Monthly Service Delivery Report for ( ) for the month Jan-2025

Data as on
Indicator Number Indicator Name Jan-2025
In-Facility Outreach Total
Part A REPRODUCTIVE AND CHILD HEALTH
M1 Ante Natal Care (ANC) Services & High Risk Pregnancies
1.1 Total number of NEW Pregnant Women registered for ANC 4 34 38
1.1.a Out of total number of NEW Pregnant Women registered with age <15 years 0 0 0
1.1.b Out of total number of NEW Pregnant Women registered with age 15-19 years 0 0 0
1.1.c Out of total number of NEW Pregnant Women registered with age >19 to 49 years 4 34 38
1.1.d Out of total number of NEW Pregnant Women registered with age >49 years 0 0 0
1.1.1 Out of the total NEW ANC registered, number registered within 1st trimester (within 12 weeks) 2 25 27
1.1.2 Total ANC footfall/cases (Old cases + New Registration) attended 13 65 78
1.2 ANC services
1.2.1 Number of PW given Td1 (Tetanus Diptheria dose 1) 0 10 10
1.2.2 Number of PW given Td2 (Tetanus Diptheria dose 2) 1 5 6
1.2.3 Number of PW given Td Booster (Tetanus Diptheria dose booster) 1 6 7
1.2.4 Number of PW provided full course 180 Iron Folic Acid (IFA) tablets 2 18 20
1.2.5 Number of PW provided full course 360 Calcium tablets 2 18 20
1.2.6 Number of PW given one Albendazole tablet after 1st trimester 0 0 0
1.2.7 Number of PW received 4 or more ANC check ups 1 35 36
1.2.8 Number of PW given ANC Corticosteroids in Pre-Term Labour 0 0 0
1.3 Pregnant Women (PW) with Hypertension (BP>140/90)
1.3.1 New cases of PW with hypertension detected 0 0 0
1.4 Pregnant Women (PW) with Anaemia
1.4.1 Number of PW tested for Haemoglobin (Hb ) 4 or more than 4 times for respective ANCs 2 10 12
1.4.2 Number of PW having Hb level<11(7.1 to 10.9 g/dl) (Out of total tested cases) 3 16 19
1.4.3 Number of PW having Hb level<=7 g/dl (Out of total tested cases) 0 0 0
1.5 Pregnant Women (PW) with Gestational Diabetes Mellitus (GDM)
1.5.1 Number of PW tested for Blood Sugar using OGTT(Oral Glucose Tolerance Test) 0 0 0
1.5.2 Number of PW tested positive for GDM out of total OGTT(Oral Glucose Tolerance Test) conducted 0 0 0
1.5.3 Number of PW given Metformin out of total tested positive for GDM 0 0
1.6 Pregnant Women (PW) with Syphilis
1.6.1 Syphilis test conducted for Pregnant Women
1.6.1.a Number of pregnant/Direct-In-Labor (DIL) women screened/tested (with VDRL/RPR/TPHA/RDT/PoC) for 4 16 20
1.6.1.b Number of pregnant/DIL women found Seropositive for Syphilis by VDRL/RPR/TPHA/RDT/PoC test 0 0 0
Number of pregnant/DIL women found Syphilis-Seropositive and given treatment with injection
1.6.1.c Benzathine Penicillin (IM) 0 0
1.6.1.d Number of live births among Syphilis Seropositive Pregnant Women 0 0
Number of babies born to Syphilis-Seropositive Pregnant Women tested positive/ clinically diagnosed for
1.6.1.e congenital Syphilis 0 0
1.6.1.f Out of above, babies with congenital Syphilis received curative treatment 0 0
1.7 Tuberculosis test conducted for Pregnant Women
1.7.1 Number of Pregnant Women screened for TB 0 0 0
1.7.2 Number of Pregnant Women identified with Presumptive TB symptoms 0 0 0
1.7.3 Number of Pregnant Women referred out of those identified with Presumptive TB symptoms 16 16
1.8 High Risk /Complicated Pregnancies
1.8.1 Total High Risk Pregnancy (HRP) Intrapartum including following: 0 0
1.8.1.a Number of Pregnant Women with Post-Partum Haemorrhage(Immediately after delivery) in the facility. 0 0
1.8.1.b Number of Pregnant Women with Sepsis in the facility. 0 0
1.8.1.c Number of Pregnant Women identified with Eclampsia in the facility 0 0
1.8.1.d Number of Pregnant Women identified with obstructed labour in the facility. 0 0
