HIS, FHSIS process & forms, DQC process and Tools - Copy.pptx

TRAINING OR TRAINORS
ON DATA QUALITY CHECK (DQC)
June 21-24, 2022
BARMMHealth Project

Part I
Understanding the Health
Information Systems Framework
& EO 342

Demand for
health care
services
• Preferences
• Information on
Client
Behavior
• Price (money,
time)
Supply of health
care services
• Personnel
• Facilities
• Commodities
Policy and systems
• Financing
• Human resources
for health
• Policy, standards
and regulation
• Health
information
• Logistics Mgt
• Governance
Strategic instruments for Increasing FP service utilization
MMR
IMR
UFM
FP service
utilization
3
Unmet
need
for FP

Improved
quality of
locally
generated
data
Improved
planning,
policy and
decision
making at
all levels
(national,
regional,
provincial,
municipal/
city,
barangay)
Evidence-
based
interventions
made to
improve
health
service
delivery
performance
Achievement
of UHC
goals:
better health
outcomes,
more
equitable
financing
and more
responsive
health
systems
HEALTH INFORMATION SYSTEMS FRAMEWORK

The Maternal, Newborn and Child Health and Nutrition (MNCHN)
continuum
Stage Pre-pregnancy Pregnancy Delivery,
postpartum &
newborn
Child
Services Family planning Pre-natal,
maternal
nutrition
Safe delivery,
postpartum
care,
newborn care
Child
nutrition and
health care
Health and
socio-
economic
outcomes
Reduced unplanned
& high risk
pregnancies;
achievement of
couple’s desired
fertility; reduced
population growth;
socio-economic
development (1)
Maternal
nutrition &
care
affecting
delivery
outcomes;
future
health of
children (2)
Reduced
maternal
mortality;
neonatal
mortality (3)
Child
nutrition and
health
affecting
survival &
future health
and socio-
economic
outcomes (4)
CSR
Data w/c will serve as
bases for these
interventions should
be valid and reliable

The Maternal, Newborn and Child Health and Nutrition (MNCHN)
Strategy
Stage Pre-pregnancy Pregnancy Delivery,
postpartum &
newborn
Child
Services Family planning Pre-natal,
maternal
nutrition
Safe delivery,
postpartum
care,
newborn care
Child
nutrition and
health care
Health and
socio-
economic
outcomes
Reduced unplanned
& high risk
pregnancies;
achievement of
couple’s desired
fertility; reduced
population growth;
socio-economic
development
Maternal
nutrition &
care
affecting
delivery
outcomes;
future
health of
children
Reduced
maternal
mortality;
neonatal
mortality
Child
nutrition and
health
affecting
survival &
future health
and socio-
economic
outcomes
CPR/
FPCU
ANC
4
SBA,
FBD,
EBF
FIC,
micro-
nutrient
supplem
entation

Field Health
Service
Information
System
(FHSIS)
• Part of the
system of the
designated
statistics – as
provided for
under Executive
Order 352 (Social
Sector Admin
Data II-2)
• Only information
system
implemented
down to the
barangay level
The System of
Designated Statistics
(SDS) identifies &
designates the most
critical and essential
statistics required for
social and economic
planning/analysis
based on approved
criteria per Executive
Order (EO) No. 352
The SDS is an evolving
process that allows for
creation and build-up
of a list of the
statistical activities that
will generate critical
data for planners and
policymakers in the
government and
private sector.

Field Health
Service
Information
System
(FHSIS)
• To support the
management of local
and nationwide
health service
delivery &
interventions
• To provide the basic
service data needed
to monitor activities
of each health
program, including
family planning (FP)

Importance of FHSIS to local decision-making
• FHSIS is the only system that provides data on health
service delivery indicators at the barangay,
municipality/city, provincial, regional and national levels
• Evidence-planning and focused health interventions ,
resource allocation, and policy development depend on
the reliability and validity of FHSIS data
• Serves as evidence for PhilHealth Financing claims

Part II
Refresher on the
FHSIS Recording & Reporting
Guidelines & Form for FP
FHSIS MOP 2018

• serves as the overall reference for the
operationalization of the FHSIS at various levels of
operations.
• guides local health managers and staff to collect and
generate information useful to the LGUs in
improving access to quality services and in
managing more efficiently and effectively the
various public health programs in their respective
localities
• provides the LGUs and the National/Regional DOH &
BARMM MOH with a clearly established set of
public health program indicators to be tracked and
monitored nationwide, the results of which are
expected to guide:
• policy formulation
• resource allocation and prioritization
• Other essential decision-making processes.

• defines & summarizes the indicators to
be collected and reported through the
FHSIS in line with the DOH overall health
sector monitoring and evaluation
framework
• outlines the process/methodology of
collecting, recording and reporting data
using the set of FHSIS forms/tools at
various levels of operations;
• provides basic guides in the validation,
analysis and interpretation of data;
• defines the roles and functions of
concerned DOH and LGU offices involved
in the management and implementation
of the FHSIS.

• Defines the roles and functions of every group of stakeholders
concerned in the management and implementation of this
nationwide information system.
• Specifically on Data Quality Check/Assurance, Chapter 2-Section F
of DOH FHSIS MOP specifies that:
• Regional FHSIS coordinators shall spearhead data validation of
provincial and city FHSIS reports and ensure quality of FHSIS data
from lower reporting units
• DMOs shall participate in data quality checks and validation
activities
• Provincial FHSIS coordinators shall ensure data quality and
validation of city and municipal FHSIS reports;
• Municipal/City FHSIS coordinators shall ensure data quality and
validation of barangay FHSIS reports on a quarterly basis
together with their respective program coordinators;

Part II
Recording & Reporting of FP Data
FHSIS MOP 2018

Recording & Reporting Forms for FP
Level Recording Forms Reporting Forms
BHS – Midwife
Health Center –
Midwife
1. Masterlist of WRA and
Adolescent Women for FP
Services
2. FP Form 1
3. FP Target Client List
4. Summary Table
1. M1
RHU/City Health
Office
1. Monthly Consolidation
Table
1. Q1

Masterlist of WRA and Adolescent
Women 10-14 years old
Form used to extract data and information on women
with unmet need for family planning

WHAT IS WRA MASTERLIST FORM?
• Recording form aimed at generating basic information about women of
reproductive age and who among them have unmet need for FP.
• BHS midwives and community health workers and other volunteers are
expected to conduct the WRA masterlisting at least annually.
• Identified WRA with unmet need for FP are visited, provided with FP
information and encouraged to go through 1-1 counselling and provided
with FP services/methods of their choice

WHAT IS FP FORM 1
• Form 1 records the demographic-socio-economic profile of the
client, their medical & obstetrical history as well as the
presence of risks for sexually transmitted infections and
violence against women.
• It also records the results of physical examination undertaken.
• At the bottom of the front page is a space for the signature of
the client, and the guardian (for those below 18 rs old)
• The back-side is where the service provider records the
medical findings during each visit, the FP method accepted
and the date of follow-up with the name and signature of the
service provider.

WHAT IS THE TARGET CLIENT LIST
• Recording form used by the midwife containing the list of FP
clients which allows the midwives to systematically organize,
plan and document FP service performance monthly, quarterly
and annually
• Helps in tracking and monitoring FP services; helps in planning
and carrying out patient care and FP service delivery (including
FP counselling provided to patients)
• Serves as the source document for the official reports that need
to be submitted by the facility (source of M1)

Recording Data into the TCL
• At the end of each day, the BHS/RHU midwife should transfer related data
from the FP form 1 information into the TCL for FP Services.
• The Target Client List for FP Services should include all eligible women
aged 15-49 years old and those adolescents 10-14 years old with
spouses/partners who received any FP method from the reporting unit
• Women 50 years old and above can still be written in the TCL for FP
service tracking but will no longer be reported in the M1

No.
TARGET CLIENT LIST FOR FAMILY PLANNING SERVICES
Previous Method***
(9)
Complete Address
(4)
Complete Name
(FN, MI, LN)
(3)
Family Serial No.
(2)
Date of
Registration
(mm/dd/yy)
(1)
Type of
Client*
(7)
SE Status
1 - NHTS
2 - Non-NHTS
(6)
Age/ Date
of Birth
(5)
Source**
(8)
1
2
3
4
5
6
7
8
9
10
* Type of Client:
NA = New Acceptors
CU = Current Users
OA = Other Acceptors
CU-CM = Changing Method
CU-CC = Changing Clinic
CU-RS = Restarter
** Source:
Public
Private
*** Previous Method:
CON = Condom
Pills-POP = Progestin Only Pills
Pills-COC = Combined Oral Contraceptives
INJ = DMPA or CIC
IMP = Single rod sub-thermal Implant
IUD-I = IUD Interval
IUD-PP = IUD Postpartum
NFP-LAM = Lactational Amenorrhea Method
NFP-BBT = Basal Body Temperature
NFP-CMM = Cervical Mucus Method
NFP-STM = Symptothermal Method
NFP-SDM = Standard Days Method
NONE or New Acceptor
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Date Reason****
________________________ (Name of FP Method)
FOLLOW-UP VISITS
(Upper Space: Schedule Date of next visit / Lower Space: Actual Date of Visit)
(10)
DROP-OUT
(11)
Remarks/
Actions Taken
(12)
**** Reasons:
A = Pregnant
B = Desire to become pregnant
C = Medical complications
D = Fear of side effects
E = Changed Clinic
F = Husband disapproves
G = Menopause
H = Lost or moved out of the area or residence
I = Failed to get supply
J = Change Method
K = Underwent Hysterectomy
L = Underwent Bilateral Salpingo-oophorectomy
M = No FP Commodity
N = Unknown
O = Age out for BTL
For LAM:
A - Mother has a menstruation or not amenorrheic within 6 months OR
B - No longer practicing fully/exclusively breastfeeding OR
C - Baby is more than six (6) months old

Guide
and the reason for dropping.

