Monthly Reporting Matrix to Track and Monitor Status of EO12 and AO 2017-0005 Implementation

Municipality/City of____________________________ Total Population:______________________________

Province of __________________________ Estimated Number of WRA with unmet MFP______________________________

Program/Activities/Pr 2017 2018

2017
ojects under Key TOTAL
Remarks Total Remarks
Result Area Indicator Qtr 1 Qtr 2 Qtr 3 Qtr 4 Qtr 1 Qtr 2 Qtr 3 Qtr 4

A. Demand Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Generation
A.1. Total Number of WRA actually reached and identified with UNMFP

A.1.1. Number of WRA reached through community based activities (i.e. Family
Development Sessions; house to house visits; RPFP sessions; USAPAN series)
A.2.1 Women aged 10-14 with unmet need for FP are identified
A.2.2.Women aged 15-19 with unmet need for FP are identified
A.2.3.Women aged 20-49 with unmet need for FP are identified
A.3.1. Number of NON-NHTS WRA reached and identified with unmet need for MFP
A.3.2. Number of NHTS-WRA reached and identified with unmet need for MFP
A.4. Total number of WRA identified with unmet needs referred and linked for appropriate
services
B. Service B.1. Total Number of WRA with UMFP provided with FP Information, counseling, and
Delivery appropriate MFP serivces

B.2. Number of NON NHTS Women provided with FP information, counseling, and
appropriate MFP services
B.3. No. of New acceptors of modern FP methods through post-partum FP
B.3.1. 10-14 years old, new acceptors through post partum FP
B.3.2. 15-19 years old, new acceptors through post partum FP
B.3.3. 20 years old & above, new acceptors through post partum FP
B.4. New acceptors of modern FP methods through outreach missions
B.4.1. 10-14 years old New acceptors of modern FP methods through outreach missions

B.4.2. 15-19 years old New acceptors of modern FP methods through outreach missions

B.4.3. 20 years old & above New acceptors of modern FP methods through outreach
missions

B.5. New acceptors of modern FP methods through regular public health facilities

B.5.1. 10-14 years old New acceptors of modern FP methods served

B.5.2. 15-19 years old New acceptors of modern FP methods served
B.5.3. 20 years old & above New acceptors of modern FP methods served
B.6. Total number of New Acceptors for Modern Family Planning Methods
B.6.1. LAM
B.6.2. NFP
B.6.3. Pills
B.6.4. Injectables
B.6.5. IUD
B.6.6. NSV
B.6.7. BTL
B.6.8. Subdermal Implants
Notations:
Post-partum FP (PPFP) is the provision of mFP after birth up to 42 days (6weeks);
LAM should be counted up to 6 weeks
Any mFP service that is provided after 42 days shall be considered as either an outreach
mFP service or local routine service in the facility depending on which setting such mFP
Prepared by: services were provided