1.8.2 Total High Risk Pregnancy (HRP) Antepartum (Only New Cases are to be reported) 1 2 3
1.8.3 Total no. of ANC or PNC cases referred to Higher/ any other facility 1 1
M2 Deliveries
2.1 Deliveries conducted at Home
2.1.1 Number of Home Deliveries attended by
2.1.1.a Number of Home Deliveries attended by Skill Birth Attendant(SBA) (Doctor/Nurse/ANM) 0 0
2.1.1.b Number of Home Deliveries attended by Non SBA (Trained Birth Attendant(TBA) /Relatives/etc.) 0 0
2.1.2 Number of PW given Tablet Misoprostol during home delivery 0 0
2.1.3 Number of newborns received 7 Home Based Newborn Care (HBNC) visits in case of Home delivery 0 0
2.2 Number of Institutional Deliveries conducted (Including C-Sections) 11 11
 Out of total institutional deliveries(excluding C-section), number of women stayed for 48 hours or more
2.2.1 after delivery 0 0
Out of total Institutional deliveries, number of Institutional Deliveries (Excluding C-Sections) conducted at
2.2.2 night (8 PM- 8 AM) 0 0
2.3 Age wise total number of delivery (Home +Institutional) reported (2.3.1+2.3.2+2.3.3+2.3.4) 11 0 11
2.3.1 Out of total number of delivery, PW with age <15 years 0 0 0
2.3.2 Out of total number of delivery, PW with age 15-19 years 0 0 0
2.3.3 Out of total number of delivery, PW with age >19-49 years 11 0 11
2.3.4 Out of total number of delivery, PW with age > 49 years 0 0 0
2.4 Number of newborns received 6 HBNC visits after Institutional Delivery 33 33
2.5 No. of identified Sick new-borns referred by ASHA to facility under HBNC Programme 0 0
2.6 Total number of Children received all scheduled 5 Home visits under HBYC 0 0
M3 Pregnancy outcome & details of new-born/children
3.1 Pregnancy Outcome (in number)
3.1.1 Live Birth
3.1.1.a Live Birth - Male 7 0 7
3.1.1.b Live Birth - Female 4 0 4
3.1.2 Number of Pre-term newborns ( < 37 weeks of pregnancy) 0 0 0
3.1.3 Still Birth
3.1.3.a Intrapartum (Fresh) Still Birth 0 0 0
3.1.3.b Antepartum (Macerated) Still Birth 0 0 0
3.2 Abortion (spontaneous) 2 0 2
3.3.1 Post-abortion/MTP Complications
3.3.1.a Total Post-abortion/MTP Complications Identified 0 0
Post-abortion/MTP complications identified (where abortions were carried out in facilities other than
3.3.1.b. public and accredited private health facilities) 0 0
3.4 Details of Newborn children
3.4.1. Number of Newborns weighed at birth 0 0 0
3.4.2. Number of Newborns having weight less than 2500 gms 0 0 0
3.4.2.a Out of the above, number of Newborns having weight less than 1800 gms 0 0 0
3.4.3. Number of Newborns breast fed within 1 hour of birth 0 0 0
3.4.4. No. of Newborns discharged from the facility were exclusively breastfed till discharge 2 2
3.5. Rashtriya Bal Swasthaya Karyakram (RBSK)
3.5.1 Number of Newborns screened for defects at birth (as per Comprehensive Newborn Screening, RBSK) 0 0 0
Number of Newborns identified with visible birth defects (including Neural tube defect, Down's
3.5.1.a Syndrome, Cleft Lip & Palate, Club foot and Developmental dysplasia of the hip) 0 0 0
M4 Anaemia Mukt Bharat
4.1 IFA Coverage
Number of women of reproductive age (WRA) 20-49 years (non-pregnant, non-lactating), provided 4 Red
4.1.1. Iron and folic acid (IFA) tablets in a month 3 4 7
4.1.2. Number of children (6-59 months old) provided 8-10 doses (1ml) of IFA syrup (Bi weekly) 5 15 20
4.1.3 Number of children 5-9 years provided Weekly Iron Folic Acid (IFA Pink) tablets in a month
4.1.3.a Number of out of school children (5 -9 years) given 4-5 IFA Pink tablets at Anganwadi Centres 10 10
4.2 Anaemia- Identified & Treated
4.2.1 Beneficiaries identified with Mild and Moderate Anaemia