Drop out Rules:
• Pills
• Fails tore supply from the last 21st (white) up to the last
brown pill
• Tansfers to another facility, changed method
• Decides to stop for any reason
• More than 49 years old
• DMPA (every 3 months)
• Fails to visit the clinic on the scheduled date and last day
of the 4 weeks)
• Changing clinic, method

Drop out Rules:
• IUD
• Decides not to use/removed
• Expelled and not reinserted
• Did not return 3-6 weeks after insertion
• No follow up or no visit after 2 years from the last visit
• Condom
• Fails to return for re supply
• Partner more than 49 years old

Drop out Rules:
• LAM
• One of the criteria not met
• NFP
- SDM:
• Fails to return for follow up to check on the proper use
• Fails to identify her fertile days
• - BBT/ST
• Fails to return for follow up to check on the proper use
• Fails to identify her fertile days

Drop out Rules:
• BTL/NSV
• Client/Partner reaches 50years old
• Reaches menopause
• Underwent procedure like hysterectomy or bi-lateral
salphingo-oophorectomy
• Implant
• Fails to return after 3 years from date of insertion
• Decides to remove for any reason
• Transfer to other clinic
• More than 50 years ols

WHAT IS A SUMMARY TABLE for FP
• Recording form for the midwife to summarize monthly
accomplishments and quarterly accomplishments
• 12-month-column document midwife records all monthly data by
FP method.
• The ST for FP contains monthly and quarterly data for:
• WRA with unmet need
• FP CU Beginning of the Month
• New Acceptors
• Other Acceptors
• Drop-Outs

ALTERNATIVE WAY OF ORGANIZING & PRESENTING THE TCL

WHAT IS A MONTHLY REPORT 1 OR M1
• contains the summary data of each indicator on program
accomplishment or service coverage categorized into family
health services, infectious disease and prevention services,
non-communicable disease prevention and control services.
• indicators reflected in the TCLs and STs are to be reported
through M1. Midwives should copy the data from the ST on
Program Accomplishment/Service Coverage to M1 and submit
this on a monthly basis to the public health nurse

Monthly Report
Form (M1)
 The Monthly Report Form or M1 for FP
contains indicators related to accounting
and tracking of women with unmet need
for mFP and current users and acceptors
for FP. The indicators are disaggregated by
FP method and by Age Group (10-14, 15-
19, 20-49)
 Women 10-49 with unmet
need for modern FP method
(Section A1)
48
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
a. BTL - Total
b. NSV - Total
c. Condom - Total
d.1 Pills-POP - Total
d.2 Pills-COC - Total
e. Injectables (DMPA/POI)-Tot.
f. Implant - Total
g.1 IUD-I- Total
g.2 IUD-PP - Total
h. NFP-LAM - Total
i. NFP-BBT - Total
j. NFP-CMM - Total
k. NFP-STM - Total
l. NFP-SDM - Total
m. Total
Total for WRA
15-49 y/o
(Col. 2)
Age
10-14 y/o 15-19 y/o 20-49 y/o
(End of Month)
Current Users
(Col. 1)
A1. Modern FP Unmet Need
(Col. 4)
Remarks
(Col. 3)
Name of BHS: _______________________________
Name of Barangay: _______________________________
(Present Month)
1. No. of WRA with unmet need for modern FP - Total
A2. Use of FP Method
(Beginning Month)
Current Users Acceptors
(Col. 5)
(Present Month)
Drop-outs
(Previous Month)
New Acceptors
(Col. 2)
(Col. 1) (Col. 4)
(Present Month)
(Col. 6)
(Col. 3)
FHSIS REPORT for the MONTH: ________ YEAR: _______
Other Acceptors
Section A. Family Planning Services for Women of Reproductive Age
New Acceptors
(Col. 7)
For submission to RHU/MHC
Projected Population of the Year: _______________________________
Name of Province: _______________________________
Name of Municipality/City: _______________________________
BRGY

Monthly Report
Form (M1)
 The Monthly Report Form or M1 for FP contains
indicators related to accounting and tracking of current
users and new acceptors for FP. The indicators are
disaggregated by FP method and by Age Group (10-14,
15-19, 20-49)
 FP Methods (Column 1)
 Current User Beginning of the
Month (Column 2)
 New Acceptors Previous Month
(Column 3)
 Other Acceptors Present Month
(Column 4)
 Dropout Present Month (Column 5)
 Current Users End of Month
(Column 6)
 New Acceptors Present Month
(Column 7)
49
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
a. BTL - Total
b. NSV - Total
c. Condom - Total
f. Implant - Total
g.1 IUD-I- Total
g.2 IUD-PP - Total
h. NFP-LAM - Total
i. NFP-BBT - Total
j. NFP-CMM - Total
k. NFP-STM - Total
l. NFP-SDM - Total
m. Total
Total for WRA
15-49 y/o
(Col. 2)
Age
10-14 y/o 15-19 y/o 20-49 y/o
(End of Month)
Current Users
(Col. 1)
(Col. 4)
Remarks
(Col. 3)
Name of BHS: _______________________________
Name of Barangay: _______________________________
(Present Month)
(Beginning Month)
(Col. 5)
(Present Month)
Drop-outs
(Previous Month)
New Acceptors
(Col. 2)
(Col. 1) (Col. 4)
(Present Month)
(Col. 6)
(Col. 3)
Other Acceptors
New Acceptors
(Col. 7)
Name of Province: _______________________________
BRGY

Monthly Report
Form (M1)
15-19, 20-49)
Month (Column 2)
(Column 3)
(Column 4)
(Column 6)
(Column 7)
50
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
a. BTL - Total
b. NSV - Total
c. Condom - Total
f. Implant - Total
g.1 IUD-I- Total
g.2 IUD-PP - Total
h. NFP-LAM - Total
i. NFP-BBT - Total
j. NFP-CMM - Total
k. NFP-STM - Total
l. NFP-SDM - Total
m. Total
Total for WRA
15-49 y/o
(Col. 2)
Age
10-14 y/o 15-19 y/o 20-49 y/o
(End of Month)
Current Users
(Col. 1)
(Col. 4)
Remarks
(Col. 3)
Name of BHS: _______________________________
Name of Barangay: _______________________________
(Present Month)
(Beginning Month)
(Col. 5)
(Present Month)
Drop-outs
(Previous Month)
New Acceptors
(Col. 2)
(Col. 1) (Col. 4)
(Present Month)
(Col. 6)
(Col. 3)
Other Acceptors
New Acceptors
(Col. 7)
Name of Province: _______________________________
BRGY

Monthly Report
Form (M1)
15-19, 20-49)
Month (Column 2)
(Column 3)
(Column 4)
(Column 6)
(Column 7)
51
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
a. BTL - Total
b. NSV - Total
c. Condom - Total
f. Implant - Total
g.1 IUD-I- Total
g.2 IUD-PP - Total
h. NFP-LAM - Total
i. NFP-BBT - Total
j. NFP-CMM - Total
k. NFP-STM - Total
l. NFP-SDM - Total
m. Total
Total for WRA
15-49 y/o
(Col. 2)
Age
10-14 y/o 15-19 y/o 20-49 y/o
(End of Month)
Current Users
(Col. 1)
(Col. 4)
Remarks
(Col. 3)
Name of BHS: _______________________________
Name of Barangay: _______________________________
(Present Month)
(Beginning Month)
(Col. 5)
(Present Month)
Drop-outs
(Previous Month)
New Acceptors
(Col. 2)
(Col. 1) (Col. 4)
(Present Month)
(Col. 6)
(Col. 3)
Other Acceptors
New Acceptors
(Col. 7)
Name of Province: _______________________________
BRGY

Monthly Report
Form (M1)
15-19, 20-49)
Month (Column 2)
(Column 3)
(Column 4)
(Column 6)
(Column 7)
52
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
a. BTL - Total
b. NSV - Total
c. Condom - Total
f. Implant - Total
g.1 IUD-I- Total
g.2 IUD-PP - Total
h. NFP-LAM - Total
i. NFP-BBT - Total
j. NFP-CMM - Total
k. NFP-STM - Total
l. NFP-SDM - Total
m. Total
Total for WRA
15-49 y/o
(Col. 2)
Age
10-14 y/o 15-19 y/o 20-49 y/o
(End of Month)
Current Users
(Col. 1)
(Col. 4)
Remarks
(Col. 3)
Name of BHS: _______________________________
Name of Barangay: _______________________________
(Present Month)
(Beginning Month)
(Col. 5)
(Present Month)
Drop-outs
(Previous Month)
New Acceptors
(Col. 2)
(Col. 1) (Col. 4)
(Present Month)
(Col. 6)
(Col. 3)
Other Acceptors
New Acceptors
(Col. 7)
Name of Province: _______________________________
BRGY

Monthly Report
Form (M1)
indicators related to accounting and tracking of
current users and new acceptors for FP. The
indicators are disaggregated by FP method and by
Age Group (10-14, 15-19, 20-49)
 Current User Beginning of the Month
(Column 2)
(Column 3)
(Column 4)
 Current Users End of Month (Column
6)
(Column 7)
53
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
a. BTL - Total
b. NSV - Total
c. Condom - Total
f. Implant - Total
g.1 IUD-I- Total
g.2 IUD-PP - Total
h. NFP-LAM - Total
i. NFP-BBT - Total
j. NFP-CMM - Total
k. NFP-STM - Total
l. NFP-SDM - Total
m. Total
Total for WRA
15-49 y/o
(Col. 2)
Age
10-14 y/o 15-19 y/o 20-49 y/o
(End of Month)
Current Users
(Col. 1)
(Col. 4)
Remarks
(Col. 3)
Name of BHS: _______________________________
Name of Barangay: _______________________________
(Present Month)
(Beginning Month)
(Col. 5)
(Present Month)
Drop-outs
(Previous Month)
New Acceptors
(Col. 2)
(Col. 1) (Col. 4)
(Present Month)
(Col. 6)
(Col. 3)
Other Acceptors
New Acceptors
(Col. 7)
Name of Province: _______________________________
BRGY

Monthly Report
Form (M1)
Age Group (10-14, 15-19, 20-49)
(Column 2)
(Column 3)
(Column 4)
6)
(Column 7)
54
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
a. BTL - Total
b. NSV - Total
c. Condom - Total
f. Implant - Total
g.1 IUD-I- Total
g.2 IUD-PP - Total
h. NFP-LAM - Total
i. NFP-BBT - Total
j. NFP-CMM - Total
k. NFP-STM - Total
l. NFP-SDM - Total
m. Total
Total for WRA
15-49 y/o
(Col. 2)
Age
10-14 y/o 15-19 y/o 20-49 y/o
(End of Month)
Current Users
(Col. 1)
(Col. 4)
Remarks
(Col. 3)
Name of BHS: _______________________________
Name of Barangay: _______________________________
(Present Month)
(Beginning Month)
(Col. 5)
(Present Month)
Drop-outs
(Previous Month)
New Acceptors
(Col. 2)
(Col. 1) (Col. 4)
(Present Month)
(Col. 6)
(Col. 3)
Other Acceptors
New Acceptors
(Col. 7)
Name of Province: _______________________________
BRGY

Monthly Report
Form (M1)
Age Group (10-14, 15-19, 20-49)
(Column 2)
(Column 3)
(Column 4)
6)
(Column 7)
55
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
a. BTL - Total
b. NSV - Total
c. Condom - Total
f. Implant - Total
g.1 IUD-I- Total
g.2 IUD-PP - Total
h. NFP-LAM - Total
i. NFP-BBT - Total
j. NFP-CMM - Total
k. NFP-STM - Total
l. NFP-SDM - Total
m. Total
Total for WRA
15-49 y/o
(Col. 2)
Age
10-14 y/o 15-19 y/o 20-49 y/o
(End of Month)
Current Users
(Col. 1)
(Col. 4)
Remarks
(Col. 3)
Name of BHS: _______________________________
Name of Barangay: _______________________________
(Present Month)
(Beginning Month)
(Col. 5)
(Present Month)
Drop-outs
(Previous Month)
New Acceptors
(Col. 2)
(Col. 1) (Col. 4)
(Present Month)
(Col. 6)
(Col. 3)
Other Acceptors
New Acceptors
(Col. 7)
Name of Province: _______________________________
BRGY