___________________
Name and Position
Province/ City of____________________________

Total Population: ___________________________

Estimated Number of WRA with unmet need for mFP:___________________________

Program/Activities/Projects
under Key Result Area

A. Demand
Generation
B. Service Delivery
Prepared by:

___________________
Name and Position
 Co

_________________________

_________________________
f WRA with unmet need for mFP:___________________________

Indicator

A.1. Total Number of WRA actually reached and identified with UNMFP
A.1.1. Total Number of WRA reached through community based activities (i.e. Family
Development Sessions; house to house visits; RPFP sessions; USAPAN series)
A.2.1. Women aged 10-14 with unmet need for FP identified
A.2.2.Women aged 15-19 with unmet need for FP identified
A.2.3. Women aged 20-49 with unmet need for FP identified
A.3.1. Number of NON-NHTS WRA reached and identified with unmet need for MFP
A.3.2. Number of NHTS-WRA reached and identified with unmet need for MFP
A.4. Total number of WRA identified with unmet needs referred and linked for appropriate
services
B.1. Total Number of WRA with unmet need for MFP provided with FP Information,
counseling, and appropriate MFP serivces
B.2. Number of NON NHTS Women provided with FP information, counseling, and
appropriate MFP services
B.3. No. of New acceptors of modern FP methods through post-partum FP
B.3.1. 10-14 years old, new acceptors through post partum FP
B.3.2. 15-19 years old, new acceptors through post partum FP
B.3.3. 20 y.o. & Above, new acceptors through post partum FP
B.4. New acceptors of modern FP methods through outreach missions
B.4.1. 10-14 years old New acceptors of modern FP methods through outreach missions
B.4.2. 15-19 years old New acceptors of modern FP methods through outreach missions
B.4.3. 20 y.o. & above New acceptors of modern FP methods through outreach missions
B.5. New acceptors of modern FP methods provided in regular public health facilities
B.5.1. 10-14 years old New acceptors of modern FP methods served
B.5.2. 15-19 years old New acceptors of modern FP methods served
B.5.3. 20 y.o. & Above New acceptors of modern FP methods served
B.6. Total number of New Acceptors for Modern Family Planning Methods
B.6.1. LAM
B.6.2. NFP
B.6.3. Pills
B.6.4. Injectables
B.6.5. IUD
B.6.6. NSV
B.6.7. BTL
B.6.8. Subdermal Implants
Noted/ Approved:

___________________________
Provincial Health Officer
 Consolidated Reporting Matrix to Track and Monitor Status of EO12 and AO 2017-0005 Implementatio

Total Population:____
Estimated Number of

2017
Qtr 1 Qtr 2 Qtr 3

Jan Feb Mar Apr May Jun Jul Aug Sep

Implementation

pulation:______________________________
ed Number of WRA with unmet MFP______________________________

2017
2018
TOTAL
Qtr 4 Qtr 1 Qtr 2

Oct Nov Dec Jan Feb Mar Apr May Jun

Notations:
Post-partum FP (PPFP) is the provision of mFP after birth up to
LAM should be counted up to 6 weeks
Any mFP service that is provided after 42 days shall be consider
mFP service or local routine service in the facility depending on
services were provided
8
Total Remarks
Qtr 3 Qtr 4

Jul Aug Sep Oct Nov Dec

up to 42 days (6weeks);

nsidered as either an outreach

ing on which setting such mFP
 Monthly Reporting Matrix to Track and Monitor Status of EO12 and AO 2017-0005 Implementa

Province/ City of____________________________

Total Population: ___________________________
Estimated Number of WRA with unmet need for mFP:___________________________

Program/Activities/Projects
under Key Result Area
A. Demand
Generation
B. Service Delivery
Prepared by:

___________________
Name and Position

RHU 1 - Name of Health Facility

RHU 2 - Name of Health Facility
RHU 3 - Name of Health Facility
RHU 4 - Name of Health Facility
RHU 5 - Name of Health Facility
RHU 6 - Name of Health Facility
hly Reporting Matrix to Track and Monitor Status of EO12 and AO 2017-0005 Implementation

_________________________
_________________________
f WRA with unmet need for mFP:___________________________

Indicator RHU 1

A.1. Total Number of WRA actually reached and identified with UNMFP

A.1.1. Total Number of WRA reached through community based activities (i.e. Family
Development Sessions; house to house visits; RPFP sessions; USAPAN series)
A.2.1. Women aged 10-14 with unmet need for FP identified
A.2.2.Women aged 15-19 with unmet need for FP identified
A.2.3. Women aged 20-49 with unmet need for FP identified
A.3.1. Number of NON-NHTS WRA reached and identified with unmet need for MFP
A.3.2. Number of NHTS-WRA reached and identified with unmet need for MFP
A.4. Total number of WRA identified with unmet needs referred and linked for appropriate
services
B.1. Total Number of WRA with unmet need for MFP provided with FP Information,
counseling, and appropriate MFP serivces
B.2. Number of NON NHTS Women provided with FP information, counseling, and
appropriate MFP services
B.3. No. of New acceptors of modern FP methods through post-partum FP
B.3.1. 10-14 years old, new acceptors through post partum FP
B.3.2. 15-19 years old, new acceptors through post partum FP
B.3.3. 20 y.o. & Above, new acceptors through post partum FP
B.4. New acceptors of modern FP methods through outreach missions
B.4.1. 10-14 years old New acceptors of modern FP methods through outreach missions
B.4.2. 15-19 years old New acceptors of modern FP methods through outreach missions