4.2.1.a Number of out of school adolescent girls (10-19 years) having anaemia (Hb 8.1-11.9 g/dl) 5 15 20
4.2.1.b Number of lactating mothers (of 0-6 months old child) having anaemia (Hb 8.1-11.9 g/dl) 1 0 1
Number of women of reproductive age (non-pregnant, non-lactating) (20-49 years) having anaemia (Hb
4.2.1.c 8.1-11.9 g/dl) 0 0 0
4.2.2 Beneficiaries identified with Severe Anaemia
4.2.2.a Number of out of school adolescent girls (10-19 years) having severe anaemia (Hb <8 g/dl) 0 0 0
4.2.2.b Number of lactating mothers (of 0-6 months old child) having severe anaemia ((Hb <8 g/dl) 0 0 0
Number of women of reproductive age (non-pregnant, non-lactating) (20-49 years) having severe anaemia
4.2.2.c (Hb <8 g/dl) 0 0 0
4.2.3 Beneficiaries diagnosed with mild and moderate Anaemia, put on treatment
4.2.3.a Number of anaemic in-school Children (5-9 years) put on treatment 0 0 0
4.2.3.b Number of anaemic in-school adolescent girls (10-19 years) put on treatment 0 0 0
4.2.3.c Number of anaemic out of school adolescent girls (10-19 years) put on treatment 0 0 0
4.2.3.d Number of anaemic in-school adolescent boys (10-19 years) put on treatment 0 0 0
4.2.3.e Number of anaemic lactating mothers (of 0-6 months old child) put on treatment 0 0 0
4.2.3.f Number of anaemic women of reproductive age (non-pregnant, non-lactating) (20-49 years) put on 0 0 0
M5 Post Natal Care (PNC)
5.1. In case of home delivery, number of women receiving 1st Postpartum checkups within 48 hours 0 0 0
 5.2. Number of women receiving Postpartum checkup between 48 hours and 14 days after Institutional 0 0
5.3. Number of mothers provided full course of 180 IFA tablets after delivery 8 0 8
5.4. Number of mothers provided full course 360 Calcium tablets after delivery 0 0 0
M6 Sexually Transmitted Infections/Reproductive Tract Infections (STI/RTI) Cases
6.1 Number of new STI/RTI cases identified
6.1.1. Number of males assessed for STI/RTI 0 0
6.1.1.a Out of the above, number of males diagnosed with STI/RTI 0 0
6.1.1.b Out of the above, number of males treated for STI/RTI 0 0
6.1.2. Number of females (all females) assessed for STI/RTI 0 0
6.1.2.a Out of the above, number of females (all females) diagnosed with STI/RTI 0 0
6.1.2.b Out of the above, number of females (all females) treated for STI/RTI 0 0
6.1.3. Number of H/TG assessed for STI/RTI 0 0
6.1.3.a Out of the above, number of H/TG people diagnosed with STI/RTI 0 0
6.1.3.b Out of the above, number of H/TG people treated for STI/RTI 0 0
M7 Family Planning
7.1. Number of Interval IUCD Insertions (excluding PPIUCD and PAIUCD) 0 0
7.2. Number of Postpartum (within 48 hours of delivery) IUCD insertions 2 2
7.3. Number of IUCD Removals 1 1
7.4. Number of complications following IUCD Insertion 0 0
7.5. Injectable Contraceptive MPA- First Dose 0 0 0
7.6. Injectable Contraceptive MPA- Second Dose 1 0 1
7.7. Injectable Contraceptive MPA- Third Dose 0 0 0
7.8. Injectable Contraceptive MPA- Fourth and above Dose 3 0 3
7.9. Number of Combined Oral Pill cycles distributed to the beneficiary 1 0 1
7.10. Number of Condom pieces distributed to the beneficiary 5 0 5
7.11. Number of Centchroman (weekly) pill strips distributed to the beneficiary 23 85 108
7.12. Number of Emergency Contraceptive Pills (ECP) given to the beneficiary 2 3 5
7.13. Number of Pregnancy Test Kits (PTK) utilized 3 19 22
7.14 Quality in sterilization services
7.14.1 Complications following male sterilization 0 0
7.14.2 Complications following female sterilization 0 0
M8 CHILD IMMUNISATION
8.1 Number of Infants 0 to 11 months old who received:
