. of women screened for breast mass 0
Page 26 of 77
 4. Overweight/Obese 1 1 2 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 10 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I 3 a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II 5 b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III 2 c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 2 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 0 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 2 1 3

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: FEBRUARY YEAR: 2021
Name of Barangay: Maqueda
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User Dropout Current User New Acceptors
New Acceptors Acceptors
Other Acceptors (End of Month)
A2. Use of FP Method (Beginning of Month) (Present Month) (Col. (Present Month)
(Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
(Col. 1)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 1 1 0 0 0 0 0 1 1 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-Total 0 0 6 6 0 0 0 0 0 0 1 1 0 0 0 0 0 0 7 7 0 0 0 0
d.1 Pills-POP 0 0 1 1 0 0 0 1 1 0
d.2 Pills-COC 6 6 0 0 0 0 0 6 6 0
e Injectables (DMPA/POI) 12 12 0 0 0 0 0 12 12 0
f. Implant 6 6 0 0 0 0 0 6 6 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 6 6 0 0 0 0 0 6 6 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
Page 27 of 77
m. Total Current Users 0 0 31 31 0 0 0 0 0 0 1 1 0 0 0 0 0 0 32 32 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. trimester 0 0 0 0 9. No. of pregnant women screened for syphilis 0
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 1 1 13. No. of pregnant women screened for HIV 0
4. No. of pregnant women for the 2nd or more times given at least 3 doses of Td 1 1 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2ofPlus)
No. pregnant women who completed dose of iron with folic acid No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with
5. 0 15. 0
supplementation
No. of pregnant women who completed doses of calcium carbonate anemia
6. supplementation 0 16. No. of pregnant women screened for gestational diabetes 0
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. 0 1 1 27. No. of postpartum women with Vitamin A supplementation 1 1
postpartum check-ups
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 1 1 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 1 1 16. MCV 2 0
3. BCG 0 10. OPV 3 0 1 1 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 1 1 18. CIC 0
5. DPT-HiB-HepB 1 1 1 2 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 2 2 13. PCV 2 0 3 3 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 1 1 14. PCV 3 0 1 1 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition Services for Infants and Children
Infants 6 months old initiated to
Newborn initiated on breastfeeding immediately after Children 12-59 months old given 2 doses
23. birth lasting to 90 minutes 0 26. complementary feeding with continues 1 1 29. of Vitamin A 200,000 I.U 0
breastfeeding
Infants 6 months old initiated to Infant 6-11 months old who completed
24. Preterm/LBW infants given iron supplementation 0 27. complementary feeding but no longer or 0 30. 0
never been breastfed MNP supplementation
Infants 6-11 months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 160 190 350 b. SAC, 5-9 years old dewormed (2 doses) 44 59 103
Page 28 of 77
 a. PSAC, 1-4 years old dewormed (2 doses) 22 30 52 c. Adolescents, 10-19 years old dewormed (2 doses) 94 101 195
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. Vitamin A 0 39. ORS with zinc 0
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. 0 41. 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 12 18 30 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. Smear 0
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: FEBRUARY YEAR: 2021
Name of Barangay: Oroc-Osoc
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User Dropout Current User New Acceptors
Acceptors (End of Month)
A2. Use of FP Method (Beginning of Month) (Present Month) (Present Month)
(Col. 1) Page 29 of 77
A2. Use of FP Method (Beginning of Month) New Acceptors Other Acceptors (Present Month) (Present Month)
(Previous Month) (Present Month) (Col.
(Col. 1) (Col. 2) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 15-19 20-49 (Col. 4) 10-14 15-19 20-49
Total Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 3 3 0 0 0 0 0 3 3 0
d. Pills-Total 0 0 6 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 6 0 0 0 0
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 6 6 0 0 0 0 0 6 6 0
e Injectables (DMPA/POI) 2 4 6 0 0 0 0 2 4 6 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 4 4 1 1 0 0 0 0 5 5 1 1
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 2 17 19 0 0 1 1 0 0 0 0 0 0 0 0 0 2 18 20 0 0 1 1
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. 0 0 1 1 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 1 1 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
4. No. of pregnant women for the 2nd or more times given at least 3 doses of Td 1 1 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2 Plus)
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation
No. of pregnant women who completed doses of calcium carbonate anemia
6. supplementation 2 2 16. No. of pregnant women screened for gestational diabetes 0
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 1 1 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 1 1 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 1 1
c. No. of live births with unknown birth weight 1 1 23. a. No. of vaginal deliveries 1 1
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 1 1
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. postpartum check-ups 1 1 27. No. of postpartum women with Vitamin A supplementation 1 1

26. No. of postpartum women who completed iron with folic acid supplementation 0

Page 30 of 77
 Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 1 1 8. OPV 1 0 15. MCV 1 1 1
2. CPAB 0 9. OPV 2 0 16. MCV 2 2 2
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 3 1 4 18. CIC 2 2
5. DPT-HiB-HepB 1 0 12. PCV 1 2 2 4 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 1 1 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 2 0 2 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition Services for Infants and Children
Infants 6 months old initiated to
23. Newborn initiated on breastfeeding immediately after 0 26. complementary feeding with continues 0 29. Children 12-59 months old given 2 doses 0
birth lasting to 90 minutes of Vitamin A 200,000 I.U
breastfeeding
Infants 6 months old initiated to Infant 6-11 months old who completed
24. Preterm/LBW infants given iron supplementation 0 27. complementary feeding but no longer or 0 30. MNP supplementation 0
never been breastfed
Infants 6-11 months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. Vitamin A 100,000 I.U 0 31. MNP supplementation 0
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 116 124 240 b. SAC, 5-9 years old dewormed (2 doses) 39 40 79
a. PSAC, 1-4 years old dewormed (2 doses) 32 25 57 c. Adolescents, 10-19 years old dewormed (2 doses) 45 59 104
C4. Management of Sick Infants and Children
33. Sick infants 6-11 months old seen 0 36. Sick children 12-59 months old received 0 39. Diarrhea cases 0-59 months old received 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
35. Sick children 12-59 months old seen 0 38. Diarrhea cases 0-59 months old received 0 41. Pneumonia cases 0-59 months completed 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
2. No. of deaths due to Rabies 0 4. No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 15 4 19 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
2. Current smokers 5 0 5 6. No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap 0
Smear
3. Alcohol binge drinkers 8 2 10 7. No. of women screened for breast mass 0
4. Overweight/Obese 2 2 4 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
Page 31 of 77
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 1 1

