ffirtfi[. lAlJ,ll,lL'. FHSIS REPORT for the QUARTER: YEAR: 2n ta. Municipality/City
Name: Province: Projected Popu. FHSISvg,Nl2. Q{R.I{ L'. - .Mo{TDIt"N.rflL C.,!
FHSISvg,Nl2
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FHSIS REPORT for the QUARTER:
Municipality/City Name:
lAlJ,ll,lL'
lndicators Col.
R.I{ L'
Projected Popu
Province:
-
Deliveries
Q{
2n ta
YEAR:
I
.Mo{TDIt"N.rflL
C.,!IR"U -
Elig. Pop.
No.
%
Col.2
Co[3
Col.4
lnterpretation
Recommendation/ ActionsTaken
Col.5
Cot.6
*
Pregnant women with 4 or more prenatal visits
*
Pregnant women given 2 doses of Tetanus Toxoid
Pregnant Women given TT2plus
1,4{, *
l?%
.jsu
tz%
4{
S
2.q 7
!
Pregnantwomen given complete iron with folic acid supplementation
t rlt
S
t,.7
Post partum women with at least 2 post-partum visits?
a6S
Post partum women given complete iron supplementation
e64
ll
Proportion of Post partum women given Mtamin A
supplementationf
I u1t--l-1 \wq-t\n
witt""-' fu,lrl""1
^fl*
Proportion Post partum wOmen initiated breastfeeding within t hour after giving birth
t
*6 L/
(
l+a9
0hU/ A We\4
10-49 years old women given lron supplementation? 0v1t.e rs&\wt\e okr,b Etigible Poputation: Jf,TP x 2.7o/o'
I
664
r,uhl gv\e 4dB
Panonl
24fr s3 h
No* AY
/ru
4fi
ff
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ff"{fl
4,ts -- ?gb
FfrSrS v. 2012. Q Form
-
lndicators
Current User (Beg. of Quarter)
ruI.MILY
PL.,4.N.ATTATG. cPR = (Cot.
6lfP
x12.325o/ol
Recom mendation/Actions Taken
Col.9
a. Female Ster/BTL
FHSIS
-
CIIILD
Col.
lnfants given BCG
I
Number
Pop.
Male
Col.2
Col.3
\.81-/-.-
Q w/in 24 hours
lnfants given Hepatitis B1C
> 24 hours
ffvL\3
€
I
o
ls7
1
lnfants given PENTAC
Proportion of lnfant given OPV
C
Proportion of lnfants given MCVQ
Female Col. 1
')
g? b
134
l*
3 :to
rfl
o5 o fI o o-o ;\l -{= o)cL FO'
9e
1
o o
F q)
oJ :, I o-a -r3CL A,. x0, otrL ,o r.
I5
G.
!r lo
o o) o
-co
FfISIS v. 2012- Q Form (page7of 8)
- DISE,flSE CO.NTROL -