8.1.1. Child immunisation - Vitamin K (Birth Dose) 0 0
8.1.2. Child immunisation - BCG 1 11 12
8.1.3. Child immunisation - Pentavalent 1 0 15 15
8.1.4. Child immunisation - Pentavalent 2 2 10 12
8.1.5. Child immunisation - Pentavalent 3 0 15 15
8.1.6. Child immunisation - OPV 0 (Birth Dose) 2 0 2
8.1.7. Child immunisation - OPV1 0 15 15
8.1.8. Child immunisation - OPV2 2 10 12
8.1.9. Child immunisation - OPV3 0 13 13
8.1.10. Child immunisation - Hepatitis-B0 (Birth Dose) 2 5 7
8.1.11. Child immunisation - Inactivated Injectable Polio Vaccine 1 (IPV 1) 0 15 15
8.1.12. Child immunisation - Inactivated Injectable Polio Vaccine 2 (IPV 2) 0 13 13
8.1.13. Child immunisation - Rotavirus 1 0 15 15
8.1.14. Child immunisation - Rotavirus 2 9 10 19
8.1.15. Child immunisation - Rotavirus 3 0 13 13
8.1.16. Child immunisation - PCV1 0 15 15
8.1.17. Child immunisation - PCV2 1 12 13
8.2 Number of Children 9-11 months who received:
8.2.1. Child immunisation(9 - 11 months) - Inactivated Injectable Polio Vaccine 3 (IPV 3) 1 12 13
8.2.2. Child immunisation (9-11months) - Measles & Rubella (MR)/Measles containing vaccine(MCV) - 1st Dose 0 0 0
8.2.3. Child immunisation (9-11months) - JE 1st dose 0 8 8
8.2.4. Child immunisation - PCV Booster 1 13 14
8.2.5 Number of children aged between 9 and <12 months FULLY IMMUNIZED {BCG +OPV123+ Pentavalent123+ MR/ Measles Containing
8.2.5.a FULLY IMMUNIZED children aged between 9 and <12 months- Male 1 6 7
8.2.5.b FULLY IMMUNIZED children aged between 9 and <12 months- Female 1 4 5
8.3 Children given following vaccination after 12 months (delayed vaccinations)
Child immunisation(after 12 months-delayed vaccination) - Measles & Rubella (MR)/Measles containing
8.3.1. vaccine(MCV)- 1st Dose 0 0 0
8.3.2. Child immunisation (after 12 months-delayed vaccination) - JE 1st dose 1 8 9
8.3.3. Child immunisation - DPT 1 after 12 months of age (delayed vaccination) 0 0 0
 8.3.4. Child immunisation - DPT 2 after 12 months of age (delayed vaccination) 0 0 0
8.3.5. Child immunisation - DPT 3 after 12 months of age (delayed vaccination) 0 0 0
8.3.6. Child immunisation - DPT Booster after 24 months of age (delayed vaccination) 0 0 0
8.3.7. Child immunisation - OPV Booster after 24 months of age (delayed vaccination) 0 0 0
8.3.8. Child immunisation - JE Booster after 24 months of age (delayed vaccination) 0 0 0
8.4 Number of Children more than 12 months who received:
8.4.1. Child immunisation - Measles & Rubella (MR)/ Measles containing vaccine(MCV)- 2nd Dose (16-24 1 0 1
8.4.2. Child immunisation - DPT 1st Booster 1 9 10
8.4.3. Child immunisation - OPV Booster 1 9 10
Number of children more than 16 months of age who received Japanese Encephalitis (JE) vaccine- 2nd
8.4.4. dose (16-24 months) 0 0 0
8.5 Number of Children more than 23 months who received:
8.5.1. Child Immunization- Typhoid 0 0 0
8.5.2. Children more than 5 years received DPT5 (2nd Booster) 1 3 4
8.5.3. Children more than 10 years received Td10 (Tetanus Diptheria10) 0 2 2
8.5.4. Children more than 16 years received Td16 (Tetanus Diptheria16) 0 3 3
8.6 Adverse Event Following Immunisation (AEFI)
8.6.1. Number of cases of AEFI -Minor (eg.- fever, rash, pain etc) 2 0 2
8.6.2. Number of cases of AEFI - Severe (eg.- anaphylaxis, fever>102 degrees, not requiring hospitalization etc.) 0 0 0
8.6.3. Number of cases of AEFI - Serious (eg.- hospitalization, death, disability , cluster etc.) 0 0 0
8.6.3.a Out of Number of cases of AEFI - Serious , total number of AEFI deaths 0 0 0
8.7 Number of Immunisation sessions
8.7.1. Immunisation sessions planned 1 7 8
8.7.2. Immunisation sessions held 1 7 8