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: FEBRUARY YEAR: 2021
Name of Barangay: Paniman
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP Current0User
Current User Acceptors Dropout New Acceptors
(Beginning of Month) New Acceptors Other Acceptors (Present Month) (End of Month) (Present Month)
A2. Use of FP Method (Col.
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 15-19 20-49 (Col. 4) 10-14 15-19 20-49
Total Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 7 7 0 0 0 0 0 7 7 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-Total 0 0 53 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 53 0 0 1 1
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 53 53 0 0 0 0 0 53 53 1 1
e Injectables (DMPA/POI) 2 15 17 0 0 0 0 2 15 17 0
f. Implant 6 6 0 0 0 0 0 6 6 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 4 4 0 0 0 0 0 4 4 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 2 85 87 0 0 0 0 0 0 0 0 0 0 0 0 0 2 85 87 0 0 1 1
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
2. No. of pregnant women assessed of their nutritional status during the 1st 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0

Page 32 of 77
 No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. (Td2 Plus) 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0

No. of pregnant women who completed dose of iron with folic acid No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with
5. supplementation 0 15. anemia 0

6. No. of pregnant women who completed doses of calcium carbonate 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. postpartum check-ups 0 27. No. of postpartum women with Vitamin A supplementation 0
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 3 1 4 15. MCV 1 0
2. CPAB 0 9. OPV 2 1 4 5 16. MCV 2 0
3. BCG 0 10. OPV 3 1 3 4 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 2 4 6 18. CIC 0
5. DPT-HiB-HepB 1 3 1 4 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 4 2 6 13. PCV 2 2 0 2 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 2 2 14. PCV 3 1 0 1 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition Services for Infants and Children
Newborn initiated on breastfeeding immediately after Infants 6 months old initiated to Children 12-59 months old given 2 doses
23. 0 26. complementary feeding with continues 1 1 29. 0
birth lasting to 90 minutes breastfeeding of Vitamin A 200,000 I.U
Infants 6 months old initiated to
24. Preterm/LBW infants given iron supplementation 0 27. complementary feeding but no longer or 0 30. Infant 6-11 months old who completed 0
MNP supplementation
never been
Infants 6-11breastfed
months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 1 1 28. Vitamin A 100,000 I.U 0 31. MNP supplementation 0
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
33. Sick infants 6-11 months old seen 0 36. Sick children 12-59 months old received 0 39. Diarrhea cases 0-59 months old received 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. 0 41. 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0
Page 33 of 77
 E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. 0
Smear
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: FEBRUARY YEAR: 2021
Name of Barangay: Tabog
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User
Current User Acceptors Dropout (End of Month) New Acceptors
(Beginning of Month) New Acceptors Other Acceptors (Present Month) (Present Month)
A2. Use of FP Method (Col.
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 6)
15-19 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 1 1 0 0 0 0 0 1 1 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-Total 0 0 13 13 0 0 1 1 0 0 0 0 0 0 0 0 0 0 14 14 0 0 0 0
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 13 13 1 1 0 0 0 0 14 14 0
e Injectables (DMPA/POI) 8 8 0 0 0 0 0 8 8 0
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f. Implant 10 10 0 0 0 0 0 10 10 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 32 32 0 0 1 1 0 0 0 0 0 0 0 0 0 0 33 33 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 1 1
No. of pregnant women assessed of their nutritional status during the 1st
2. trimester 0 1 3 4 9. No. of pregnant women screened for syphilis 0

a. No. of pregnant women seen in the first trimester who have normal BMI 1 3 4 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. 1 1 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2 Plus)
No. of pregnant women who completed dose of iron with folic acid No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with
5. 0 15. 0
supplementation anemia
6. No. of pregnant women who completed doses of calcium carbonate 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
25. No. postpartum women together with their newborn who completed at least 2 0 27. No. of postpartum women with Vitamin A supplementation 0
postpartum check-ups

26. No. of postpartum women who completed iron with folic acid supplementation 0

Section C. Child Care and Services

Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 3 4 7 15. MCV 1 1 1 2

Page 35 of 77
2. CPAB 0 9. OPV 2 0 2 2 16. MCV 2 2 1 3
3. BCG 1 3 4 10. OPV 3 0 1 1 17. FIC 0 1 1
4. Hep B, within 24 hours 0 11. IPV 0 1 1 18. CIC 2 0 2
5. DPT-HiB-HepB 1 2 0 2 12. PCV 1 0 6 6 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 1 1 13. PCV 2 0 1 1 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 3 3 14. PCV 3 0 0 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition Services for Infants and Children
Infants 6 months old initiated to
23. Newborn initiated on breastfeeding immediately after 0 26. complementary feeding with continues 0 29. Children 12-59 months old given 2 doses 0
birth lasting to 90 minutes of Vitamin A 200,000 I.U
breastfeeding
Infants 6 months old initiated to
Infant 6-11 months old who completed
24. Preterm/LBW infants given iron supplementation 0 27. complementary feeding but no longer or 0 30. MNP supplementation 0
never been breastfed
Infants 6-11 months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. Vitamin A 100,000 I.U 0 31. MNP supplementation 0
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 98 103 201 b. SAC, 5-9 years old dewormed (2 doses) 15 32 47
a. PSAC, 1-4 years old dewormed (2 doses) 20 13 33 c. Adolescents, 10-19 years old dewormed (2 doses) 63 58 121
C4. Management of Sick Infants and Children
33. Sick infants 6-11 months old seen 0 36. Sick children 12-59 months old received 0 39. Diarrhea cases 0-59 months old received 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. ORS 0 41. treatment 0
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
2. No. of deaths due to Rabies 0 4. No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 8 11 19 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
2. Current smokers 3 0 3 6. No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap 0
Smear
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
b. No. of HHs with Level II
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