1. Determine the Current Users Beginning of Month by FP method and by Age
Group (10-14, 15-19, 20-49) [This is equivalent to Current Users End of
Previous Month] or copy Column 6 from M1 of Previous Month
2. Determine the number New Acceptors of the Previous Month by FP method
and by Age Group (10-14, 15-19, 20-49) or copy Column 7 from M1 of
Previous Month
3. Determine the number New Acceptors of the Present Month by FP method and
by Age Group (10-14, 15-19, 20-49) [TCL: refer to date of registration and
Type of Client is NA] and reflect under Column 7
4. Determine the number of Other Acceptors of the Present Month by FP method
and by Age Group (10-14, 15-19, 20-49) [TCL: refer to date of registration
and Type of Client is CC, CM, RS]
56

5. Determine the number of Drop-outs by FP method and by Age Group (10-14, 15-
19, 20-49) [TCL: refer to Dropout date]
6. Compute for Current Users End of Month using the following formula:
Ex. Preparing for M1 of July
Current Users for Beginning of July (Equal to CU End of Month of June)
+ Total New Acceptors of the Previous Month (Equal to NA Present of June)
+ Total Other Acceptors for the Current Month (Equal to OA of July)
- Drop-outs (Count the clients in TCL with July Dropout Date)
57

10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
a. BTL - Total
b. NSV - Total
c. Condom - Total
f. Implant - Total
g.1 IUD-I- Total
g.2 IUD-PP - Total
h. NFP-LAM - Total
i. NFP-BBT - Total
j. NFP-CMM - Total
k. NFP-STM - Total
l. NFP-SDM - Total
m. Total
Total for WRA
15-49 y/o
(Col. 2)
Age
10-14 y/o 15-19 y/o 20-49 y/o
(End of Month)
Current Users
(Col. 1)
(Col. 4)
Remarks
(Col. 3)
Name of BHS: _______________________________
Name of Barangay: _______________________________
(Present Month)
(Beginning Month)
(Col. 5)
(Present Month)
Drop-outs
(Previous Month)
New Acceptors
(Col. 2)
(Col. 1) (Col. 4)
(Present Month)
(Col. 6)
(Col. 3)
Other Acceptors
New Acceptors
(Col. 7)
Name of Province: _______________________________
BRGY
Monthly Report
Form (M1)
STEP 1
Determine the Current
Users Beginning of Month
by FP method and by Age
Group (10-14, 15-19, 20-49)
[This is equivalent to
Current Users End of
Previous Month] or copy
Column 6 from M1 of
Previous Month
58
June 2020
July 2020

10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
a. BTL - Total
b. NSV - Total
c. Condom - Total
f. Implant - Total
g.1 IUD-I- Total
g.2 IUD-PP - Total
h. NFP-LAM - Total
i. NFP-BBT - Total
j. NFP-CMM - Total
k. NFP-STM - Total
l. NFP-SDM - Total
m. Total
Total for WRA
15-49 y/o
(Col. 2)
Age
10-14 y/o 15-19 y/o 20-49 y/o
(End of Month)
Current Users
(Col. 1)
(Col. 4)
Remarks
(Col. 3)
Name of BHS: _______________________________
Name of Barangay: _______________________________
(Present Month)
(Beginning Month)
(Col. 5)
(Present Month)
Drop-outs
(Previous Month)
New Acceptors
(Col. 2)
(Col. 1) (Col. 4)
(Present Month)
(Col. 6)
(Col. 3)
Other Acceptors
New Acceptors
(Col. 7)
Name of Province: _______________________________
BRGY
Monthly Report
Form (M1)
STEP 2
Determine the number
New Acceptors of the
Previous Month by FP
method and by Age Group
(10-14, 15-19, 20-49) or
copy Column 7 from M1 of
Previous Month
59
June 2020
July 2020

6
7
8
9
10
1
2
3
4
5
________________________ (Name of FP Method)
FOLLOW-UP VISITS
(10)
DROP-OUT
(11)
Remarks/
Actions Taken
(12)
No.
Previous Method***
(9)
Complete Address
(4)
Complete Name
(FN, MI, LN)
(3)
Family Serial No.
(2)
Date of
Registration
(mm/dd/yy)
(1)
Type of
Client*
(7)
SE Status
1 - NHTS
2 - Non-NHTS
(6)
Age/ Date
of Birth
(5)
Source**
(8)
* Type of Client:
NA = New Acceptors
CU = Current Users
CU-RS = Restarter
** Source:
Public
Private
CON = Condom
INJ = DMPA or CIC
**** Reasons:
A = Pregnant
E = Changed Clinic
G = Menopause
J = Change Method
M = No FP Commodity
N = Unknown
O = Age out for BTL
For LAM:
Monthly Report
Form (M1)
STEP 3
Determine the number New
Acceptors of the Present
Month by FP method and by
Age Group (10-14, 15-19, 20-49)
[TCL: refer to date of
registration and Type of Client
is NA] 60
July 2020

6
7
8
9
10
1
2
3
4
5
________________________ (Name of FP Method)
FOLLOW-UP VISITS
(10)
DROP-OUT
(11)
Remarks/
Actions Taken
(12)
No.
Previous Method***
(9)
Complete Address
(4)
Complete Name
(FN, MI, LN)
(3)
Family Serial No.
(2)
Date of
Registration
(mm/dd/yy)
(1)
Type of
Client*
(7)
SE Status
1 - NHTS
2 - Non-NHTS
(6)
Age/ Date
of Birth
(5)
Source**
(8)
* Type of Client:
NA = New Acceptors
CU = Current Users
CU-RS = Restarter
** Source:
Public
Private
CON = Condom
INJ = DMPA or CIC
**** Reasons:
A = Pregnant
E = Changed Clinic
G = Menopause
J = Change Method
M = No FP Commodity
N = Unknown
O = Age out for BTL
For LAM:
Monthly Report
Form (M1)
STEP 4
Determine the number Other
Acceptors of the Present Month
by FP method and by Age Group
(10-14, 15-19, 20-49)
[TCL: refer to date of
registration and Type of Client
is CM, CC, or RS] 61
July 2020

6
7
8
9
10
1
2
3
4
5
________________________ (Name of FP Method)
FOLLOW-UP VISITS
(10)
DROP-OUT
(11)
Remarks/
Actions Taken
(12)
No.
Previous Method***
(9)
Complete Address
(4)
Complete Name
(FN, MI, LN)
(3)
Family Serial No.
(2)
Date of
Registration
(mm/dd/yy)
(1)
Type of
Client*
(7)
SE Status
1 - NHTS
2 - Non-NHTS
(6)
Age/ Date
of Birth
(5)
Source**
(8)
* Type of Client:
NA = New Acceptors
CU = Current Users
CU-RS = Restarter
** Source:
Public
Private
CON = Condom
INJ = DMPA or CIC
**** Reasons:
A = Pregnant
E = Changed Clinic
G = Menopause
J = Change Method
M = No FP Commodity
N = Unknown
O = Age out for BTL
For LAM:
Monthly Report
Form (M1)
STEP 5
Determine the number of Drop-
outs by FP method and by Age
Group (10-14, 15-19, 20-49)
[TCL: refer to Dropout date and
count the clients with dropout
dates; Make sure the TCL is
updated] 62
July 2020

Monthly Report
Form (M1)
STEP 6
Compute for the number of
Current Users End of Month
A. Current users
beginning of the month
+ B. New Acceptors
previous month
+ C. Other Acceptors of
the present month
- D. Drop-outs present
month
-------------------------------------------
= E. Current Users end of
present month
63
A + B C D E
+ - =
July 2020

WHAT IS THE MONTHLY CONSOLIDATION TABLE?
• The supervising nurse/FHSIS Coordinator in the RHU/MHC/CHO
records all FP performance data from all barangays into this monthly
consolidation recording form. It becomes the source document of the
nurse in generating the quarterly report for FP at the municipal/city level.

MCT – MONTHLY CONSOLIDATION TABLE

WHAT IS A QUARTERLY REPORT 1 OR Q1
• The Quarterly Form is the official health report of the municipality/city for
the quarter. It contains the consolidated three-month reports from all the
BHSs and RHU/MHC during the quarter. The PHN forwards this report to
the Provincial/City FHSIS Coordinator at the PHO/CHO every third week
of the first month of the succeeding quarter for provincial/city
consolidation. The municipality/city prepares only one quarterly report. In
case there is more than one RHU/MHC in the municipality/city, the
MHO/CHO shall be responsible for directing the consolidation of all the
quarterly data from different RHUs/MHCs and the preparation of one
Quarterly Form for the municipality/city.

Guide
The FP Program Accomplishment Report for the quarter has three sections.
Section A1. Modern FP Unmet Need
Column 1 Listed in this column is the indicator on unmet need for modern FP.
Column 2 Provide the total of WRA 15-19 and 20-49 identified with unmet need for
modern FP and the estimated number of WRA.
Column 3 Write your analysis/interpretation of the data on this space.
Column 4 Write any recommendation or actions that need to be undertaken under
this Column.
Section A2. Use of FP Method
Column 1 Listed in this column are the different FP Methods
Column 2 Current Users (Beginning of Quarter). Write on the space provided
the total no. of FP clients who have been carried over from previous quarter.

Guide
Column 3 New Acceptors (End of Quarter). Write on the space provided the
number of new acceptors for the end of the quarter. (NA of Last month of Previous
Quarter, plus first 2 months of Present Quarter).
Column 4 Other Acceptors (Present Quarter). Write on the space provided the
number of clients who had Changed Method (CM), Changed Clinic (CC) and the
Restarters (RS).
Column 5 Drop-outs (Present Quarter). Write on the space provided the number
of clients who dropped-out during the quarter.
Column 6 Current Users (End of Quarter). Write on the space provided the total
number of FP clients who have been carried over from the previous quarter after
deducting the drop-outs of the present quarter, adding the new acceptors end of quarter
and other acceptors (RS, CC, CM) of the present quarter.
Column 7 New Acceptors of the Present Quarter. Note that under this column, you
simply account for each month’s new acceptor for the quarter:
Example: Jan, Feb, March
Column 8 CPR. This is computed by dividing the Current Users End of Quarter (Column
6) by the Total Population x 25.854%

Part III
Data Flow, Submission
Timelines, Familiarity
with the Forms
(DQC for FP)

New
Sections/
New
Provisions
under
FHSIS 2018
• Tracking and Reporting of Women 10 to 14
years old, 15 to 19 years old, and 20 to 49
years old with Unmet Need for modern FP
method
• Disaggregation of FP Service coverage into
10 to 14 years old, 15 to 19 years old, and
20 to 49 years old
• The 2018 FHSIS MOP provides specific
Guidelines for special FP clients and special
circumstances – Section D.
• The guidelines in recording, collection and
reporting of FP service coverage in hospitals
– introduced in Section G.