8.8 Children received Vitamin A Doses between 9 months and 5 years
8.8.1. Child immunisation - Vitamin A Dose - 1 1 9 10
8.8.2. Child immunisation - Vitamin A Dose - 5 0 0 0
8.8.3. Child immunisation - Vitamin A Dose - 9 0 0 0
M9 Number of cases of Childhood Diseases
9.1 New cases of Childhood Diseases (0-5 years) & Leprosy (0-14 years) Include new cases of OPD/IPD/Emenrgency
9.1.1. Childhood Diseases - Malaria 0 0
9.1.2. Childhood Diseases - Diarrhoea 1 0 1
9.1.3. Childhood Diseases - Diarrhoea treated with ORS 1 0 1
9.1.4. Childhood Diseases - Diarrhoea treated with Zinc for 14 days 0 0 0
Part B National Programmes
M10 National Vector Borne Disease Control Programme(NVBDCP)
10.1 Malaria
10.1.1 Rapid Diagnostic Test (RDT )
10.1.1.a RDT conducted for Malaria 0 0 0
10.1.1.b Malaria (RDT) - Plasmodium Vivax test positive 0 0 0
10.1.1.c Malaria (RDT) - Plasmodium Falciparum test positive 0 0 0
10.1.1.d Malaria (RDT) - Mixed test positive 0 0 0
10.2 Lymphatic Filaraisis
10.2.1. Number of persons that consumed MDA(Mass Drug Administration) drugs during the MDA round 0 0 0
Number of Lymphatic Filarisis lymphoedema patients received MMDP(Morbidity Management And
10.2.2. Disability Prevention) kits 0 0 0
M11 Adolescent Health
11.1. Coverage under MHS- Menstrual Hygiene Scheme (GOI supported)
11.1.1. Number of adolescent girls provided sanitary napkin packs by ASHA
11.1.2. Number of sanitary napkin packs distributed free to ASHA (for her personal use) 0 0
11.1.3. Number of adolescent girls attended monthly meeting 0 0
Number of adolescent girls provided sanitary napkin packs by State/UT supported Menstrual Hygiene
11.1.4. Scheme (MHS) 0 0 0
11.2 Peer Educator Programme
11.2.1. Number of Peer Educators selected 0 0
11.2.2. Out of the selected Peer Educators, numbers trained 0 0
11.2.3. Number of Adolescent Health & Wellness Days organized 1 7 8
11.2.4. Number of Adolescent Friendly Club Meetings organized 0 0
M12 National TB Elimination Programme (NTEP)
12.1. Number of notified TB patients who are on Anti Tuberculosis Therapy 0 0
12.2. Number of Presumptive TB (ie with 4 Symptom complex of TB) identified 0 0 0
12.3. Number of Presumptive TB (ie with 4 Symptom complex of TB) identified and sent for any TB testing 0
 Number of Presumptive TB (ie with 4 Symptom complex of TB) identified and sent for any TB testing
12.3.a within the facility 0 0
Number of Presumptive TB (ie with 4 Symptom complex of TB) identified and sent for any TB testing
12.3.b outside the facility 0 0
12.4. Of the number sent for testing, number who were tested (by any test) for TB within the facility 0 0
12.5. Of the number sent for testing, number who were tested (by any test) for TB outside the facility 0 0
12.6. Of the number tested, number of persons diagnosed as TB patients. 0 0
12.7. Number of TB patients availing treatment through a Treatment supporter for the reporting month 0 0
12.8. Number of Directly Observed Treatment, Short-course (DOTS) cases completed successfully 0 0
Part C Health facility Services
M13 Patient Services
13.1 Out Patient Department (OPD in Facility) by disease/ health condition (excluding teleconsultation)
13.1.1. Outpatient - Diabetes 0 0
13.1.2. Outpatient - Hypertension 0 0
13.1.3. Outpatient - Stroke (Paralysis) 0 0
13.1.4. Outpatient - Cardiovascular Disease 0 0
13.1.5. Outpatient - Mental illness 0 0
13.1.6. Outpatient - Epilepsy 0 0
13.1.7. Outpatient - Ophthalmic Related 0 0
13.1.8. Outpatient - Dental 0 0
13.1.9. Outpatient - ENT 0 0
13.1.10. Outpatients- Asthma 0 0
13.1.11. Outpatient - COPD 0 0
13.1.12. Outpatient - Tuberculosis 0 0
13.1.13. Outpatient - Palliative Care 0 0