Page 36 of 77
1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0
2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: FEBRUARY YEAR: 2021
Name of Barangay: Consolidation
Name of BHS: Bikal
Name of Municipality/City: CARAMOAN I
Name of Province: CAMARINES SUR
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User Dropout Current User New Acceptors
New Acceptors Acceptors
Other Acceptors (End of Month)
A2. Use of FP Method (Beginning of Month) (Present Month) (Col. (Present Month)
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
2. No. of pregnant women assessed of their nutritional status during the 1st 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. (Td2 Plus) 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation
No. of pregnant women who completed doses of calcium carbonate anemia
6. supplementation 0 16. No. of pregnant women screened for gestational diabetes 0
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total

Page 37 of 77
 Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
25. No. postpartum women together with their newborn who completed at least 2 0 27. No. of postpartum women with Vitamin A supplementation 0
postpartum check-ups
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition Services for Infants
Infants 6 months old initiated to and Children
Newborn initiated on breastfeeding immediately after Children 12-59 months old given 2 doses
23. birth lasting to 90 minutes 0 26. complementary
Infants 6 monthsfeeding with continues
old initiated to 0 29. of Vitamin 0
24. Preterm/LBW infants given iron supplementation 0 27. breastfeeding feeding but no longer or
complementary 0 30. Infant 6-11Amonths
200,000 I.Uwho completed
old 0
Infants 6-11breastfed
months given 1 dose of MNP supplementation
Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. never been 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
33. Sick infants 6-11 months old seen 0 36. Sick children 12-59 months old received 0 39. Diarrhea cases 0-59 months old received 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. 0 41. 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
2. No. of deaths due to Rabies 0 4. No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
2. Current smokers 0 6. No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap 0
Smear
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0

Page 38 of 77
 Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0

Page 39 of 77
 FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Bikal
Name of BHS: Bikal
Name of Municipality/City: #REF!
Name of Province: #REF!
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) (Col. 3) (Col. 4)
10-14 15-19 20-49
1. No. of WRA with unmet need for modern FP 0
Acceptors Current User
Current User Dropout New Acceptors
(Beginning of Month) New Acceptors Other Acceptors (Present Month) (End of Month) (Present Month)
A2. Use of FP Method (Previous Month) (Present Month) (Col.
(Col. 1) (Col. 2) (Col. 5) (Col. 7)
(Col. 3) (Col. 4) 6)
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. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. trimester 0 0 0 0 9. No. of pregnant women screened for syphilis 0

a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0

4. No. of pregnant women for the 2nd or more times given at least 3 doses of Td 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2 Plus)
No. of pregnant women who completed dose of iron with folic acid No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with
5. 0 15. 0
supplementation anemia

Page 40 of 77
 No. of pregnant women who completed doses of calcium carbonate
6. supplementation 0 16. No. of pregnant women screened for gestational diabetes 0

7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. 0 27. No. of postpartum women with Vitamin A supplementation 0
postpartum check-ups

26. No. of postpartum women who completed iron with folic acid supplementation 0

Section C. Child Care and Services

Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition Services for Infants and Children
Infants 6 months old initiated to
23. Newborn initiated on breastfeeding immediately after 0 26. complementary feeding with continues 0 29. Children 12-59 months old given 2 doses 0
birth lasting to 90 minutes of Vitamin A 200,000 I.U
breastfeeding

Infants 6 months old initiated to

Infant 6-11 months old who completed
24. Preterm/LBW infants given iron supplementation 0 27. complementary feeding but no longer or 0 30. MNP supplementation 0
never been breastfed
Infants 6-11 months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. Vitamin A 0 39. ORS with zinc 0

34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0

35. Sick children 12-59 months old seen 0 38. Diarrhea cases 0-59 months old received 0 41. Pneumonia cases 0-59 months completed 0
ORS treatment

Page 41 of 77
 Section E. Infectious Disease Prevention & Control Services
1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. Smear 0
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0

4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0

Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0

Section G. Environmental Health and Sanitation Services

Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
b. No. of HHs with Level II
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)

2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit

3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0

3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Hanoy
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 3) (Col. 4)
1. No. of WRA with unmet need for modern FP Current0User
Current User Acceptors Dropout New Acceptors
(Beginning of Month) New Acceptors Other Acceptors (Present Month) (End of Month) (Present Month)
A2. Use of FP Method (Col.
(Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
(Col. 1)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
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b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
2. No. of pregnant women assessed of their nutritional status during the 1st 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. (Td2 Plus) 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation anemia
6. No. of pregnant women who completed doses of calcium carbonate 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. postpartum check-ups 0 27. No. of postpartum women with Vitamin A supplementation 0
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0