B.4.3. 20 y.o. & above New acceptors of modern FP methods through outreach missions

B.5. New acceptors of modern FP methods provided in regular public health facilities
B.5.1. 10-14 years old New acceptors of modern FP methods served
B.5.2. 15-19 years old New acceptors of modern FP methods served
B.5.3. 20 y.o. & Above New acceptors of modern FP methods served
B.6. Total number of New Acceptors for Modern Family Planning Methods
B.6.1. LAM
 B.6.2. NFP
B.6.3. Pills
B.6.4. Injectables
B.6.5. IUD
B.6.6. NSV
B.6.7. BTL
B.6.8. Subdermal Implants
Noted/ Approved: Notations:
Post-partu
___________________________ LAM shoul
Provincial Health Officer Any mFP s
days shall b
outreach m
service in t

alth Facility
alth Facility
alth Facility
alth Facility
alth Facility
alth Facility
 Month _________________________

RHU 2 RHU 3 RHU 4 RHU 5 RHU 6 Total Remarks

ations:
-partum FP (PPFP) is the provision of mFP after birth up to 42 days (6weeks);
should be counted up to 6 weeks
mFP service that is provided after 42
shall be considered as either an
each mFP service or local routine
ce in the facility
 Consolidated Reporting Matrix to Track and Monitor Status of EO12 and AO 2017-0005 Implementation

REGIONAL OFFICE
Region ____________________________
Total Population: ___________________________
Estimated Number of WRA with unmet need for mFP:___________________________

Program/Activities/Projects
2017 2018
2017
Total Remarks
under Key Result Area Indicator Qtr 1 Qtr 2 Qtr 3 Qtr 4
TOTAL
Qtr 1 Qtr 2 Qtr 3 Qtr 4

B. Demand Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Generation A.1. Total Number of WRA actually reached and identified with UNMFP
A.1.1. Number of WRA reached through community based activities (i.e. Family Development Sessions; house to
house visits; RPFP sessions; USAPAN series)
A.2.1. Women aged 10-14 with unmet need for FP are identified
A.2.2.Women aged 15-19 with unmet need for FP are identified
A.2.3. Women aged 20-49 with unmet need for FP are identified
A.3.1. Number of NON-NHTS WRA reached and identified with unmet need for MFP
A.3.2. Number of NHTS-WRA reached and identified with unmet need for MFP
A.4. Total number of WRA identified with unmet needs referred and linked for appropriate services
C. Service Delivery B.1. Total Number of WRA with unmet need for MFP provided with FP Information, counseling, and appropriate
MFP serivces

