FHSIS Recording and Reporting

Tools in Data Quality Check

DQC Workshop for Selected

FP/MNCHN Indicators
 Data Management Process

Recording of Health Services

Data consolidation and analysis

PROGRAM
INDICATORS Data utilization
FP/MNCHN
(National/Regional
Level)
Planning & Budgeting
Policy Formulation or Updating
Development of Interventions
 Components of FHSIS 2012

 Recording Tools
 Reporting Tools
Components of FHSIS ver. 2012
 Recording Tools - Facility-based
documents with more detailed data and
contains day to day activities of the health
workers. Source of data is the services
delivered to patients/clients.
 IndividualTreatment Record (ITR)
 Target Client List (TCL)
 Summary Table (ST)
 Monthly Consolidation Table (MCT)
 1. ITR
The Individual Treatment Record (ITR) is a
document, form or piece of paper where the
date, name, address of patient, presenting
symptoms or complaint of the patient on
consultation and the diagnosis (if available),
treatment and date of treatment are
recorded. This record will be maintained as
part of the system of records at each health
facility on all patients seen.
 Sample ITR
DELA CRUZ, ROSE M.

2106 Rizal Avenue, Siniloan, Laguna

Age: 32 years
Birthday: February 7, 1980
Religion: Catholic
Weight: 52 kg
Occupation: Housekeeper

4/15/2012
Complaint: Headache & vomiting
Vital signs: BP = 120/80 mmHG
Diagnosis:
Treatment/Recommendations:
 ITRs under the FHSIS
1 Management of the Sick Young Infant Age 1 Week up to 2 Months

2 Management of the Sick Child Age 2 Months up to 5 Years

3 Children Under-Five Years of Age with Health Problems other than IMCI
Classification / Other Children / Adults

4 Maternal Client Record for Prenatal Care

5 Maternal Client Record for Post-partum and Neonatal Care
6 Family Planning Service Record
7 Dental Health Program – Form 1
8 TB Program – Individual Treatment Card
9 ITR for Malaria Prevention and Control Program
10 ITR for the Leprosy Prevention and Control Program
11 ITR for the Schistosomiasis Prevention and Control Program
12 ITR for the Filariasis Prevention and Control Program
 2. Target Client List (TCL)

Target Client List (TCL)

Description: Summary lists of focus
groups culled from the ITRs or FP1s
specifically formatted (Prenatal Care, Post-
Partum Care, Under 1 Year Old Children,
Family Planning, Sick Children, NTP TB
Register, National Leprosy Control Program
Form 2 or Central Registration Form)
 Target Client Lists constitute the second recording
tool of the FHSIS and are intended to serve several
purposes:
 Enables the midwife or nurse to plan and carry out patient
care and service delivery.
 To monitor service delivery to groups of patients identified
as “targets” or “eligibles” for a particular health program.
 To facilitate the monitoring and supervision of service
delivery activities, report services delivered.
 To provide a clinic-level database which can be accessed
for further studies.
 Target Client Lists to be maintained in the FHSIS version
2012 are as follows:
 Target Client List for Prenatal Care
 Target Client List for Post-Partum Care
 Target Client List for Nutrition and Expanded Program for
Immunization
 Target Client List for Family Planning
 Target Client List for Sick Children

 Registry Forms for Filariasis, Leprosy, Malaria,

Schistosomiasis and Tuberculosis shall be the source for all
Disease Control Indicators instead of a separate TCL.
 TCL Sample
TCL-PN TARGET CLIENT LIST FOR PRENATAL CARE
DATE OF FAMILY D AT E
REGIS- SERIAL LMP EDC PRENATAL VISITS
NAME ADDRESS AGE mm/dd/yy (mm/dd/yy)
TRATION NO. (8)