TRAINING OF TRAINORS
ON DATA QUALITY CHECK (DQC)
June 29-July 2, 2022
BARMMHealth Project

Part VI
FP in Hospital Recording
and Reporting
(DQC for FP)

I. BACKGROUND/ POLICY BASIS
• Section 5.05 of the RPRH IRR specifically mandates
that all public health facilities shall provide the full range
of modern family planning methods
• Specifically, FP in hospitals are expected to include:
• Delivery of information to clients
• Counselling and assessment
• Provision of pills, injectables, condoms
• Performance of procedures such as IUD insertion &
removal, implant insertion & removal, BTL & NSV
• Support to the practice of NFP
• Management of complications and adverse reactions
following the use of contraceptives
• Provision of information and services in different
sections or units of the hospitals
Section 4.06 Access to Family Planning Information and
Services. No person shall be denied information and access
to family planning services, whether natural or artificial: 83

In October 2014 DOH issued the DM No. 2014-0312:
guidelines for setting up family planning services in
hospitals.
• defines the full range of FP services that public
hospitals can provide, along with instructions on
how FP service provision can effectively be set
• defines the processes of recording & reporting,
logistics management, financing, and management
of complications given current clinical standards
• laid out the roles and responsibilities of the public
hospitals and the DOH offices to ensure effective
implementation of the guideline. The DOH Memo
applies to all LGU hospitals and DOH Regional
Hospitals and Medical Centers.
84

I. BACKGROUND/ POLICY
BASIS
• In March 2017, DOH AO
2017-0005 was issued –
“Guidelines in Achieving
Desired Family Size through
Accelerated Reduction in
Unmet Needs for Modern
FP” mandates that:
• All provincial hospitals
and DOH medical
centers shall implement
their recording and
reporting systems
using the DOH
Operational Guide
85

Executive Order 352 establishes FHSIS as part of the
designated statistics of the Philippines, thus requiring all
health facilities, including hospitals, to report the critical
health indicators, including among others, the FP Current
Users (including new acceptors and drop-outs)
86

II. WHY ESTABLISH A HOSPITAL RECORDING &
REPORTING SYSTEM FOR FP
• To document and clearly capture the share of hospitals
in the overall FP program performance and health
outcome
• To use the data for evidenced-based interventions and
establish the basis for future actions and decisions on
family planning (plans/strategies/commodity
procurements, budgets, commodity procurements)
• To document compliance with the existing provisions
of the RPRH Law and IRR & DOH policies – and clearly
document the flow of FP service provision
• To establish the MOVs for PhilHealth reimbursement
for FP services; to generate support documents for
PhilHealth’s HCPPAS
87

Improved
quality of
local/
regional/
national
data
Improved
planning,
policy and
decision
making at
all levels
(national,
regional,
provincial,
municipal/
city,
barangay)
Evidence-
based
interventions
made to
improve
health
service
delivery
performance
Achievement
of health
sector
reform goals:
financial
protection,
better health
outcomes,
and more
responsive
health
systems
Hospital’s
performance
data
LGU
performance
data

Demand for
health care
services
• Preferences
• Information
• Price
(money,
time)
Supply of health
care services
• Personnel
• Facilities
• Commodities
Policy and
systems
• Financing
• Human
resources
for health
• Policy,
standards
and
regulation
• Health
information
• Logistics
Mgt
• Governance
Framework for FP service utilization
MMR
IMR
UFM
FP service
utilization
89
Are these systematically
recorded and reported?

MAJOR INDICATORS FOR FP PROGRAM
IMPLEMENTATION:
WOMEN ABLE TO ACCESS
FP METHODS OF THEIR CHOICE
[NO. OF FPCU; CONTRACEPTIVE PREVALENCE RATE (CPR)]
COMMODITY SECURITY (REDUCTION/ELIMINATION OF FP
COMMODITY STOCK-OUTS)
INCREASED CAPACITIES FOR FP SERVICE PROVISION
INCREASED DEMAND FOR FP SERVICES
REDUCTION/ELIMINATION OF
UNMET NEEDS FOR FP

III. DOH GUIDELINE FOR FP REORDING AND REPORTING
• Establishes clear operational procedures and guidelines,
consistent with these DOH policies, for recording, reporting
and maintaining the records of services along with the updated
versions of the forms, with:
i. Clear illustration of FP client flow
ii.Clear illustration of FP client data flow
• Ensures that the forms are in synchrony with the existing
FHSIS recording & reporting system to ensure that FP
performance by the hospital is clearly captured in the
overall FHSIS Reports of all public health facilities.
• Provides the hospital with the option to record clients
electronically using basic Excel encoding tool that
supports easy preparation of M1, and A1 for the hospitals
• Allows for web-based reporting of hospitals’ monthly
performance (M1s) therefore consolidating the share of all
hospitals in addressing unmet needs for FP
92

FP in the HOSPITAL OPERATIONAL GUIDE for RECORDING
and REPORTING - will serve as an operational manual for
recording, maintaining and reporting FP performance and
services provided at the hospital and tracking all the services
provided to all clients seeking family planning services, including
FP counselling services in all LGU hospitals and DOH Regional
Hospitals and Medical Centers.
FORMS TO BE USED includes:
1. Hospital’s List of Potential FP Clients
2. FP Form 1 & Consent Forms
3. FP Client Card
4. Hospital FP Client Record (Equivalent to RHUs’/HCs’ TCLs)
5. Monthly Form (M1)
6. Annual Form (A1) (including the supporting Annual
Consolidation Table)
7. Hospital’s Daily Stock Record
8. Hospital’s Daily Dispending Record
9. Hospital’s Monthly Inventory Form
10. Hospital’s Annual Statistical Report
93

IV. RECORDING FORMS
1. Hospital’s List of Potential FP Clients
2. FP Form 1 (including parental consent form for
women below 18
3. FP Client Card
4. Hospital FP Client Record (Equivalent to RHU’s
FP Client List)
5. Informed Consent Form
94

IV. RECORDING FORMS
1. HOSPITAL’S LIST OF POTENTIAL FP CLIENTS
Hospital Departments (including, among others, the OPD,
OB Ward, and Pedia) will identify and maintain a daily list of
potential FP clients which will be forwarded to the FP point
person for consolidation. The list will include:
• clients who may have expressed intention to use an FP
method but have not yet been provided with either
information or services
• clients who may have been provided with initial
information through group information-giving but have not
yet been provided with actual FP services.
This Potential FP Client List contains the following
information: Name of the Client, Age, Sex, Gravida/Para or
G/P (for female clients), address and contact number. 95

IV. RECORDING FORMS
1. LIST OF POTENTIAL CLIENTS
96
Sex
(M or F)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL
LIST OF POTENTIAL FP CLIENTS
Contact Number
Remarks
[Can include information
on w here the patient w as
initially seen/identified
(e.g. Ward, OPD, Pedia)]
Year: __________ Month ____________
Date Name of Potential FP Client Age
Gravida/
Para
(G/P)
Address
All clients with potential unmet needs for FP
shall be recorded in the LIST OF POTENTIAL
CLIENTS; will include:
• clients who expressed intention to
use an FP method but have not yet
been provided with either information
or services
• clients who have been provided with
initial information through group
information-giving but have not yet
been provided with actual FP services.

IV. RECORDING FORMS
2. FP FORM 1
Once the client decided to accept a method, the provider will
generate critical information and fill-out the FP Form 1. For Family
Planning, the ITR is the FP Record or FP Form 1.
This is a two-page form with the front page divided into five sections
namely:
• medical history
• obstetrical history
• assessment of risk for STI
• assessment of risk for violence against women (VAW) and
• physical examination.
• It likewise includes socio-demographic information (client’s
personal data, type of acceptor and FP method used) and
acknowledgment section (contains statement that the client had
been counselled and her signature).
97

IV. RECORDING FORMS
2. FP FORM 1
• The back portion is divided into columns and provides the
following information: date of visit; medical findings (medical
observations, complaints, complications, service
rendered/procedures, lab exams, treatment and referrals);
method/supplies given (method/brand and number of units);
name of provider and signature and date of follow-up visit). This
record will be maintained by the hospital for all FP acceptors
seen.
• PARENTAL CONSENT – For client below 18 years old, a
written consent must be secured from their
parents/guardian prior to provision of any FP method from
the hospital.
99

IV. RECORDING FORMS
3. FP CLIENT CARD
• Home-based card held by the FP Client - This serves as the FP
service card of the client, which s/he will need to bring every time
s/he seek any FP service from any facility. It contains the
following information:
• client name
• client contact number
• date of client visit,
• the FP services provided
• the date of expected follow-up or next service date
• G/P
• NHTS membership
• The name of the facility where services were secured
• the name/signature of the service provider.
• name and address of the hospital or the RHU/HC unit that
issued the card.
100

IV. RECORDING FORMS
3. FP CLIENT CARD
101
NHTS?
Yes__
No __
G/P _____
Date of
Visit
Date of
Follow-up/
Next Service
Date
Name of the
Facility which
Rendered the
Service
FP
Counselling
Methods
Used/
FP Commodity
Provided
Client Card Issued by: _____________________ (Facility)
Reminders:
1. Please bring this FP Client card in every facility visit
2. Immediately return to the facility in case of dizziness or any discomfort
3. Take note of the dates of follow-up visit indicated by the service provider
Name of Client: ___________________________________
Client Number: _____________________
Age: ______________________
Contact Number: _____________________
Address: __________________________________
FP SERVICES PROVIDED
(Please Check)
Name/ Signature of
Service Provider
FP CLIENT CARD
The FP Client will
need to keep this
home-based card and
will bring this every
time s/he seek any FP
service from any
facility

IV. RECORDING FORMS
• Both the FP Form 1 and the FP Client Card are not enough for
the systematic and organized consolidation of client records and
FP services provided by the hospitals – it is important to have a
HOSPITAL FP CLIENT RECORD (HFPCR) similar to the client
list of the RHUs/HCs for the continued provision and tracking of
FP services to hospital-based clients
• The FP Point Person/Team will use the FP Registry in defining
the potential FP users; Clients in the FP Registry shall serve as
the list of potential clients for FP that can be provided with FP
counselling services. Once the client accepts a method, the
provider will generate critical information and fill-up FP Form 1.
The client will be issued with a FP Client Card and will be
recorded in the HOSPITAL FP CLIENT RECORD.
102