13.1.14. Other Services
13.1.14.a Number of Palliative Patients visited at home 0 0
13.2 Outpatient attendance (All) (excluding teleconsultation)
13.2.1. Allopathic- Outpatient attendance 0 0
13.2.2. Ayush - Outpatient attendance 0 0
13.3 Inpatient details
13.3.1 Total Number of cases Referred out (OPD+IPD+Emergency)
13.3.1.a Total cases Referred out (OPD+IPD+Emergency)-During Day 0 0
13.3.2 Day Care Admissions 0 0
13.3.3 Total number of telemedicine consultation provided 0 0
13.4 Janani Shishu Suraksha Karyakram (JSSK)
13.4.1 Number of Pregnant Women(PW) and Post Natal Care (PNC) Beneficiaries provided
13.4.1.a Total number of PW and PNC - JSSK Beneficiaries 0 0 0
13.4.1.b Number of PW and PNC benificiaries provided - Free Medicines under JSSK 0 0 0
13.4.1.c Number of PW and PNC benificiaries provided - Free Diet under JSSK 0 0
13.4.1.d Number of PW and PNC benificiaries provided - Free Diagnostics under JSSK 0 0
13.4.1.e Number of PW and PNC benificiaries provided - Free Home to facility transport under JSSK 0 0
13.4.1.f Number of PW and PNC benificiaries provided - Interfacility transfers when needed under JSSK 0 0
13.4.1.g Number of PW and PNC benificiaries provided - Free Drop Back home under JSSK 0 0
13.4.2 Number of sick infants provided
13.4.2.a Number of infants admitted at facility due to any sickness- JSSK Beneficiaries 0 0
13.4.2.b Number of sick infants provided - Free Medicines under JSSK 0 0
13.4.2.c Number of sick infants provided - Free Home to facility transport under JSSK 0 0
13.4.2.d Number of sick infants provided - Interfacility transfers when needed under JSSK 0 0
13.4.2.e Number of sick infants provided - Free Drop Back home under JSSK 0 0
13.5. Number of Jan Arogya Samiti (JAS) meetings held 0 0
Number of Anganwadi centres reported to have conducted atleast one Village Health & Nutrition Day
13.6 (VHNDs)/UHND/ Outreach / Special Outreach sessions 0 0
13.7 Total number of UHND/VHND sessions conducted in the reporting month 0 0 0
13.8 Total number of Outreach/Special Outreach camps conducted in the reporting month 0 0 0
13.9 Stock outs
13.9.a Total no. of essential drugs for which stock-outs reported 0 0
13.10. National Viral Hepatitis Control Program (Diagnosis and Management of viral hepatitis)
13.10.1 Total number of blood samples screened by ELISA/Rapid tests for viral hepatitis
Total number of blood samples screened by ELISA/Rapid tests for viral hepatitis B i.e. HBsAg (excluding
13.10.1.a pregnant women) 0 0 0
13.10.1.b Total number of blood samples screened by ELISA/Rapid tests for viral hepatitis C(Anti- HCV) 0 0 0
13.10.2 Total number of blood samples tested positive by ELISA/ Rapid tests for viral hepatitis & its management
 Total number of blood samples tested positive by ELISA/ Rapid tests for Hepatitis B (out of those tested for
13.10.2.a HBsAg excluding pregnant women) 0 0 0
Total number of blood samples tested positive by ELISA/ Rapid tests for Hepatitis C (out of those tested for
13.10.2.b Anti-HCV) 0 0 0
13.10.3 Hepatitis B in pregnancy
13.10.3.a Number of Pregnant Women tested for HBsAg 0 0 0
13.10.3.b Number of Pregnant Women who are HBsAg positive(out of those tested for Hepatitis B i.e. HBsAg) 0 0 0
13.10.3.c Number of Pregnant Women found positive for HBsAg referred out to higher centre for institutional 0 0
13.10.3.d Number of newborn who received birth dose of Hepatitis B vaccine born to HBsAg positive pregnant 0 0 0
M14 Laboratory Testing
14.1 Total Number of Lab Tests
14.1.1 Total Number of Lab Tests done- Inhouse 0 0
14.1.2 Total Number of Lab Tests done- Outsourced 0 0
14.2 Hb Tests Conducted