B.2. Number of NON NHTS Women provided with FP information, counseling, and appropriate MFP services
B.3. No. of New acceptors of modern FP methods through post-partum FP
B.3.1. 10-14 years old, new acceptors through post partum FP
B.3.2. 15-19 years old, new acceptors through post partum FP
B.3.3. 20 y.o. & Above, new acceptors through post partum FP
B.4. New acceptors of modern FP methods through outreach missions
B.4.1. 10-14 years old New acceptors of modern FP methods through outreach missions
B.4.2. 15-19 years old New acceptors of modern FP methods through outreach missions
B.4.3. 20 y.o. & above New acceptors of modern FP methods through outreach missions
B.5. New acceptors of modern FP methods provided in regular public health facilities
B.5.1. 10-14 years old New acceptors of modern FP methods served
B.5.2. 15-19 years old New acceptors of modern FP methods served
B.5.3. 20 y.o. & Above New acceptors of modern FP methods served
B.6. Total number of New Acceptors for Modern Family Planning Methods
B.6.1. LAM
B.6.2. NFP
B.6.3. Pills
B.6.4. Injectables
B.6.5. IUD
B.6.6. NSV
B.6.7. BTL
B.6.8. Subdermal Implants
Notations:
Post-partum FP (PPFP) is the provision of mFP after birth up to 42 days (6weeks);
LAM should be counted up to 6 weeks
Any mFP service that is provided after 42 days shall be considered as either an outreach mFP service or local routine service in the
facility

Prepared by: Noted/ Approved:

__________________ ___________________________
Name and Position Regional Health Office
 Monthly Reporting Matrix to Track and Monitor Status of EO12 and AO 2017-0005 Implementa

Province/ City of____________________________

Total Population: ___________________________
Estimated Number of WRA with unmet need for mFP:___________________________

Program/Activities/Projects
under Key Result Area
A. Demand
Generation
B. Service Delivery
Prepared by:

___________________
Name and Position
hly Reporting Matrix to Track and Monitor Status of EO12 and AO 2017-0005 Implementation

_________________________
_________________________
f WRA with unmet need for mFP:___________________________

Indicator PHO 1

A.1. Total Number of WRA actually reached and identified with UNMFP

A.1.1. Total Number of WRA reached through community based activities (i.e. Family
Development Sessions; house to house visits; RPFP sessions; USAPAN series)
A.2.1. Women aged 10-14 with unmet need for FP identified
A.2.2.Women aged 15-19 with unmet need for FP identified
A.2.3. Women aged 20-49 with unmet need for FP identified
A.3.1. Number of NON-NHTS WRA reached and identified with unmet need for MFP
A.3.2. Number of NHTS-WRA reached and identified with unmet need for MFP
A.4. Total number of WRA identified with unmet needs referred and linked for appropriate
services
B.1. Total Number of WRA with unmet need for MFP provided with FP Information,
counseling, and appropriate MFP serivces
B.2. Number of NON NHTS Women provided with FP information, counseling, and
appropriate MFP services
B.3. No. of New acceptors of modern FP methods through post-partum FP
B.3.1. 10-14 years old, new acceptors through post partum FP
B.3.2. 15-19 years old, new acceptors through post partum FP
B.3.3. 20 y.o. & Above, new acceptors through post partum FP
B.4. New acceptors of modern FP methods through outreach missions
B.4.1. 10-14 years old New acceptors of modern FP methods through outreach missions
B.4.2. 15-19 years old New acceptors of modern FP methods through outreach missions

B.4.3. 20 y.o. & above New acceptors of modern FP methods through outreach missions

B.5. New acceptors of modern FP methods provided in regular public health facilities
B.5.1. 10-14 years old New acceptors of modern FP methods served
B.5.2. 15-19 years old New acceptors of modern FP methods served
B.5.3. 20 y.o. & Above New acceptors of modern FP methods served
B.6. Total number of New Acceptors for Modern Family Planning Methods
B.6.1. LAM
B.6.2. NFP
B.6.3. Pills
B.6.4. Injectables
B.6.5. IUD
B.6.6. NSV
B.6.7. BTL
B.6.8. Subdermal Implants
Noted/ Approved: Notations:
Post-partu
___________________________ LAM shoul
Regional Health Office Any mFP s
days shall b
outreach m
service in t
 Month _________________________

PHO2 PHO3 PHO4 PHO5 PHO6 Total Remarks

ations:
-partum FP (PPFP) is the provision of mFP after birth up to 42 days (6weeks);
should be counted up to 6 weeks
mFP service that is provided after 42
shall be considered as either an
each mFP service or local routine
ce in the facility