mm/dd/yy G-P FIRST SECOND THIRD

(1) (2) (3) (4) (5) (6) (7) TRIMESTER TRIMESTER TRIMESTER
 TCL Sample
TARGET CLIENT LIST FOR PRENATAL CARE

DATE TETANUS TOXOID VACCINE MICRONUTRIENT SUPPLEMENTATION STI SURVEILLANCE PREGNANCY LIVEBIRTHS
TETANUS GIVEN (11) (12) (13) (14)
RESULT REMARKS
STATUS (10) DATE & NUMBER TESTED GIVEN OUT- BIRTH PLACE OF
FOR SY DATE
(9) IRON W/ FOLIC ACID FOR SY
TESTING
PENICILLIN COME*/G WEIGHT ATTENDED
TERMI- Health
Y/N ender NID BY***
TT1 TT2 TT3 TT4 TT5 WAS GIVEN DATE (+/-) / DATE
Date
NATED (grams) Facility**
(M/F) (15)
 3. Summary Table (ST)

 The Summary Tables is a form with 12-

month columns retained at the facility
(BHS) where the midwife records all
monthly data. The Summary Table is
composed of
 Health Program Accomplishment;
 Morbidity Diseases.
 ST - Health Program Accomplishment – the midwife
records a summary of all the data from TCL or registries.
 Easy source of summary data for reports being prepared by the
midwife.
 Need to keep this updated as this can serve as proof of
accomplishments to show LGU officials whenever they visit the
facility.
 Serves as the data source for any survey, special study, or
research that may include the facility. This can serve as a tool for
the midwife to assess her own accomplishments.
 Basis for evidence based response/actions
 ST-Morbidity Diseases – the midwife
accomplishes this table on a monthly
basis.
 source of ten leading causes of morbidity and
reportable disease for the municipality/city.
 help the Health Centers staff get the monthly
trend of diseases
 basis for evidence based response/actions
 Summary Table
for
BARANGAY
NAME OF BARANGAY:
NAME OF HEALTH CENTER:
MUNICIPALITY OF:
PROVINCE/CITY:
REGION:
2.13.1 MATERNAL CARE - PRENATAL and POSTPARTUM CARE
INDICATORS TARGET JAN FEB MAR 1st Q APR MAY JUNE 2nd Q JULY AUG SEPT 3rd Q OCT NOV DEC 4th Q TOTAL

PRENATAL CARE

1. Pregnant women with 4 or

more prenatal visits
2. Pregnant women given
2 doses of TT
3. Pregnant women given
TT2 plus
4. Pregnant women given
complete iron with folic acid

POSTPARTUM CARE

1. Postpartum women with

at least 2 PPV

2. Postpartum women

given complete iron

3. Women 10-49 years old

given Iron supplementation

4. Postpartum women

given Vitamin A

5. Postpartum women

initiated breastfeeding

STI SURVEILLANCE

1. No. of pregnant women seen

2. No. of pregnant women

tested for syphilis

3. No. of pregnant women

positive for syphilis

4. No. of pregnant women (+)

for syphilis given Penicillin

2.13.2 FAMILY PLANNING (Part 1 of 2)
INDICATORS TARGET JAN FEB MAR 1st Q APR MAY JUNE 2nd Q JULY AUG SEPT 3rd Q OCT NOV DEC 4th Q TOTAL

1. Current Users Beginning

► Female Sterilization

► Male Sterilization

► Pills

► IUD (PP-IUD/ I-IUD)

► Injectables (DMPA/CIC)

► NFP-CM

► NFP-BBT

► NFP-STM

► NFP-SDM

► NFP-LAM

► Condom

► Implant

2. Total New Acceptors

► Female Sterilization
► Male Sterilization
► Pills
► IUD (PP-IUD/ I-IUD)
► Injectables (DMPA/CIC)

► NFP-CM
► NFP-BBT
► NFP-STM
► NFP-SDM
► NFP-LAM
► Condom
► Implant
3. Total Other Acceptors
► Female Sterilization
► Male Sterilization
► Pills
► IUD (PP-IUD/ I-IUD)
► Injectables (DMPA/CIC)