SEX REMARKS/
ACTION
mm/dd/yy (use codes) (use codes) (8) TAKEN
1ST 2ND 3RD 4TH 5TH 6TH 7TH 8TH 9TH 10TH 11TH 12TH DATE Reason*** (10)
*TypeofClient: **PreviousMethod: ***ReasonsforDrop-Out
CU= Current Users CON= Condom NFP-BBT= Basal Body Temperature SDM = StandardDays Method A = Pregnant F= Husbanddisapproves K = ChangeMethod ForLAM:
NA = NewAcceptors INJ-POI-Progestin-only Injectable NFP-CM = Cervical Mucus Method MSTR/Vasec = MaleSter./Vasectomy B = Desiretobecome G= Menopause L= Underwent Hysterectomy A -Motherhas amenstruationornot amenorrheic within6mos. or
OtherAcceptors: INJ-CIC-ComboinedInjectableContraceotives NFP-STM = Sympothermal Method FSTR/BTL= FemaleSter./Bilateral pregnant H= Lost ormovedout oftheareaor
M= Underwent Bilateral B - Nolongerpracticingfully/exclusively breastfeedingor
*CU-CM = ChangingMethod IIUD= Interval Intra-uterineDevice NFP-LAM = Lactational AmenorrheaMethod tubal ligation C= Medical complications orresidence Salpingo-oophorectomy C- Baby is morethansix (6)months old
*CU-CC= ChangingClinic PP-IUD= Post-partum Intra-uterineDevice D= Fearofsideeffects I= Failedtoget supply N= NoFP Commodity
*CU-RS = Restarter PILLS POP = Progestin-only Pills E = ChangedClinic J= IUDexpelled O= Unknown
PILLS COC= CombinedOral Contraceptives P = Ageout forBTL
HOSPITALFPCLIENTRECORD- __________________ (NameofFPMethod)
DATEOFREGISTRATION
NAME ADDRESSandCONTACT NUMBER
PREVIOUS
METHOD**
FOLLOW-UPVISITS
(UpperSpace:NextServiceDate/LowerSpace:DateAccomplished)
DROP-OUT
(9)
Indicate
1ifNHTS and
2ifnon-NHTS (FforFemale;
M forMale)
AGEBirthdate
Gravida/
Para
(G/P)
Date ofFP
CounselingPriorto
Final Acceptance
TYPE OF
CLIENT*
FHSIS
HFPCR
103
allows the FP Point
Person/Team to
systematically
organize, plan and
document FP service
performance
monthly, quarterly
and annually

IV. RECORDING FORMS
4. HOSPITAL FP CLIENT RECORD (Patterned after the FHSIS
FP-TCL) - allows the FP Point Person/Team to systematically
organize, plan and document FP service performance monthly,
quarterly and annually
• to record and to plan and carry out patient care and FP service
delivery (including FP counselling provided to patients)
• to monitor and track service delivery to clients or beneficiaries
• to provide a summary per FP method.
• to serve as the source document for the official reports that
need to be submitted by the hospital (for services delivered
within the hospital or during mobile service outreach service
provision
Given the new role of the hospitals in FP service provision, the HFPCR is
expected to facilitate the monitoring and supervision of FP service
delivery activities in the hospitals and to accurately report services
delivered in the hospitals 104

IV. RECORDING FORMS
5. HOSPITAL FP INFORMED CONSENT FORM for Methods
Requiring Procedures. In the case of FP Clients, requiring
procedures, the following DOH FP Clinical guideline
requirements will hold with respect to documenting client
consent:
The FP counsellor shall ensure informed consent by:
• Reinforcing counseling to avoid regret and emphasizing
that BTL is a permanent method
• Explaining to the client the six elements of informed
consent written on the Informed Consent Form.
• Checking that the Informed Consent Form is signed
correctly by the client.
105

IV. RECORDING FORMS
Counseling must include the six elements of informed consent.
When the client desires to undergo BTL/vasectomy, he signs an
informed consent form that proves that the following six elements
have been discussed; and that the client fully understands and
comprehends the following before he/she accepts to go through
the procedure intended:
• Temporary contraceptives are available to the client
• Voluntary sterilization is a surgical procedure
• The surgical procedure involves risks, in addition to benefits.
Among the risks is the possibility that the procedure may fail
• The effect of the procedure should be considered permanent.
• The procedure does not protect against sexually transmitted
disease, including HIV/AIDS.
• The client can decide against the procedure at any time before
the operation is performed without losing the right to medical
health or other services or benefits.
106

Type 1 Clients: FP clients who decided to secure and regularly seek
FP services from the hospital and will be continuously recorded and
reported by the hospital under the HFPCR:
• will be continuously recorded by the hospital as current users in the
HFPCR unless they drop out, decide to transfer, or reach the age of
50 and above.
• will initially be recorded in the HFPCR as either OTHER
ACCEPTORS (if they already used a previous method) or NEW
ACCEPTORS (NA) if they received FP services for the first time and
will be accounted for as FP CURRENT USER (continuing user)
during the next reporting month.
• Clients aged 49 and below that were provided with BTL services by
the hospital shall be continuously recorded as a BTL current user
unless they’ve reached the age of 50.
• Other commodity-based clients (Pills, IUD, PSI, injectable, condom,
SDM) who have decided to regularly seek services/resupply from the
hospital (oftentimes, those living near the hospitals) shall likewise be
recorded as continuing FP current users of the hospital 108

Type 2 Clients: FP clients who initially decided to seek services
from the hospital but later went back to their respective
municipalities/cities to avail of needed services from their
RHUs/HCS; they will be recorded initially as NA or Other Acceptors
(Changed Method, Changed Clinic, Restart) by the hospital but will
be marked as drop-outs by the hospital upon seeking services
from the other facility (RHU or HC).
• These are clients who were provided with FP services
/commodities only once (or for a limited period of time) at the
hospitals but were referred back to RHUs/HCs for follow-up FP
services/supply of commodities and future recording and reporting.
• Upon referral to the other facility and transfer of responsibility, the
hospital will need to record these clients as DROP-OUTS and
subsequently deleted from the HFPCR, while the receiving facility,
e.g., RHU/HC (which ideally should be part of a referral
network/SDN) will record these clients as OTHER ACCEPTORS
(part of current users or CU) in the TCL. They will be continuously
recorded by the RHU/HC as CU in the TCL unless they drop out,
decide to transfer, or reach the age of 50 and above. 109

Type 3 Clients: These are clients who initially seek FP
services from the RHUs/HCs but opt to seek services or
change their source of service from RHUs/HC to the hospital.
• clients who initially seek out regular FP services/
commodities from RHUs/HCs but later on decided to
regularly obtain services from the hospital for different
reasons (e.g., change of residence);
• To be recorded initially as NA or Other Acceptors
(Changed Method, Changed Clinic, Restart) by the
RHUs/HCs but upon referral and transfer of responsibility
to the hospital, the RHU/HC will need to record these
clients as DROP-OUTS and subsequently delete them
from the TCL, while the hospital will record the clients as
OTHER ACCEPTORs in the HFPCR. To be continuously
recorded as current users by the hospital in the HFPCR
unless they drop out, decide to transfer, or reach the age
of 50 and above. 110

111
In dropping out FP clients by method, hospitals
shall follow the existing DOH FHSIS guidelines
to ensure synchronized FP recording and
reporting by all public health facilities
(to be discussed in a separate presentation)

V. REPORTING FORMS
2. Annual Form (A1) (including the supporting
Annual Consolidation Table)
VI. LOGISTICS MANAGEMENT RECORDING &
REPORTING
3. Hospital’s Daily Stock Record
4. Hospital’s Daily Dispending Record
5. Hospital’s Monthly Inventory Form
112

V. REPORTING FORMS
The Monthly Form 1 for FP contains indicators related to
accounting and tracking current users and new
acceptors for FP. It will help the hospital’s FP Point
Person/Team capture the monthly data so that it would
be easier for him/her to consolidate and prepare the
quarterly report to be submitted to the PHO/CHO or the
DOHRO.
113

V. REPORTING FORMS
114

V. REPORTING FORMS
STEPS IN PREPARING FOR THE MONTHLY FORM (M1):
1. Determine the Current Users for Beginning of April (2016)
[This is equivalent to Current Users as of previous month: March
2016]
2. Add the Total New Acceptors of the previous Month (March
2016)
3. Add the Total Other Acceptors (April 2016)
4. Deduct the Drop-outs for the Current Month (April 2016)
Example:
FPCU (as of end of April 2016) =
Current Users for Beginning of April (Equal to End of Month of
March) = 189
+ Total New Acceptors of the Previous Month = 33
+ Total Other Acceptors for the Current Month = 13
- Drop-outs = 5
Thus FPCU end of April 2016 = 230 115

New
Acceptors
(NA)
New users of any
FP method
Other
Acceptors
(OA)
Changed Method
Changed Clinic
Restart

117
Example:
FPCU (as of end of April
2016) =
Current Users for Beginning
of April (Equal to End of
Month of March) = 189
+ Total New Acceptors of the
Previous Month = 33
+ Total Other Acceptors for
the Current Month = 13
- Drop-outs = 5
Thus FPCU end of April 2016
= 230

118
REPORTING FORMS
Submission of M1 Reports:
• M1s of community/municipal/city hospitals managed by the
component municipalities/cities will be submitted to the
MHO/CHO.
• M1s of city hospitals managed by the chartered city will be
submitted to the CHO.
• M1s of district and provincial hospitals owned and managed
by the provincial government will be submitted to the PHO.
• M1s of DOH-retained hospitals and medical centers will be
submitted to the concerned DOHRO.
Schedule of Submission:
• Consistent with the FHSIS reporting schedule, all hospitals need to
submit their M1 reports 15 days after the month being reported.
M1s must be submitted in duplicate copies. Original copies must be
submitted to the PHO/CHO/DOHRO while the duplicate must be
retained at the hospital for reference.