14.2.1 Number of Hb tests conducted including kit tests 0 0 0
14.2.2 Out of the total number of Hb tests done, Number having Hb < 7 mg 0 0 0
14.3 HIV tests
14.3.1.a Number of males screened for HIV by Whole Blood Finger Prick/RDT test/POC test 0 0 0
14.3.1.b Out of the above, No. of males found reactive for HIV 0 0 0
14.3.1.c Number of HIV reactive males subjected to HIV test at Confirmatory Centre (Stand Alone-ICTC) 0 0
14.3.1.d Out of the above, No. of males confirmed as HIV Positive 0 0
14.3.2.a Number of females (non-ANC) screened for HIV by Whole Blood Finger Prick/RDT test/POC test 0 0 0
14.3.2.b Out of the above, No. of females (non-ANC) found reactive for HIV 0 0 0
14.3.2.c Number of HIV reactive females (non-ANC) subjected to HIV test at Confirmatory Centre (Stand Alone- 0 0
14.3.2.d Out of the above, No. of females (non-ANC) confirmed as HIV Positive 0 0
14.3.3.a Number of Pregnant Women (PW-ANC) screened for HIV by Whole Blood Finger Prick/RDT test/POC test 0 0 0
14.3.3.b Out of the above, No. of PW(ANC) found reactive for HIV 0 0 0
14.3.3.c Number of HIV reactive PW(ANC) subjected to HIV test at Confirmatory Centre (Stand Alone-ICTC) 0 0
14.3.3.d Out of the above, No. of PW(ANC) confirmed as HIV Positive 0 0
14.3.3.e Number of Pregnant Women (ANC&DIL) screened for HIV more than once(Repeated testing) 0 0
14.3.4.a Number of H/TG people screened for HIV by Whole Blood Finger Prick/RDT test/POC test 0 0 0
14.3.4.b Out of the above, No. of H/TG people found reactive for HIV 0 0 0
14.3.4.c Number of HIV reactive H/TG people subjected to HIV test at Confirmatory Centre (Stand Alone-ICTC) 0 0
14.3.4.d Out of the above, No. of H/TG people confirmed as HIV Positive 0 0
14.4 STI/RTI attendees Tested for Syphilis
14.4.1.a Total number of males tested for Syphilis (RPR/VDRL/PoC/ RDT/TPHA) 0 0 0
14.4.1.b Out of the above, number of males tested reactive for Syphilis (RPR/VDRL/PoC/ RDT/TPHA) 0 0 0
14.4.1.c Out of the above, number of males treated for Syphilis 0 0
14.4.2.a Total number of female (non-ANC) tested for Syphilis (RPR/VDRL/PoC/ RDT/TPHA) 0 0 0
14.4.2.b Out of the above, number of females (non-ANC) tested reactive for Syphilis (RPR/VDRL/PoC/ RDT/TPHA) 0 0 0
14.4.2.c Out of the above, number of females (non-ANC) treated for Syphilis 0 0
14.4.3.a Total number of H/TG people tested for Syphilis (RPR/VDRL/PoC/ RDT/TPHA) 0 0 0
14.4.3.b Out of the above, number of H/TG people tested reactive for Syphilis (RPR/VDRL/PoC/ RDT/TPHA) 0 0 0
14.4.3.c Out of the above, number of H/TG people treated for Syphilis 0 0
Part D Mortality Details
M15 Details of deaths reported
15.1.1.a New born deaths within 24 hrs(1 to 23 Hrs 59 minutes) of birth at Facility/Facility to facility in transit 0 0
15.1.1.b New born deaths within 24 hrs(1 to 23 Hrs 59 minutes) of birth in Community (at home or home to facility 0 0
15.1.2.a New born deaths within 1 week (1 to 7 days) at Facility/Facility to facility in transit 0 0
15.1.2.b New born deaths within 1 week (1 to 7 days) At Community (at home or home to facility transit) 0 0
15.1.3.a New born deaths within 8 to 28 days at Facility/Facility to facility in transit 0 0
15.1.3.b New born deaths within 8 to 28 days At Community (at home or home to facility transit) 0 0
15.1.4.a Infant Deaths (>28 days to 12 months) at Facility/Facility to facility in transit 0 0
15.1.4.b Infant Deaths (>28 days to 12 months) At Community (at home or home to facility transit) 0 0
15.2 Neonatal Deaths up to 4 weeks (0 to 28 days) due to
15.2.1. Neonatal Deaths up to 4 weeks (0 to 28 days) due to Sepsis 0 0