► NFP-CM
► NFP-BBT
► NFP-STM
► NFP-SDM
► NFP-LAM
► Condom
► Implant
2.14.3 FAMILY PLANNING (Part 2 of 2)

INDICATORS TARGET JAN FEB MAR 1st Q APR MAY JUNE 2nd Q JULY AUG SEPT 3rd Q OCT NOV DEC 4th Q TOTAL

4. Total Drop-out
► Female Sterilization
► Male Sterilization
► Pills
► IUD (PP-IUD/ I-IUD)
► Injectables (DMPA/CIC)
► NFP-CM
► NFP-BBT
► NFP-STM
► NFP-SDM
► NFP-LAM
► Condom
► Implant
5. Total Current Users
► Female Sterilization
► Male Sterilization
► Pills
► IUD (PP-IUD/ I-IUD)
► Injectables (DMPA/CIC)
► NFP-CM
► NFP-BBT
► NFP-STM
► NFP-SDM
► NFP-LAM
► Condom
► Implant
2.13.4 CHILD CARE (Part 1 of 3)

JAN FEB MAR 1st Q APR MAY JUN 2nd Q JUL AUG SEPT 3rdQ OCT NOV DEC 4thQ TOTAL
INDICATORS TARGET
M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F

1. Immunization given <1 yr

► BCG

w/in 24 hrs
► Hepa B1
> 24 hrs

► PENTA 2

► OPV 2

MCV1 (AMV)
► MCV
MCV2 (MMR)

1
► ROTA
2

► PCV 2

2. Fully Immunized Child

3. Completely Immunized

Child (12-23 mos)

4. Child Protected at Birth (CPAB)

4. Monthly Consolidation Table (MCT)
Monthly Consolidation Table (MCT)
The Public Health Nurse (PHN) records
data from all barangays. This is the source
document of the nurse for the Quarterly
Form. The MCT shall serve as the output
table of the RHU as it already contains
listing of indicators by barangay.
Monthly Consolidation Table
for
HEALTH CENTER
NAME OF HEALTH CENTER:

MUNICIPALITY OF:

PROVINCE/CITY:

REGION:
2.14.1 MATERNAL CARE Month: Year: ____________

N A M E OF B A R A N G A Y
INDICATORS

1. Pregnant women

● W/4 or more prenatal visits

● Given 2 doses of TT

● Given TT2 plus

● Given complete iron with

folic acid

2. Postpartum women

● With at least 2 PPV

● Given complete iron

● Women 10-49 years old

● Given Vitamin A

● Initiated Breastfeeding

3. No. of pregnant women seen

4. No. of pregnant women

tested for SYPHILIS

5. No. of pregnant women
positive for SYPHILIS

6. No. of pregnant women

given Penicillin
2.14.2 FAMILY PLANNING (Part 1 of 3) Month:__________________ Year: ___________________

N A M E OF B AR AN G AY
INDICATORS

1. Total Current Users beginning

► Female Ster/BTL
► Male Ster/Vasectomy
► Pills
► IUD (P-IUD and I-IUD)
► Injectables (DMPA/CIC)
► NFP-CM
► NFP-BBT
► NFP-STM
► NFP-SDM
► NFP-LAM
► Condom
► Implant

2. Total New Acceptors

► Female Ster/BTL
► Male Ster/Vasectomy
► Pills
► IUD (P-IUD and I-IUD)
► Injectables (DMPA/CIC)
► NFP-CM
► NFP-BBT
► NFP-STM
► NFP-SDM
► NFP-LAM
► Condom
► Implant
2.14.3 FAMILY PLANNING (Part 2 of 3) Month: _____________ Year: ___________________

N A M E OF B A R AN G AY
INDICATORS

3. Total Other Acceptors

► Female Ster/BTL
► Male Ster/Vasectomy
► Pills
► IUD (P-IUD and I-IUD)
► Injectables (DMPA/CIC)
► NFP-CM
► NFP-BBT
► NFP-STM
► NFP-SDM
► NFP-LAM
► Condom
► Implant