V. REPORTING FORMS
1. Annual Form (A1)
The Annual Form 1 for FP contains indicators related to
accounting and tracking current users, new acceptors, and
drop-outs for the whole year. It will help the hospital’s FP
Point Person/Team capture the yearly data allow her/him to
consolidate and prepare the needed report for FHSIS.
The guide contains the Annual Consolidation Table which
will support the consolidation of all M1 data to generate the
end-of-year data
119

V. REPORTING FORMS
2. Annual Form (A1)
ANNUAL FORM OR A1 FOR FP - captures the annual
performance on FP; it accounts and tracks current users
and new acceptors for FP for the whole calendar year (Jan-
Dec)
Submission of A1 Reports. A1 of LGU hospitals will be
submitted to the PHO/CHO/MHO while A1 of DOH Regional
Hospitals and Medical Centers will be submitted to their
respective DOHRO. Consistent with the FHSIS reporting
schedule, all hospitals will need to submit A1 reports 3
weeks after the year being reported.
Important: A1 must be submitted in duplicate forms. Original copies
must be submitted to the PHO/CHO/DOHRO while duplicate copies
must be retained at the hospital for reference. 120

V. REPORTING FORMS
2. Annual Form (A1)
121

123
In preparing the
HOSPITAL SERVICE
STATISTICS REPORT
FORM FOR FP, you can
use information from the
A1

124
Hospitals Which Have Initially
Implemented the FP Recording and
Reporting System

New
Acceptors
(Previous
Month)
End
February/
Beginning
March
Feb March End March March
a. Female Sterilization/BTL 3642 61 5 3698 57 1 3682 No age = 1 3696
b. Male Sterilization/Vasectomy 0 0 0 0 0 0 0 0
c1. Pills -POP 358 33 358 38 12 0 29 38
c2. Pills-COC 160 4 160 14 10 0 12 No age = 1 13
d1. IIUD (Interval IUD) 88 0 1 97 17 0 96 97
d2. PP- IUD (Post-partum IUD) 284 7 0 292 38 1 241 291
e1. Injectables- POI 393 13 363 81 7 0 73 81
e2. Injectables -CIC 0 0 0 0 0 0 0 0
f. NFP-CM (Cervical Mucus) 0 0 0 0 0 0 0 0
g. NFP-BBT (Basal Body Temperature) 0 0 0 0 0 0 0 0
h. NFP-STM (Symptothermal Method) 0 0 0 0 0 0 0 0
i. NFP-SDM (Standard Days Method) 0 0 0 2 5 0 0 0
j. NFP-LAM (Lactational Amenorrhea Method) 0 0 0 0 0 0 0 0
k. Condom 355 8 344 31 10 0 30 31
l. Progestin-only Subdermal Implant 791 0 118 673 0 1 585 No age = 6 666
6071 126 1349 4926 156 3 4748 4913
FHSIS REPORT for the MONTH May YEAR: 2017
Age Disaggregation
of Current Users
(end of the Month)
Name of Hospital: BICOL REGIONAL TRAINING AND TEACHING HOSPITAL
Address: RIZAL ST., LEGAZPI CITY
FP Point Person: SARAH JANE L. TAWINGAN
Province/Region: REGION V
FAMILY PLANNING METHOD
Current
User
(Beginning
Month)
Acceptors
Dropout
(Present
Month)
Current
User
(End of
Month)
5 9
10 1
20-49
Other
Acceptors
(Present
Month)
0 0
0 14
New
Acceptors
of the
present
Month
14 and
Below
15-19
March
8
0 0
10 1
1 50
12 1
0 81
WRA
Current
Users
(15-49)
T o t a l 78 165
0 0
0 0
2 0
0 0
0 0
38

New Acceptors
Other
Acceptors
May-17 Jun-17
(a)+(b)+(c )
a. Female Sterilization/BTL 1961 0 48 0 2009 0 3 2006
b. Male Sterilization/Vasectomy 0 0 0 0 0 0 0 0
c. Pills 6330 60 18 82 6326 2 1019 5305
d. IUD 5007 83 28 122 4996 11 707 4278
e. Injectables 1269 13 15 11 1286 0 199 1087
f. NFP-CM (Cervical Mucus) 0 0 0 0 0
g. NFP-BBT (Basal Body Temperature) 0 0 0 0 0
h. NFP-STM (Symptothermal Method) 0 0 0 0 0
i. NFP-SDM (Standard Days Method) 0 0 0 0 0
j. NFP-LAM (Lactational Amenorrhea Method) 0 0 0 0 0
k. Condom 252 4 2 9 249 0 15 234
l. Progestin-only Subdermal Implant 149 0 0 2 147 0 6 141
14968 160 111 226 15013 13 1949 13051
BATANGAS MEDICAL CENTER
FP POINT PERSON: Teodora Rhodora Rayos
Kumintang Ibaba, Batangas City
MEDICAL CENTER CHIEF: DR. RAMONCITO C. MAGNAYE
Current User
END OF MAY, 2017
Acceptors
Dropout
(Present
Month)
JUNE 2017
T o t a l
All Current Users
served by BATMC
by END OF
JUNE 2017
Age Disaggregation of ALL
Current Users
SERVED BY BATMCas of
JUNE2017
14 and Below 15-19 20-49

New
Acceptors
(Previous
Month)
a. Female Sterilization/BTL 0 0 4383 0 0 4379
b. Male Sterilization/Vasectomy 0 0 0 0 0 0
c. Pills 62 37 1289 29 9 1062
d. IIUD/ PPIUD 41 48 689 67 4 548
e. Injectables 17 18 1050 28 2 964
f. NFP-CM (Cervical Mucus) 0 0 0 0 0 0
g. NFP-BBT (Basal Body Temperature) 0 0 0 0 0 0
h. NFP-STM (Symptothermal Method) 0 0 0 0 0 0
i. NFP-SDM (Standard Days Method) 0 0 0 0 0 0
j. NFP-LAM (Lactational Amenorrhea Method) 0 0 0 0 0 0
k. Condom 0 0 95 0 0 94
l. Progestin-only Subdermal Implant 0 0 83 0 1 76
120 103 7589 124 16 7123
T o t a l 7501 71 450
95 0 1
83 0 6
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
1051 0 84
20-49
Other
Acceptors
(Present
Month)
695 1 137
0 0 0
1256 8 218
4321 62 4
Current User
(Beginning
Month)
Acceptors
Dropout
(Present
Month)
Current User
(End of
Month)
New
Acceptors
of the
present
Month
14 and
Below
15-19
FHSIS REPORT for the MONTH JUNE YEAR: 2017
Age Disaggregation
of Current Users
(end of the Month)
Name of Hospital: DR. PAULINO J. GARCIA MEMORIAL RESEARCH AND MEDICAL CENTER
Address: CABANATUAN CITY
FP Point Person:
Province: _____NUEVA ECIJA_____

New
Acceptors
(Previous
Month)
a. Female Sterilization/BTL 2317 10 0 2365 6 0 2363
b. Male Sterilization/Vasectomy 2 0 0 2 0 2
c1. Pills 10 0 0 10 0 10
d1. PP- IUD (Post-partum IUD) 685 212 0 934 13 5 671
e1. Injectables 71 0 0 71 0 0 71
f. NFP-CM (Cervical Mucus) 0 0 0 0 0
g. NFP-BBT (Basal Body Temperature) 0 0 0 0 0
h. NFP-STM (Symptothermal Method) 0 0 0 0 0
i. NFP-SDM (Standard Days Method) 0 0 0 0 0
j. NFP-LAM (Lactational Amenorrhea Method) 0 0 0 0 0
k. Condom 0 0 0 0 0
l. Progestin-only Subdermal Implant 0 0 0 0 0
3085 222 0 3382 19 5 3117
T o t a l 75 260
0
0
0
0
0
0
0
0 o
37 258
0
20-49
Other
Acceptors
(Present
Month)
0
38 2
New
Acceptors
of the
present
Month
14 and
Below
15-19
Current
User
(Beginning
Month)
Acceptors
Dropout
(Present
Month)
Current User
(End of
Month)
FHSIS REPORT for the MONTH May YEAR: 2017
Age Disaggregation
of Current Users
(end of the Month)
Name of Hospital: ORIENTAL MINDORO PROIVINCIAL HOSPITAL
Address: Sta. Isabel Street, Calapan, Oriental Mindoro
FP Point Person: RACHEL MENDOZA
Province/Region: REGION IV-B MIMAROPA

REPORTING
3. HOSPITAL’S DAILY STOCK RECORD FOR FP (serves as
the hospital’s basis for determining FP commodity availability,
which shall be tracked vis a vis the existing FP current users
listed in the HFPCR and potential new acceptors; need to
ensure commodity security, thus tracking of commodities
available at the end of each day/month is vital.
The FP Point Person/Team shall keep the Hospital Daily Stock
Record and should account for the following:
• Quantities in stock (previous month’s balance)
• Quantities received
• Quantities dispensed to clients
• Losses (noted during inventory) and Expiring Commodities
• Stock Available at the end of the day/month
From this daily recording, we can compute for balance of that
commodity every day and the end of the month balance. 131

Family Planning
OCP Trust (POPSHOP)
per pill pack
2010
October
Day Stocks Received
From:
Quantity Received Quantity Dispensed
at the RHU to
Patients
Quantity Issued to
Midwives
Losses Balance
20
1 20
2 20
3 20
4 20
5 DKT 60 2 78
6 78
7 1 77
8 77
9 77
10 77
11 77
12 77
13 77
14 77
15 77
16 77
17 77
18 77
19 77
20 1 76
21 76
22 76
23 76
24 76
25 76
26 76
27 76
28 76
29 76
30 76
31
76
Stock name and preparation:
Program:
Units of Stock:
Daily Stock Record Book
Year:
Month:
Previous Month's Balance
End of Month Balance
General
Information
Status of stock
coming in the Facility
Status of
stock
going out
of the
Facility
Losses
noted
(inventory)
Exluton (POP)
Family Planning
per cycle
2016
June
Daily check
and
balance
Central Office
Qty Dispensed
to Clients
Qty Issued to
Different
Hosptl Depts

REPORTING
4. HOSPITAL’S DAILY STOCK RECORD FOR FP
The FP Point Person/Team shall:
• Fill out the General Information.
• Indicate the previous month’s balance (baseline inventory
balance).
• Identify source and quantity of stock received at the facility
at a particular day.
• Indicate quantity dispensed to patients at the hospital.
• Indicate the quantity issued to the different hospital
departments, if any.
• Indicate losses (if any) and record on the day losses were
noted.
• Indicate daily check and balance.
• Compute for end of month balance.
134

REPORTING
5. HOSPITAL’S DAILY DISPENSING RECORD BOOK – this
record contains the quantities of FP commodities dispensed to
specific clients for specific FP commodities.
The FP Point Person/Team at the hospital shall keep the copy
of this form and shall use this to document and to complete the
information on total commodities dispensed to clients everyday
135

REPORTING
5. HOSPITAL’S DAILY DISPENSING RECORD BOOK
The FP Point Person/Team shall:
• Fill out the General Information
• List down the names of ALL commodities, drugs, and
medicines and its preparation within the program of your
record.
• Identify the date of visit, name, address, and age of
client/patient
• Indicate the quantity of commodities provided to the
client/patient
• Ensure that client/patient acknowledges receipt of
commodities/drugs indicating their signature
• Indicate other notes in the remarks portion
• Update the HOSPITAL’S DAILY STOCK RECORD FOR FP
137

REPORTING
6. Monthly Physical Inventory and Commodity Expiration
Record - The monthly physical count verifies the availability
and number of units of each drug or medical supply currently
in stock. It provides an opportunity to verify that the data in the
Daily Stock Record Books are correct and separate expiring
commodities.
138