Page 43 of 77
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. 0 29. Children 12-59 months old given 2 doses 0
complementary
Infants 6 monthsfeeding with continues
old initiated to
birth lasting to 90 minutes breastfeeding of Vitamin
Infant 6-11Amonths
200,000 I.Uwho completed
old
24. Preterm/LBW infants given iron supplementation 0 27. complementary feeding but no longer or 0 30. MNP supplementation 0
Infants 6-11breastfed
never been months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. Vitamin A 0 39. ORS with zinc 0
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
35. Sick children 12-59 months old seen 0 38. Diarrhea cases 0-59 months old received 0 41. Pneumonia cases 0-59 months completed 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. 0
Smear
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
Page 44 of 77
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Haponan
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User
Current User Acceptors Dropout (End of Month) New Acceptors
(Beginning of Month) New Acceptors Other Acceptors (Present Month) (Present Month)
A2. Use of FP Method (Col.
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 15-19 20-49 (Col. 4) 10-14 15-19 20-49
Total Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
4. No. of pregnant women for the 2nd or more times given at least 3 doses of Td 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2 Plus)
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation
No. of pregnant women who completed doses of calcium carbonate anemia
6. 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0

Page 45 of 77
 a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. postpartum check-ups 0 27. No. of postpartum women with Vitamin A supplementation 0
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
Newborn initiated on breastfeeding immediately after Children 12-59 months old given 2 doses
23. birth lasting to 90 minutes 0 26. complementary
Infants 6 monthsfeeding with continues
old initiated to 0 29. of Vitamin 0
24. Preterm/LBW infants given iron supplementation 0 27. breastfeeding 0 30. Infant 6-11Amonths
200,000 I.Uwho completed
old 0
complementary feeding but no longer or MNP supplementation
Infants 6-11breastfed
never been months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. Vitamin A 0 39. ORS with zinc 0
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
35. Sick children 12-59 months old seen 0 38. Diarrhea cases 0-59 months old received 0 41. Pneumonia cases 0-59 months completed 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. 0
Smear
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0

Page 46 of 77
 Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Maqueda
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP Current0User
Current User Acceptors Dropout New Acceptors
(Beginning of Month) New Acceptors Other Acceptors (Present Month) (End of Month) (Present Month)
A2. Use of FP Method (Col.
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Page 47 of 77
 Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
2. No. of pregnant women assessed of their nutritional status during the 1st 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. (Td2 Plus) 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation anemia
6. No. of pregnant women who completed doses of calcium carbonate 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. postpartum check-ups 0 27. No. of postpartum women with Vitamin A supplementation 0
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. 0 29. Children 12-59 months old given 2 doses 0
complementary
Infants 6 monthsfeeding with continues
old initiated to
birth lasting to 90 minutes breastfeeding feeding but no longer or of Vitamin
Infant 6-11Amonths
200,000 I.Uwho completed
old
24. Preterm/LBW infants given iron supplementation 0 27. complementary 0 30. MNP supplementation 0
Infants 6-11breastfed
never been months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. 0 39. 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
35. Sick children 12-59 months old seen 0 38. Diarrhea cases 0-59 months old received 0 41. Pneumonia cases 0-59 months completed 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services

Page 48 of 77
 E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. Smear 0
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
b. No. of HHs with Level II
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Oroc-Osoc
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User Dropout Current User New Acceptors
New Acceptors Acceptors
Other Acceptors (End of Month)
A2. Use of FP Method (Beginning of Month) (Present Month) (Col. (Present Month)
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
Page 49 of 77
 d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. (Td2 Plus) 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation anemia
6. No. of pregnant women who completed doses of calcium carbonate 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
25. No. postpartum women together with their newborn who completed at least 2 0 27. No. of postpartum women with Vitamin A supplementation 0
postpartum check-ups
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0

Page 50 of 77
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. 0 29. Children 12-59 months old given 2 doses 0
birth lasting to 90 minutes complementary
Infants 6 monthsfeeding with continues
old initiated to of Vitamin
24. Preterm/LBW infants given iron supplementation 0 27. breastfeeding feeding but no longer or
complementary 0 30. Infant 6-11Amonths
200,000 I.Uwho completed
old 0
Infants 6-11breastfed
months given 1 dose of MNP supplementation
Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. never been 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
33. Sick infants 6-11 months old seen 0 36. Sick children 12-59 months old received 0 39. Diarrhea cases 0-59 months old received 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. 0 41. 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
2. No. of deaths due to Rabies 0 4. No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
2. Current smokers 0 6. No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap 0
Smear
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Paniman
Page 51 of 77
 Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User Dropout Current User New Acceptors
New Acceptors Acceptors
Other Acceptors (End of Month)
A2. Use of FP Method (Beginning of Month) (Present Month) (Col. (Present Month)
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. trimester 0 0 0 0 9. No. of pregnant women screened for syphilis 0
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
4. No. of pregnant women for the 2nd or more times given at least 3 doses of Td 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2 Plus)
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation
No. of pregnant women who completed doses of calcium carbonate anemia
6. supplementation 0 16. No. of pregnant women screened for gestational diabetes 0
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0

Page 52 of 77
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
25. No. postpartum women together with their newborn who completed at least 2 0 27. No. of postpartum women with Vitamin A supplementation 0
postpartum check-ups
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. 0 29. Children 12-59 months old given 2 doses 0
birth lasting to 90 minutes complementary
Infants 6 monthsfeeding with continues
old initiated to of Vitamin
24. Preterm/LBW infants given iron supplementation 0 27. breastfeeding
complementary feeding but no longer or 0 30. Infant 6-11Amonths
200,000 I.Uwho completed
old 0
Infants 6-11breastfed
months given 1 dose of MNP supplementation
Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. never been 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. Vitamin A 0 39. ORS with zinc 0
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. 0 41. 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. Smear 0
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0