4. Drop-Out
► Female Ster/BTL
► Male Ster/Vasectomy
► Pills
► IUD (P-IUD and I-IUD)
► Injectables (DMPA/CIC)
► NFP-CM
► NFP-BBT
► NFP-STM
► NFP-SDM
► NFP-LAM
► Condom
► Implant
Components of FHSIS ver. 2012
 Reporting Tools - These are summary
data that are transmitted or submitted on a
weekly, monthly, quarterly and on annual
basis to the next higher level.
 Monthly Forms (M)
 Quarterly Forms (Q)
 Annual Forms (A-BHS, A1, A2, A3)
 Monthly Form 1
 The Monthly Form is the reporting form
that the midwife fills up to report her
accomplishments from the first day to the
last day of the month and submits to the
nurse at the RHU/MHC for consolidation.
Spaces are left blank for those indicators
the municipality/city needs to generate at
their level.
 Monthly Form 1
 Heading - Fill up the data asked for in the
heading: the Month being reported and
the Year, the name of the Barangay,
Name of BHS, the Municipality or City,
Province and the Projected Population of
the Barangay (except during National
Census years).
2.20.1 Maternal Care FHSIS v. 2012 - Q Form (page 1 of 8)
FHSIS ver 2012

FHSIS REPORT for the QUARTER_________________ YEAR: ______________

logo Municipality/City Name: __________________________________________
Province: ___________________Projected Population of the Year: ____________

- M A T E R N A L CA R E -
Elig Recommendation/
Indicators No. % Interpretation
Pop. Actions Taken
Col. 1 Col.2 Col. 3 Col.4 Col. 5 Col. 6

Pregnant women with 4 or more prenatal visits ♣

Pregnant women given 2 doses of Tetanus Toxoid♣

Pregnant Women given TT2plus♣

Pregnant women given complete iron with folic acid
supplementation♣
Post partum women with at least 2 post-partum
visits♣
Post partum women given complete iron
supplementation♣
Proportion of Post partum women given Vitamin A
supplementation♣
Proportion Postpartum women initiated
breastfeeding within 1 hour after giving birth♣
Women 10-49 years old given Iron supplementation♥

STI Surveillance No.

No. of pregnant women seen

No. of pregnant women tested for Syphilis

No. of pregnant women positive for Syphilis

2.21.1 Form 1 Notifiable Diseases FHSIS v. 2012 - Qmorbid (page 2 of 2)
. FHSIS v.2012

FHSIS QUARTERLY REPORT for: Year:

Municipality/City of:
Province
MORBIDITY DISEASES REPORT
For submission to the PHO
NAME BY AGE-GROUP AND BY SEX
OF ICD Code Under 1 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70 & over TOTAL

DISEASE M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F

Acute Watery Diarrhea A09 (watery)

Acute Bloody Diarrhea A09 (bloody)

Inluenza-like Illness J11

Influenza J11
Acute Flaccid Paralysis G83.9

Acute Hemorrhagic Fever Syndrome (Dengue) A91

Acute Lower Respiratory Track Infection J22

Pneumonia J18.9
Cholera A00

Diphtheria A36
Filarisis B74

Leprosy A30
Leptospirosis A27

Malaria B50-B54

Measles B05

Meningococcemia A39
Neonatal Tetanus A33

Non-neonatal Tetanus A35

Paralytic Shellfish Poinosning T61.2

Rabies A82

Schistosomiasis B65

Typhoid and paratyphoid A01

Viral Encephalitis A83-86

Acute Viral Hepatitis B15-B17

Viral Meningitis A87

Syphilis A50-A53
Gonorrhea A54.9

Urethral Discharge R36

Genital Ulcer N48.5, N76.5, N76.6
 FHSIS version 2012

FHSIS BHS ANNUAL Report for the year __________________

Name of BRGY and BHS ______________________________
Municipality/City of______________Province_______________
VITAL STATISTICS REPORT