140
1. Identify all
potential FP clients
- clients who expressed
intention to use an FP
method but have not yet
been provided with either
information or services
- clients who have been
provided w/ information
through group
information-giving but
have not undergone 1-1
counselling nor received
any FP service
Record them in the
LIST OF
POTENTIAL FP
CLIENTS
2. Conduct one-
one counselling
(by an FPCBT-1
trained health
provider)
Record and fill-
out vital
information in the
FP FORM 1
VII. HOSPITAL RECORDING & REPORTING FLOW FOR FP
3. Secure
CONSENT FORM
for methods
requiring
procedures
And PARENTAL/
GUARDIAN
CONSENT
FORMS for clients
below 18

141
6. Transfer
information into the
Hospital’s FP
CLIENT RECORD
(HFPCR)
• Those that were
provided with the
FP services by
the FP Clinic or
OB Dept
• Those that were
provided
services at the
hospital’s DR or
OR
5. Issue the FP
CLIENT CARD;
fill-out with the
needed info to
document the FP
service provided
by the hospital
If the client
already have a
client card, simply
indicate the FP
services provided,
specify next
service date &
sign
4. Provide the FP
services/
commodities
based on client’s
informed choice

142
9. By end of the year,
prepare the:
• FHSIS ANNUAL
REPORT (A1) for
FP performance
• HOSPITAL
SERVICE
STATISTICS
REPORT FORM
FOR FP
8. By end of the
month, prepare the:
• FHSIS
MONTHLY
REPORT (M1) for
FP performance
and the
• Monthly
Physical
Inventory and
Commodity
Expiration
Record (to be
used in reporting
commodity stock
status to the
DOH
7. Document the
commodity
provided/
dispensed to the
client using the
DAILY
DISPENSING
RECORD
BOOK and
update the
DAILY STOCK
RECORD to
deduct all
commodities
that were
dispensed

Hospital’s data integrity and strong
evidences of performance upon which to
base hospital’s conclusion/
decisions/actions  greater opportunity to
support the poorest population
END OF PRESENTATION 
143

Part IV
Understanding the DQC Concept,
Tools, and Processes

What is “data quality check” (DQC)?
• Involves a step-by-step process of correctly
applying the definition, formula and recording
and reporting processes as contained in DOH
FHSIS Manual of Operations.
• This process has helped uncover different
sources of inaccuracies in reported FHSIS
statistics
• Provides a systematic approach for identifying
and addressing these sources of inaccuracies in
key FP and MCH indicators of FHSIS

What is “data quality check” (DQC)?
• DQC involves:
• Revisiting the source of data (TCL) & comparing
it with the report (M1) or the draft report to
arrive at a final version
• Capturing those that have not been reported
but were served
• Validating reported numbers with no names
• Reviewing and applying drop-out definition per
FHSIS guidelines
• Developing action plans to address gaps in
recording and reporting & challenges in FP
service provision

• In collaboration with NCDPC and EB, USAID supported the development “Data Quality
Check” Guide in 2010 based on FHSIS Manual of Operations 2008 in response to
observations of unexpectedly high forecast of commodity requirements during the
formulation of PIPH
• Tested, improved and reviewed by the DOH and LGUs
• DOH suggested to expand the DQC tool to include other key MCH indicators, namely, ANC4,
SBA, FBD, EBF, FIC and Vitamin A supplementation
• DQC was institutionalized and incorporated into the DOH’s Manual of Operations for
MNCHN/FP (2nd Edition, May 27, 2011)
• DQC updated to reflect changes in the updated FHSIS Manual of Operations 2012 . Changes
include new definitions and formula of some indicators and changes in TCL and reporting
forms.
• Training Tools for DQC (FP) updated to reflect changes in the updated FHSIS Manual of
Operations 2018

Examples of reported and corrected data
Source: USAID LuzonHealth Project
Source: LuzonHealth Project

Source: USAID LuzonHealth Project
Source: LuzonHealth Project

• Reliable data to forecast commodity and service requirements
• Provided a stronger basis for improving service delivery
• Realization that not only does DQC improve data quality, it
also helps LGUs plan and implement programs better; by
improving service delivery, the quality of their data also
improves.
• Realization that new sets of information from the FHSIS can be
extracted for new programs such as information on
adolescents and services provided to them
Usefulness of the DQC’d FHSIS data for LGUs

Improved
quality of
locally
generated
data
Improved
planning,
policy and
decision
making at
all levels
(national,
regional,
provincial,
municipal/
city,
barangay)
Evidence-
based
interventions
made to
improve
health
service
delivery
performance
Achievement
of UHC
goals:
better health
outcomes,
more
equitable
financing
and more
responsive
health
systems
DATA
QUALITY
CHECKED
DATA

DEFINING KEY ACTIONS
to ADDRESS GAPS in
Recording and Reporting
& in FP Service Provision
(DQC for FP)

SUSTAINING DQC
INITIATIVES THROUGH
POLICY SUPPORT
(DQC for FP)

Detailed Steps in
Conducting Data Quality
Check for FP
(DQC for FP)

FIRST STEP:
Learn the FPCU DEFINITION
and the DROP-OUT RULES
for FP (per FHSIS MOP & FP
DOH Clinical Guideline)

CURRENT USERS BY END OF THE PRESENT MONTH =
= Current users of the previous month
plus (+) New Acceptors of the previous month
plus (+) Other Acceptors of the current month
(changed clinic, changed method
restarted)
less (-) Dropouts

Drop-out:
Pills
A client is considered drop-out from the method if she:
 fails to re-supply from the last 21 white pill up to the
last brown pill (if the pills have a set of brown
tablets/iron); or within the last seven (7) days
 gets supply or transfers to another provider or clinic.
in this case, the client is listed under the Other
Acceptor (“Changed Clinic”) in the clinic where she
transferred and a drop-out in her former clinic. Or
shifted to another method, they are dropped out
from pills and entered as Other Acceptor (“Changed
Method”) for the method of their choice
 decides to stop the use of pills for any reason
Note: The service provider should undertake a follow-up visit
of the client during the above period before dropping her
from the method.

Drop-out:
Injectables
A client is considered a drop-out if she:
 for DMPA – every 3 months: fails to visit the clinic on the
scheduled date of visit up to the last day of 4 weeks after
the scheduled date of visit
 for NET-EN – every 2 months: fails to visit the clinic on the
scheduled date of visit up to the last day of 2 weeks after
the scheduled date of visit
 gets supply or transfers to another provider. The client is
listed under the Other Acceptor (“Changed Clinic”) in the
clinic where she transferred and a drop-out in her former
clinic
 stops receiving injection for any reason
Note: the service provider should undertake a follow-up visit
within this above period before dropping her from the
method.

Drop-out:
IUD
 decides to have the IUD removed
 has expelled IUD that was not re-inserted
 did not return on the scheduled date of follow-
up visit within three (3) to six (6) weeks after
insertion
 If the client has not followed up for 2 years
after initial follow-up visit or after effectivity
date of IUD
Note: Follow-up of the client within the week of
the scheduled visit should be done before
dropping her out from the method

Drop-out:
Implant
• did not return to the facility 3 years after
after the implant insertion for removal
and replacement of the implant rod.
• Decided to remove the implant rod
Note: The service provider should
undertake a follow-up visit during the
above period prior to dropping her out
from the method.

Drop-out:
BTL
A client is considered drop-out if she:
 reaches the age of 50 years
 reaches menopause
 underwent procedure like
hysterectomy or bilateral salpingo-
oophorectomy
Note: The service provider should
undertake a follow-up visit during the
above period prior to dropping her
out from the method.

Drop-out:
Condom
A client is considered a drop-out if
she:
 fails to return for re-supply on
scheduled visit
 gets supply from another clinic
(change clinic)
 decides not to use condom for any
reason

Drop-out:
NFP-LAM
A client is considered a drop-out if she does NOT
fulfill ANY of the following criteria:
 Mother has no menstruation or amenorrheic within
six months. Spotting or bleeding during the last
fifty-six (56) days postpartum is not considered
return of menses.
 Fully/exclusive breastfeeding which means:
No other liquid or solid except breast milk is given
to the infant,
Intervals should not exceed four (4) hours during
the day and six (6) hours at night.
 Baby is less than six (6) months

Drop-out:
NFP-SDM
 fails to return on the follow-up date to
check on the proper use of the method
 if the client fails to identify her own fertile
and infertile periods
 if the user has no indication of SDM use
through beads or no knowledge of first day
of menstruation or cycle length
 decides to stop using the method
Note: The service provider should undertake a
follow-up visit during the above period prior
to dropping her out from the method.

Drop-out:
NFP-
BBT/CMM/STM
For Basal Body Temperature/Cervical Mucus Method/
Symptothermal Method
A client is considered a drop-out if client:
 fails to return on the follow-up date to check on
the correct charting and/or the proper use of the
method
 fails to identify her own fertile and infertile periods
Note: Client is given a period of time (2 months) as a
learning user to practice correct charting with
assistance before recording the client as a new
acceptor. A new acceptor is considered if the client
can identify and chart her fertile and infertile period
correctly.

Drop-out:
for ANY OF THE
METHOD
A client is considered a drop-out if client:
 Reached 50 years of age
 underwent procedure like
hysterectomy or bilateral salpingo-
oophorectomy

Ensure that you have the
following:
 M1 (Current Month and
Previous Month)
 FP TCLs
 DQC Worksheet
 Ruler
 Pencil
 Calculator
 Other relevant records
From notebooks, etc 10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
a. BTL - Total 0 0 16 16
b. NSV - Total 0 0 0 0
c. Condom - Total 0 2 4 6
d.1 Pills-POP - Total 0 0 8 8
d.2 Pills-COC - Total 0 0 20 20
e. Injectables (DMPA/POI)-Total 0 0 22 22
f. Implant - Total 0 0 10 10
g.1 IUD-I- Total 0 0 5 5
g.2 IUD-PP - Total 0 0 0 0
h. NFP-LAM - Total 0 0 15 15
i. NFP-BBT - Total 0 0 0 0
j. NFP-CMM - Total 0 0 0 0
k. NFP-STM - Total 0 0 0 0
l. NFP-SDM - Total 0 0 0 0
m. Total 0 2 100 102
FHSIS REPORT for the MONTH: DECEMBER YEAR: 2019
Name of Barangay: SAMPAGUITA
Name of BHS: SAMPAGUITA
Name of Province: _______________________________
Drop-outs Current Users New Acceptors
(Beginning Month) New Acceptors Other Acceptors (Present Month) (End of Month) (Present Month)
Current Users No. of CU listed in the TCL No. of CU listed in the TCL but
not reported
(Compute B-A only if B>A)
No. of CU not listed in the TCL
(Compute A-B only if A>B)
Acceptors
(reported from Prev. M1)
END OF NOVEMBER
(Previous Month)
NOVEMBER
As of DECEMBER (A+C-D+E+F-G) DECEMBER
(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 5) (Col. 6) (Col. 7)
(Present Month)
DECEMBER
G H I
A B C D E F
BRGY