Page 53 of 77
 Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
b. No. of HHs with Level II
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Tabog
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User Dropout Current User New Acceptors
New Acceptors Acceptors
Other Acceptors (End of Month)
A2. Use of FP Method (Beginning of Month) (Present Month) (Col. (Present Month)
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
Page 54 of 77
 b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2
No. ofPlus)
pregnant women who completed dose of iron with folic acid No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with
5. 0 15. 0
supplementation
No. of pregnant women who completed doses of calcium carbonate anemia
6. supplementation 0 16. No. of pregnant women screened for gestational diabetes 0
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. 0 27. No. of postpartum women with Vitamin A supplementation 0
postpartum check-ups
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition Services for Infants
Infants 6 months old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. complementary 0 29. Children 12-59 months old given 2 doses 0
birth lasting to 90 minutes Infants 6 monthsfeeding with continues
old initiated to of Vitamin
Infant 6-11Amonths
200,000 I.Uwho completed
old
24. Preterm/LBW infants given iron supplementation 0 27. breastfeeding feeding but no longer or
complementary 0 30. 0
Infants 6-11breastfed
never been months given 1 dose of MNP supplementation
Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. 0 39. 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. ORS 0 41. treatment 0
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

Page 55 of 77
1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. Smear 0
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: #REF!
Name of Barangay: Consolidation
Name of BHS: Bikal
Name of Municipality/City: CARAMOAN I
Name of Province: CAMARINES SUR
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User Dropout Current User New Acceptors
New Acceptors Acceptors
Other Acceptors (End of Month)
A2. Use of FP Method (Beginning of Month) (Present Month) (Col. (Present Month)
(Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
(Col. 1)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0

Page 56 of 77
 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
2. No. of pregnant women assessed of their nutritional status during the 1st 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. (Td2 Plus) 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation anemia
6. No. of pregnant women who completed doses of calcium carbonate 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. postpartum check-ups 0 27. No. of postpartum women with Vitamin A supplementation 0
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0

Page 57 of 77
 C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. 0 29. Children 12-59 months old given 2 doses 0
complementary
Infants 6 monthsfeeding with continues
old initiated to
birth lasting to 90 minutes breastfeeding of Vitamin
Infant 6-11Amonths
200,000 I.Uwho completed
old
24. Preterm/LBW infants given iron supplementation 0 27. complementary feeding but no longer or 0 30. 0
Infants 6-11 months given 1 dose of MNP supplementation
Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. never been breastfed 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
33. Sick infants 6-11 months old seen 0 36. Sick children 12-59 months old received 0 39. Diarrhea cases 0-59 months old received 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. 0 41. 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
2. No. of deaths due to Rabies 0 4. No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
2. Current smokers 0 6. No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap 0
Smear
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0

Page 58 of 77
 FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Bikal
Name of BHS: Bikal
Name of Municipality/City: #REF!
Name of Province: #REF!
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) (Col. 3) (Col. 4)
10-14 15-19 20-49
1. No. of WRA with unmet need for modern FP 0
Acceptors Current User
Current User Dropout New Acceptors
(Beginning of Month) New Acceptors Other Acceptors (Present Month) (End of Month) (Present Month)
A2. Use of FP Method (Previous Month) (Present Month) (Col.
(Col. 1) (Col. 2) (Col. 5) (Col. 7)
(Col. 3) (Col. 4) 6)
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. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. trimester 0 0 0 0 9. No. of pregnant women screened for syphilis 0

a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0

4. No. of pregnant women for the 2nd or more times given at least 3 doses of Td 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2 Plus)
No. of pregnant women who completed dose of iron with folic acid No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with
5. 0 15. 0
supplementation anemia

Page 59 of 77
 No. of pregnant women who completed doses of calcium carbonate
6. supplementation 0 16. No. of pregnant women screened for gestational diabetes 0

7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. 0 27. No. of postpartum women with Vitamin A supplementation 0
postpartum check-ups

26. No. of postpartum women who completed iron with folic acid supplementation 0

Section C. Child Care and Services

Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition Services for Infants and Children
Infants 6 months old initiated to
23. Newborn initiated on breastfeeding immediately after 0 26. complementary feeding with continues 0 29. Children 12-59 months old given 2 doses 0
birth lasting to 90 minutes of Vitamin A 200,000 I.U
breastfeeding

Infants 6 months old initiated to

Infant 6-11 months old who completed
24. Preterm/LBW infants given iron supplementation 0 27. complementary feeding but no longer or 0 30. MNP supplementation 0
never been breastfed
Infants 6-11 months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. Vitamin A 0 39. ORS with zinc 0

34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0

35. Sick children 12-59 months old seen 0 38. Diarrhea cases 0-59 months old received 0 41. Pneumonia cases 0-59 months completed 0
ORS treatment

Page 60 of 77
 Section E. Infectious Disease Prevention & Control Services
1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. Smear 0
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0

4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0

Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0

Section G. Environmental Health and Sanitation Services

Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
b. No. of HHs with Level II
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)

2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit

3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0

3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Hanoy
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 3) (Col. 4)
1. No. of WRA with unmet need for modern FP Current0User
Current User Acceptors Dropout New Acceptors
(Beginning of Month) New Acceptors Other Acceptors (Present Month) (End of Month) (Present Month)
A2. Use of FP Method (Col.
(Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
(Col. 1)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
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b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
2. No. of pregnant women assessed of their nutritional status during the 1st 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. (Td2 Plus) 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation anemia
6. No. of pregnant women who completed doses of calcium carbonate 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. postpartum check-ups 0 27. No. of postpartum women with Vitamin A supplementation 0
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0

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2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. 0 29. Children 12-59 months old given 2 doses 0
complementary
Infants 6 monthsfeeding with continues
old initiated to
birth lasting to 90 minutes breastfeeding of Vitamin
Infant 6-11Amonths
200,000 I.Uwho completed
old
24. Preterm/LBW infants given iron supplementation 0 27. complementary feeding but no longer or 0 30. MNP supplementation 0
Infants 6-11breastfed
never been months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. Vitamin A 0 39. ORS with zinc 0
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
35. Sick children 12-59 months old seen 0 38. Diarrhea cases 0-59 months old received 0 41. Pneumonia cases 0-59 months completed 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. 0
Smear
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
Page 63 of 77
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Haponan
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User
Current User Acceptors Dropout (End of Month) New Acceptors
(Beginning of Month) New Acceptors Other Acceptors (Present Month) (Present Month)
A2. Use of FP Method (Col.
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 15-19 20-49 (Col. 4) 10-14 15-19 20-49
Total Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
4. No. of pregnant women for the 2nd or more times given at least 3 doses of Td 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2 Plus)
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation
No. of pregnant women who completed doses of calcium carbonate anemia
6. 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0