DEMOGRAPHIC
Population No. of Households
Barangay No. of BHS
ENVIRONMENTAL No. %
Households with access to improved or safe water supply
● Level I (Point Source)
● Level II (Communal Faucet System or Standpost)
● Level III (Waterworks System)
Households with sanitary toilet facilities
Households with satisfactory disposal of solid waste
Households with complete basic sanitation facilities
Food Establishments
Food Establishments with sanitary permit
Food Handlers
2.22.3.2 Demographic Profile (A1-RHU)
FHSIS version 2012

FHSIS ANNUAL REPORT FOR YEAR: ______________________________________

Municipality/City Name: ___________________________________________________
No. of Health Centers _____________________
Province: _____________________Projected Population of the Year: ________________

- D E M OGR A P H IC P R OFIL E -
Number Ratio to Recommendation/
Indicators Interpretation
Male Female Total Pop. Actions Taken
Col. 1 Col. 2 Col. 3 Col. 4 Col. 5 Col. 6 Col. 7
Barangays
Barangay Health Stations
Health Centers
Households
Physicians/Doctors
Dentist
Nurses
Midwives
Medical Technologists
Sanitary Engineers
Sanitation Inspectors
Nutritionist
Active Barangay Health Workers
2.22.3.7 Morbidity Disease Report (A2-RHU)
. FHSIS v.2008

FHSIS ANNUAL REPORT for YEAR:

Municipality/City of:
ProvInce
MORBIDITY DISEASES REPORT
For submission to the PHO
ICD 10 Under 1 1-4 5-9 10 - 14 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45- - 49 50 - 54 55 - 59 60 - 64 65 & above TOT AL
DISEASE
CODE M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F
2.22.3.8 Mortality Report (A3-RHU)
. FHSIS v.2012

FHSIS ANNUAL REPORT for YEAR:

Municipality/City of:
ProvInce
MORTALITY REPORT
For submission to the PHO

Under 1 1-4 5-9 10 - 14 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45- - 49 50 - 54 55 - 59 60 - 64 65 & above T O T A L

DISEASE
M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F
 Recording
 Reporting
 Flow of Reports
FLOW OF FHSIS DOCUMENTS
Described below is the flow of FHSIS documents as described in the
manual of procedures
Documentation
of patients’
ITR/ records starts
FP1 with the
individual
treatment record
(ITR/FP1) PHO/
TCL AF Mayor

ST MCT MF

QF
FLOW OF FHSIS DOCUMENTS
Described below is the flow of FHSIS documents as described in the
User’s Guide for the FHSIS

Recording Reporting
Submitted to PHN
R ITR/
TCL ST M1
H FP1

P Submitted to PHO;
H MCT Q1 basis for Annual
N Forms: A1, A2, A3

P Submitted to CHD;
H Q1 basis for Annual
O Forms: A1, A2, A3

C Submitted to DOH;
H Q1 basis for Annual
D Forms: A1, A2, A3
Locus of Recording Reporting
Responsibility Tools
Office Person Forms Frequency Schedule of Submission to
higher level
BHS Midwife -ITR - Monthly Form (M1&M2) Monthly every second week of
-TCL succeeding month
-ST
- A-Barangay Form Annually every second week of January
RHU PHN -ITR - Quarterly Form (Q1&Q2) Quarterly every third week of the first
-TCL month of the succeeding
-ST quarter
-MCT - Annual Forms Annually every third week of January
> A1
> A2
> A3

PHO/CO Prov./City - Quarterly Report (Q1&Q2) Quarterly every fourth week of the first
FHSIS month of the succeeding
Coordinator quarter
- Annual Report Annually every fourth week of January
> A1
> A2
> A3

RHO Regional - Quarterly Report Quarterly every second week of the

FHSIS second month of the
Coordinator succeeding quarter
- Annual Report Annually every second week of March
> A1
> A2
> A3
Thank you