10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
10-14
y/o
15-19
y/o
20-49
y/o
Total
a. BTL - Total 0 0 16 16
b. NSV - Total 0 0 0 0
c. Condom - Total 0 2 4 6
d.1 Pills-POP - Total 0 0 8 8
d.2 Pills-COC - Total 0 0 20 20
e. Injectables (DMPA/POI)-Total 0 0 22 22
f. Implant - Total 0 0 10 10
g.1 IUD-I- Total 0 0 5 5
g.2 IUD-PP - Total 0 0 0 0
h. NFP-LAM - Total 0 0 15 15
i. NFP-BBT - Total 0 0 0 0
j. NFP-CMM - Total 0 0 0 0
k. NFP-STM - Total 0 0 0 0
l. NFP-SDM - Total 0 0 0 0
m. Total 0 2 100 102
FHSIS REPORT for the MONTH: DECEMBER YEAR: 2019
Name of Barangay: SAMPAGUITA
Name of BHS: SAMPAGUITA
Name of Province: _______________________________
Drop-outs Current Users New Acceptors
(Beginning Month) New Acceptors Other Acceptors (Present Month) (End of Month) (Present Month)
Current Users No. of CU listed in the TCL No. of CU listed in the TCL but
not reported
(Compute B-A only if B>A)
No. of CU not listed in the TCL
(Compute A-B only if A>B)
Acceptors
(reported from Prev. M1)
END OF NOVEMBER
(Previous Month)
NOVEMBER
As of DECEMBER (A+C-D+E+F-G) DECEMBER
(Col. 1) (Col. 2) (Col. 3) (Col. 4) (Col. 5) (Col. 6) (Col. 7)
(Present Month)
DECEMBER
G H I
A B C D E F
BRGY
M1 TCL Compute
PREVIOUS
PREVIOUS PRESENT PRESENT
TCL
Step 0. Secure a copy of the previous month’s M1, and the TCL with active clients. For
this example, we will have Nov 2019 as the previous month and Dec 2019 as the current
month

Step 1. Using the DQC Worksheet, under Column A, copy the values reported “FPCU-
End” from the previous month’s M1

Remember:
COLUMN A: FPCU
Beginning of
December
= is EQUAL to
FPCU End of
November
Previous Month’s M1
Step 1. Using the DQC Worksheet, under Column A, copy the values reported “FPCU-
End” from the previous month’s M1

Step 2. Check FP Method & Count all those that are listed and place the values
under Column B of the DQC Worksheet
Method: Pills-COC
6
7
8
9
10
1
2
3
4
5
FOLLOW-UP VISITS
(10)
DROP-OUT
(11)
Remarks/
Actions Taken
(12)
No.
Previous Method***
(9)
Complete Address
(4)
Complete Name
(FN, MI, LN)
(3)
Family Serial No.
(2)
Date of
Registration
(mm/dd/yy)
(1)
Type of Client*
(7)
SE Status
1 - NHTS
2 - Non-NHTS
(6)
Age/ Date of
Birth
(5)
Source**
(8)
* Type of Client:
NA = New Acceptors
CU = Current Users
CU-RS = Restarter
** Source:
Public
Private
BTL = Bilateral tubal ligation
NSV = No-Scalpel Vasectomy
CON = Condom
INJ = DMPA or CIC
**** Reasons:
A = Pregnant
E = Changed Clinic
G = Menopause
J = Change Method
M = No FP Commodity
N = Unknown
O = Age out for BTL
For LAM:
COUNT ALL
THAT ARE
LISTED in the
TCL

COLUMN B – ALL CLIENTS LISTED IN THE TCL

Column B:
Count the FP
Current Users
listed in the
TCLs as of end
of November

Steps in
Counting FP
CU for
Column A
(do not
dropout yet)
Check FP Method
Count all that were listed

COLUMN C: LISTED IN THE TCL BUT NOT REPORTED
Step 3. Count all those clients listed in the TCL (or in midwives notebooks/records)
but are not reported in the previous M1 (Difference between B and A, when B is
greater than A)

Column C:
Compute for No
of CU listed in
the TCL &
provided with
services but not
reported
C =B-A
if B>A
If B<A, please
proceed to
Column D

COLUMN D: REPORTED IN NUMBERS BUT NO NAMES
Step 4. Count all those numbers reflected in the M1 but have no names or are not listed
in the TCL (Difference between A and B, when A is greater than B) and reflect them
under Column D

Column D:
Compute for
No of CU reported
in numbers ,but
not listed (no
names) in the TCL
D =A-B
if A>B
If A=B, no need to
process Columns C
and D (just
indicate “0”)

COLUMN E: NEW ACCEPTORS
Step 5. Count the new acceptors of the previous month from the TCL and indicate
them under Column E

Column E:
Count the NEW
ACCEPTORS
(November)
 Date of Registration
 Age
 Type of Client
 Previous Method
 Follow-up Visit
Step 5. Count the new acceptors of the previous month from the TCL and indicate them
under Column E

Date of
Registration
(November)
Age Type of
Client
Identify NA
through date
indicated
Previous
Method
1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
5/1/1969 1/15/19 4/15/19 7/15/19 10/15/19
48 1/15/19 4/15/19 7/31/19 10/31/19
2/21/1969 1/25/19 4/25/19 7/25/19 10/25/19
48 1/25/19 4/25/19 7/25/19 10/25/19
1/1/1977 1/25/19 4/25/19 7/25/19 10/25/19
40 1/25/19 4/25/19 7/25/19 10/25/19
5/6/1973
2/17/19 5/17/19 8/17/19 11/17/19
44 2/17/19 5/17/19 8/17/19
4/25/1972 2/28/19 5/28/19 8/28/19 11/28/19
46 2/28/19 5/28/19 8/28/19
3/25/1973 1/25/19 4/25/19 7/25/19 10/25/19
45 1/25/19 4/25/19
4/30/1975 1/25/19 4/25/19 7/25/19 10/25/19
43 1/25/19 4/25/19
6/12/1977
42 11/18/19
10/17/1975
44 12/17/19
CU PILLS
8/17/2017 85 Navales, Helen
CU NONE
CU NONE
CU NONE
66 Cartageno, Jane
10/25/2017 67 Calaguas, Tala
CU NONE
12/17/2019 90 Felinas, Sita
CU NONE
CU NONE
11/18/2019 89 Labendes, Ina
10/25/2018 88 Ilagan, Gia
CU PILLS
CU PILLS
10/30/2018 87 Tamale, Dane
8/28/2018 86 Entarega, Mona
7/29/2017 84 So, Rachel
10/15/2017
Date of Registration
(mm/dd/yy)
No. Client Name
Age
Birthdate
Type of Client Previous Method
Follow up Visits
(Upper Space: Next Service Date / Lower Space: Date Accomplished)
Step 5a. In accounting for the new acceptors, review the TCL data – review the date of
registration and count those that are registered as New Acceptors (no previous method) of
the previous month (in this example: November 2019) and indicate them under Column E of
the DQC worksheet.

COLUMN F: OTHER ACCEPTORS
Step 6. Count the other acceptors of the current month from the TCL and indicate
them under Column F

Column F:
Count OTHER
ACCEPTORS
(December)
 Date of Registration
 Age
 Type of Client
 Previous Method
 Follow-up Visit
Count the
number of
Other
Acceptors
Step 6 . Count the number of other acceptors of the current month and
indicate them under Column E

Column F: Count OTHER ACCEPTORS (December)
 Date of
Registratio
n
(December)
 Age
 Type of
Client
 Previous
Method
1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
5/1/1969 1/15/19 4/15/19 7/15/19 10/15/19
48 1/15/19 4/15/19 7/31/19 10/31/19
2/21/1969 1/25/19 4/25/19 7/25/19 10/25/19
48 1/25/19 4/25/19 7/25/19 10/25/19
1/1/1977 1/25/19 4/25/19 7/25/19 10/25/19
40 1/25/19 4/25/19 7/25/19 10/25/19
5/6/1973
2/17/19 5/17/19 8/17/19 11/17/19
44 2/17/19 5/17/19 8/17/19
4/25/1972 2/28/19 5/28/19 8/28/19 11/28/19
46 2/28/19 5/28/19 8/28/19
3/25/1973 1/25/19 4/25/19 7/25/19 10/25/19
45 1/25/19 4/25/19
4/30/1975 1/25/19 4/25/19 7/25/19 10/25/19
43 1/25/19 4/25/19
6/12/1977 12/16/19
42 11/18/19 12/16/19
10/17/1975
44 12/17/19
CU PILLS
8/17/2017 85 Navales, Helen
CU NONE
CU NONE
CU NONE
66 Cartageno, Jane
10/25/2017 67 Calaguas, Tala
CU-CM PILLS
12/17/2019 90 Felinas, Sita
CU NONE
CU NONE
11/18/2019 89 Labendes, Ina
10/25/2018 88 Ilagan, Gia
CU PILLS
CU PILLS
10/30/2018 87 Tamale, Dane
8/28/2018 86 Entarega, Mona
7/29/2017 84 So, Rachel
10/15/2017
Date of Registration
(mm/dd/yy)
No. Client Name
Age
Birthdate
Type of Client Previous Method
Follow up Visits
(Upper Space: Next Service Date / Lower Space: Date Accomplished)
Step 6a. In accounting for the Other Acceptors, review the TCL data – review the date of
registration and count those that are registered as Other Acceptors during the current month
(in this example: December 2019) and indicate them under Column E of the DQC worksheet.

COLUMN G: DROPOUTS
Step 7. Applying the FHSIS rules on dropouts, count the number of clients that should
be dropped out for the current month (in this example, Dec 2019)

Column G: Identify
clients that need to be
DROPPED OUT in
December –includes
current and missed
dropouts
REFER TO
DROPOUT
CRITERIA PER
METHOD
Steps:
 Age (NOT >49yo)
 Follow-up visit
 Remarks

DROPOUT if AGE is > 49 years old
2/10/1970
49
Date of Registration (1)
(mm/dd/yy)
Family
Planning
Serial No.(2)
Client Name (3) Address (4)
Age
Birthdate (5)
1/22/2019 70 Daquia, Lena Block 1, Lot 21, Barangay Narra
2/19/2019 72 Felizar, Hazel Block 1, Lot 2, Barangay Narra
1/1/1967
52
1/26/2019 71 Rama, Elena Block 1, Lot 3, Barangay Narra
12/5/1969
50
Recheck
birthday vs. date
of follow-up visit

DROPOUT if NO FOLLOW UP VISIT
Accomplish
DROPOUT
COLUMN
1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Date Reason***
1/29/19
1/29/19
2/2/19
2/2/19
2/26/19
2/26/19
Follow up Visits (9) (Upper Space:
Next Service Date / Lower Space: Date Accomplished)
Drop-Outs (10)

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