Page 64 of 77
 a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. postpartum check-ups 0 27. No. of postpartum women with Vitamin A supplementation 0
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
Newborn initiated on breastfeeding immediately after Children 12-59 months old given 2 doses
23. birth lasting to 90 minutes 0 26. complementary
Infants 6 monthsfeeding with continues
old initiated to 0 29. of Vitamin 0
24. Preterm/LBW infants given iron supplementation 0 27. breastfeeding 0 30. Infant 6-11Amonths
200,000 I.Uwho completed
old 0
complementary feeding but no longer or MNP supplementation
Infants 6-11breastfed
never been months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. Vitamin A 0 39. ORS with zinc 0
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
35. Sick children 12-59 months old seen 0 38. Diarrhea cases 0-59 months old received 0 41. Pneumonia cases 0-59 months completed 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. 0
Smear
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0

Page 65 of 77
 Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Maqueda
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP Current0User
Current User Acceptors Dropout New Acceptors
(Beginning of Month) New Acceptors Other Acceptors (Present Month) (End of Month) (Present Month)
A2. Use of FP Method (Col.
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Page 66 of 77
 Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
2. No. of pregnant women assessed of their nutritional status during the 1st 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. (Td2 Plus) 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation anemia
6. No. of pregnant women who completed doses of calcium carbonate 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. postpartum check-ups 0 27. No. of postpartum women with Vitamin A supplementation 0
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. 0 29. Children 12-59 months old given 2 doses 0
complementary
Infants 6 monthsfeeding with continues
old initiated to
birth lasting to 90 minutes breastfeeding feeding but no longer or of Vitamin
Infant 6-11Amonths
200,000 I.Uwho completed
old
24. Preterm/LBW infants given iron supplementation 0 27. complementary 0 30. MNP supplementation 0
Infants 6-11breastfed
never been months given 1 dose of Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. 0 39. 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
35. Sick children 12-59 months old seen 0 38. Diarrhea cases 0-59 months old received 0 41. Pneumonia cases 0-59 months completed 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services

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 E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. Smear 0
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
b. No. of HHs with Level II
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Oroc-Osoc
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User Dropout Current User New Acceptors
New Acceptors Acceptors
Other Acceptors (End of Month)
A2. Use of FP Method (Beginning of Month) (Present Month) (Col. (Present Month)
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
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 d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. (Td2 Plus) 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation anemia
6. No. of pregnant women who completed doses of calcium carbonate 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
25. No. postpartum women together with their newborn who completed at least 2 0 27. No. of postpartum women with Vitamin A supplementation 0
postpartum check-ups
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0

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5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. 0 29. Children 12-59 months old given 2 doses 0
birth lasting to 90 minutes complementary
Infants 6 monthsfeeding with continues
old initiated to of Vitamin
24. Preterm/LBW infants given iron supplementation 0 27. breastfeeding feeding but no longer or
complementary 0 30. Infant 6-11Amonths
200,000 I.Uwho completed
old 0
Infants 6-11breastfed
months given 1 dose of MNP supplementation
Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. never been 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
33. Sick infants 6-11 months old seen 0 36. Sick children 12-59 months old received 0 39. Diarrhea cases 0-59 months old received 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. 0 41. 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
2. No. of deaths due to Rabies 0 4. No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
2. Current smokers 0 6. No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap 0
Smear
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Paniman
Page 70 of 77
 Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User Dropout Current User New Acceptors
New Acceptors Acceptors
Other Acceptors (End of Month)
A2. Use of FP Method (Beginning of Month) (Present Month) (Col. (Present Month)
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. trimester 0 0 0 0 9. No. of pregnant women screened for syphilis 0
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
4. No. of pregnant women for the 2nd or more times given at least 3 doses of Td 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2 Plus)
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation
No. of pregnant women who completed doses of calcium carbonate anemia
6. supplementation 0 16. No. of pregnant women screened for gestational diabetes 0
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0

Page 71 of 77
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
25. No. postpartum women together with their newborn who completed at least 2 0 27. No. of postpartum women with Vitamin A supplementation 0
postpartum check-ups
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. 0 29. Children 12-59 months old given 2 doses 0
birth lasting to 90 minutes complementary
Infants 6 monthsfeeding with continues
old initiated to of Vitamin
24. Preterm/LBW infants given iron supplementation 0 27. breastfeeding
complementary feeding but no longer or 0 30. Infant 6-11Amonths
200,000 I.Uwho completed
old 0
Infants 6-11breastfed
months given 1 dose of MNP supplementation
Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. never been 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. Vitamin A 0 39. ORS with zinc 0
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. 0 41. 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. Smear 0
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0