15.2.2. Neonatal Deaths up to 4 weeks (0 to 28 days) due to Asphyxia 0 0
15.2.3. Neonatal Deaths up to 4 weeks (0 to 28 days) due to complications of Prematurity 0 0
15.2.4. Neonatal Deaths up to 4 weeks (0 to 28 days) due to Other causes 0 0 0
15.3 Infant Deaths Between more than 28 days and less than 12 months due to
15.3.1. Number of Infant Deaths (>28 days - 12 months) due to Pneumonia 0 0
15.3.2. Number of Infant Deaths (>28 days - 12 months) due to Diarrhoea 0 0
15.3.3. Number of Infant Deaths (>28 days - 12 months) due to Fever related 0 0
15.3.4. Number of Infant Deaths (>28 days - 12 months) due to Measles 0 0
15.3.5. Number of Infant Deaths (>28 days - 12 months) due to Others 0 0 0
15.4 Child Deaths between 1 year and less than 5 years due to
15.4.1. Number of Child Deaths (1 -5 years) due to Pneumonia 0 0
15.4.2. Number of Child Deaths (1 -5 years) due to Diarrhoea 0 0
15.4.3. Number of Child Deaths (1 -5 years) due to Fever related 0 0
15.4.4. Number of Child Deaths (1 -5 years) due to Measles 0 0
15.4.5. Number of Child Deaths (1 -5 years) due to Others 0 0 0
15.5 Maternal Deaths due to
15.5.1. Number of Maternal Deaths due to APH (Antepartum Haemmorhage) 0 0
15.5.2. Number of Maternal Deaths due to PPH (Post-Partum Haemmorhage) 0 0
15.5.3. Number of Maternal Deaths due to Pregnancy related infection and sepsis, Fever 0 0
15.5.4. Number of Maternal Deaths due to Abortive complication 0 0
15.5.5. Number of Maternal Deaths due to Obstructed/prolonged labour 0 0
Number of Maternal Deaths due to Severe hypertension/fits & Hypertensive disorder in pregnancy, birth
15.5.6. and puerperium 0 0
15.5.7. Number of Maternal Deaths due to Other/Unknown Causes 0 0
15.5.8. Age wise total Maternal Deaths, occurred at Facility 0
15.5.8.a Out of total number of maternal deaths, deaths with age<15 years 0 0
15.5.8.b Out of total number of maternal deaths, deaths with age 15-19 years 0 0
15.5.8.c Out of total number maternal deaths, deaths with age more than >19-49 years 0 0
15.5.8.d Out of total number maternal deaths, deaths with age more than >49 years 0 0
15.6 Other Deaths (except Infant, Child & Maternal Deaths) 5 years and above due to
15.6.1. Number of deaths due to Diarrhoeal diseases 0 0
15.6.2. Number of deaths due to Tuberculosis 0 0
15.6.3. Number of deaths due to Respiratory diseases including infections (other than TB) 0 0
15.6.4. Number of deaths due to Other Fever Related 0 0
15.6.5. Number of deaths due to Heart disease/Hypertension related 0 0
15.6.6. Number of deaths due to Cancer 0 0
15.6.7. Number of deaths due to Neurological disease including strokes 0 0
15.6.8. Number of deaths due to Accidents/Burn cases 0 0
15.6.9. Number of deaths due to Self Harm 0 0
15.6.10. Number of deaths due to Animal bites and stings 0 0
15.6.11. Number of deaths due to Known Acute Disease 0 0
15.6.12. Number of deaths due to Known Chronic Disease 0 0
15.6.13. Number of deaths due to Other Causes 0 0 0
15.7. Deaths due to Vector Borne Diseases ( all age groups)
15.7.1. Number of Deaths due to Malaria- Plasmodium Vivax 0 0
15.7.2. Number of Deaths due to Malaria- Plasmodium Falciparum 0 0
15.8 Total Deaths (above 5 years of age) 0 0 0
15.8.1 Above 5 years to below 10 years 0 0 0
15.8.2 Above 10 years to below 19 years 0 0 0
15.8.3 Adult above >19 years 0 0 0
Part E Quality Control
M16 QA (Quality Assurance) & BEMMP (Biomedical Equipment Management & Maintenance Program)
16.1 EQAS Compliance
16.1.1. Total Quantity of Bio medical waste generated in Kg for the month (All Yellow, Red, white & Blue) 0 0
16.1.2. Total Quantity of General waste generated in Kg for the month 0 0