Page 72 of 77
 Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
b. No. of HHs with Level II
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: 2021
Name of Barangay: Tabog
Name of BHS: Bikal
Name of Municipality/City: Caramoan
Name of Province: Cam. Sur
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User Dropout Current User New Acceptors
New Acceptors Acceptors
Other Acceptors (End of Month)
A2. Use of FP Method (Beginning of Month) (Present Month) (Col. (Present Month)
(Col. 1) (Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
No. of pregnant women assessed of their nutritional status during the 1st
2. 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
Page 73 of 77
 b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
(Td2
No. ofPlus)
pregnant women who completed dose of iron with folic acid No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with
5. 0 15. 0
supplementation
No. of pregnant women who completed doses of calcium carbonate anemia
6. supplementation 0 16. No. of pregnant women screened for gestational diabetes 0
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. 0 27. No. of postpartum women with Vitamin A supplementation 0
postpartum check-ups
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0
C2. Nutrition Services for Infants
Infants 6 months old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. complementary 0 29. Children 12-59 months old given 2 doses 0
birth lasting to 90 minutes Infants 6 monthsfeeding with continues
old initiated to of Vitamin
Infant 6-11Amonths
200,000 I.Uwho completed
old
24. Preterm/LBW infants given iron supplementation 0 27. breastfeeding feeding but no longer or
complementary 0 30. 0
Infants 6-11breastfed
never been months given 1 dose of MNP supplementation
Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
Sick children 12-59 months old received Diarrhea cases 0-59 months old received
33. Sick infants 6-11 months old seen 0 36. 0 39. 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. ORS 0 41. treatment 0
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

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1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and
2. No. of deaths due to Rabies 0 4. 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap
2. Current smokers 0 6. Smear 0
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0
FHSIS REPORT for the MONTH: January YEAR: #REF!
Name of Barangay: Consolidation
Name of BHS: Bikal
Name of Municipality/City: CARAMOAN I
Name of Province: CAMARINES SUR
Projected Population of the Year:
For submission to RHU/MHC
Section A. Family Planning Services for Women of Reproductive Age
Age Total for WRA 15-49
A1. Modern FP Unmet Need (Col. 2) Remarks
(Col. 1) 10-14 15-19 20-49 (Col. 4)
(Col. 3)
1. No. of WRA with unmet need for modern FP 0
Current User Dropout Current User New Acceptors
New Acceptors Acceptors
Other Acceptors (End of Month)
A2. Use of FP Method (Beginning of Month) (Present Month) (Col. (Present Month)
(Col. 2) (Previous Month) (Present Month) (Col. 5) (Col. 7)
(Col. 1)
10-14 15-19 20-49 Total 10-14 15-19 (Col. 20-49
3) Total 10-14 (Col. 4)
15-19 20-49 Total 10-14 15-19 20-49 Total 10-14 15-19 6) 20-49 Total 10-14 15-19 20-49 Total
a. Bilateral Tubal Ligation 0 0 0 0 0 0 0 0 0
b. Non-Scalpel Vasectomy 0 0 0 0 0 0 0 0 0
c. Condom 0 0 0 0 0 0 0 0 0
d. Pills-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
d.1 Pills-POP 0 0 0 0 0 0 0 0 0
d.2 Pills-COC 0 0 0 0 0 0 0 0 0
e Injectables (DMPA/POI) 0 0 0 0 0 0 0 0 0
f. Implant 0 0 0 0 0 0 0 0 0

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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. IUD (IUD-I and IUD-PP)-Total 0
0 0 0 0 0 0
g.1 IUD-I 0 0 0 0 0 0 0 0 0
g.2 IUD-PP 0 0 0 0 0 0 0 0 0
h. NFP-LAM 0 0 0 0 0 0 0 0 0
i. NFP-BBT 0 0 0 0 0 0 0 0 0
j. NFP-CMM 0 0 0 0 0 0 0 0 0
k. NFP-STM 0 0 0 0 0 0 0 0 0
l. NFP-SDM 0 0 0 0 0 0 0 0 0
m. Total Current Users 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Section B. Maternal Care and Services
By Age Group By Age Group
Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.1 Prenatal Care
1. No. of pregnant women with at least 4 prenatal visits 0 8. No. of pregnant women given one dose of deworming tablet 0
2. No. of pregnant women assessed of their nutritional status during the 1st 0 0 0 0 9. No. of pregnant women screened for syphilis 0
trimester
a. No. of pregnant women seen in the first trimester who have normal BMI 0 10. No. of pregnant women tested positive for syphilis 0
b. No. of pregnant women seen in the first trimester who have low BMI 0 11. No. of pregnant women screened for Hepatitis B 0
c. No. of pregnant women seen in the first trimester who have high BMI 0 12. No. of pregnant women tested positive for Hepatitis B 0
3. No. of pregnant women for the first time given at least 2 doses of Td 0 13. No. of pregnant women screened for HIV 0
No. of pregnant women for the 2nd or more times given at least 3 doses of Td
4. (Td2 Plus) 0 14. No. of pregnant women tested for CBC or Hgb & Hct count 0
5. No. of pregnant women who completed dose of iron with folic acid 0 15. No. of pregnant women tested for CBC or Hgb & Hct count diagnosed with 0
supplementation anemia
6. No. of pregnant women who completed doses of calcium carbonate 0 16. No. of pregnant women screened for gestational diabetes 0
supplementation
7. No. of pregnant women given iodine capsule 0 17. No. of pregnant women tested positive for gestational diabetes 0

By Age Group By Age Group

Maternal Care Indicators Maternal Care Indicators
10-14 15-19 20-49 Total 10-14 15-19 20-49 Total
Section B.2 Intra-Partum Care and Delivery Outcome
18. No. of deliveries 0 21. No. of Health Facility-Based Deliveries 0 0 0 0
19. No. of Live births 0 0 0 0 a. No. of deliveries in public health facility 0
a. No. of live births with normal birth weight 0 b. No. of deliveries in private health facility 0
b. No. of live births with low birth weight 0 22. No. of Non-Facility-Based Deliveries 0
c. No. of live births with unknown birth weight 0 23. a. No. of vaginal deliveries 0
20. No. of deliveries attended by skilled health professionals 0 0 0 0 b. No. of deliveries by cesarean section 0
a. No. of deliveries attended by a doctor 0 24. a. No. of full-term births 0
b. No. of deliveries attended by a nurse 0 b. No. of pre-term births 0
c. No. of deliveries attended by a midwife 0 c. No. of fetal deaths 0
d. No. of abortion/miscarriage 0
Section B.3 Post-Partum and Newborn Care
No. postpartum women together with their newborn who completed at least 2
25. postpartum check-ups 0 27. No. of postpartum women with Vitamin A supplementation 0
26. No. of postpartum women who completed iron with folic acid supplementation 0
Section C. Child Care and Services
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total
C1. Immunization Services for Newborns, Infants and School-Aged Children/Adolescents
1. Livebirths 0 8. OPV 1 0 15. MCV 1 0
2. CPAB 0 9. OPV 2 0 16. MCV 2 0
3. BCG 0 10. OPV 3 0 17. FIC 0
4. Hep B, within 24 hours 0 11. IPV 0 18. CIC 0
5. DPT-HiB-HepB 1 0 12. PCV 1 0 19. Td, Grade 1 (November) 0
6. DPT-HiB-HepB 2 0 13. PCV 2 0 20. MR, Grade 1 (November) 0
7. DPT-HiB-HepB 3 0 14. PCV 3 0 21. Td, Grade 7 (November) 0
22. MR, Grade 7 (November) 0

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 C2. Nutrition
Infants 6 monthsServices for Infants
old initiated to and Children
23. Newborn initiated on breastfeeding immediately after 0 26. 0 29. Children 12-59 months old given 2 doses 0
complementary
Infants 6 monthsfeeding with continues
old initiated to
birth lasting to 90 minutes breastfeeding of Vitamin
Infant 6-11Amonths
200,000 I.Uwho completed
old
24. Preterm/LBW infants given iron supplementation 0 27. complementary feeding but no longer or 0 30. 0
Infants 6-11 months given 1 dose of MNP supplementation
Children 12-23 months who completed
25. Infants exclusively breastfed until 6th month 0 28. never been breastfed 0 31. 0
Vitamin A 100,000 I.U MNP supplementation
C3. Deworming Services for Infants, Children and Adolescents
32. 1-19 years old given 2 doses of deworming drug 0 0 0 b. SAC, 5-9 years old dewormed (2 doses) 0
a. PSAC, 1-4 years old dewormed (2 doses) 0 c. Adolescents, 10-19 years old dewormed (2 doses) 0
C4. Management of Sick Infants and Children
33. Sick infants 6-11 months old seen 0 36. Sick children 12-59 months old received 0 39. Diarrhea cases 0-59 months old received 0
Vitamin A ORS with zinc
34. Sick infants 6-11 months old received Vitamin A 0 37. Diarrhea cases 0-59 months old seen 0 40. Pneumonia cases 0-59 months old 0
Diarrhea cases 0-59 months old received Pneumonia cases 0-59 months completed
35. Sick children 12-59 months old seen 0 38. 0 41. 0
ORS treatment
Section E. Infectious Disease Prevention & Control Services
E3. Soil Transmitted Helminthiasis Prevention and Control Male Female Total E5. Tuberculosis Prevention and Control Male Female Total

1. No. of WRA 20-49 years old who completed 2 doses of deworming tablet 0 1. No. of notified TB cases, all forms 0

E8. Rabies Prevention and Control Male Female Total 2. No. of registered bacteriologicaly confirmed drug resistant TB (RR/MDR-TB Cases) 0

1. No. of animal bites 0 3. No. of TB, all forms that are cured and completely treated 0
2. No. of deaths due to Rabies 0 4. No. of registered bacteriology confirmed drug resistant TB Cases (RR/MDR-TB) cured and 0
completed treatment
Section F. Non-Communicable Disease Prevention and Control Services
Promotion of Healthy Lifestyle Male Female Total Cancer Male Female Total
1. No. of adults risk-assessed using PhilPEN 0 5. No. of adult women screened for Cervical Cancer using VIA/Pap Smear 0
2. Current smokers 0 6. No. of adult women found positive / suspect for Cervical Cancer using VIA/Pap 0
Smear
3. Alcohol binge drinkers 0 7. No. of women screened for breast mass 0
4. Overweight/Obese 0 8. No. of women with suspicious breast mass 0
Cardio Vascular Disease Male Female Total Diabetes Mellitus Male Female Total
9. No. of newly-identified hypertensive adults 0 10. No. newly-identified adults with Type 2 DM 0
Eye Blindness Male Female Total SC Immunization Male Female Total
11. No. of senior citizens screened for visual acuity 0 13. No. of senior citizens who received one (1) dose of PPV 0
12. No. of senior citizens diagnosed with eye disease/s 0 14. No. of senior citizens who received one (1) dose of influenza vaccine 0
Section G. Environmental Health and Sanitation Services
Indicators Total Remarks Indicators Total Remarks
1. No. of HHs with access to basic safe water supply 0 4. No. of HHs with basic sanitation facility 0
a. No. of HHs with Level I a. No. of HHs with pour/flush toilet connected to septic tank
b. No. of HHs with Level II b. No. of HHs with pour/flush toilet connected to community sewer/sewerage
system or any other approved treatment system
c. No. of HHs with Level III c. No. of HHs with ventilated improved pit latrine (VIP)
2 No. of HHs using safely managed drinking water services 5. No. of industrial establishments issued with sanitary permit
3. No. of HHs using safely managed sanitation services 6. No. of barangays declared ZOD
Section H. Mortality Section I. Natality
Indicators Male Female Total Indicators Male Female Total Indicators Male Female Total

1. Total Deaths 0 5. Neonatal Deaths 0 1. Livebirths 0 0 0

2. Maternal Deaths 0 6. Fetal Deaths 0 a. Livebirths among 15-19 y/o women 0
3. Under-five Deaths 0 7. Early Neonatal Deaths 0 b. No. of livebirths w/ low birth weight 0
4. Infant Deaths 0 8. Perinatal Deaths 0 0 0

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