MIS SC Format PDF

DEFINITIONAND GUIDELINE OF DATA ELEMENTS IN SUB CENTER MONTHLY FORMAT
Part A REPRODUCTIVE AND CHILD HEALTH

M1 Ante Natal Care (ANC)
Antenatal care is the healthcare received by a woman during pregnancy. Antenatal care starts with ‘history-
taking’ and is followed by examination of the woman, which basically includes: recording weight and
height, blood test for anaemia, blood pressure measurement, regular abdominal examination, etc., as per the
ANM guidelines. The woman is advised for diet, regular antenatal check-ups, and counselled for family
planning. She is also provided with immunisation for TT and IFA tablets, Calcium and Albendazole tablets
along with proper treatment required in case of any complication.
Ideally, as per the RCH schedule, 1st ANC check-up is to be done within 12 weeks, preferably as soon as the
pregnancy is suspected, 2nd ANC check-up: between 14-26 weeks, 3rd ANC check-up: between 28-34 weeks,
4th ANC check-up: between 36-40 weeks, but due to unawareness, mobility, distance, etc., the timing for the
check-ups may vary
1.1 Data Element- Total number of pregnant women registered for ANC
Definition: Total number of NEW pregnant women registered for ante natal care during the reporting month.
Guideline: The visit should include relevant check-ups required for antenatal care. Registration should
include ANC check-up. ANC first check-up is same as ANC registration. A pregnant woman is generally
registered during the very first contact with the health facility/worker, irrespective of her stage of pregnancy.
Data Source – Antenatal Register / Pregnancy Register/ RCH register
1.1.1 Data Element- Out of the total ANC registered, number registered within first trimester (within 12
weeks)
Definition: Out of the total number of pregnant women registered (reported in data element-1.1 above), the
number registered within 12 weeks (i.e. first trimester) of pregnancy during the reporting month.
Guideline: First trimester refers to the first three months (12 weeks) of a woman’s pregnancy. It should not
be confused with the first quarter of the calendar year.
Data Source – Antenatal Register / Pregnancy Register / RCH register
1.2 Ante Natal Care (ANC) Services
1.2.1 Data Element - Number of PW given TT1

Definition: Total number of pregnant women who received the first dose of TT immunization during the
reporting month.
Guideline: Two doses of TT are administered to the pregnant woman during pregnancy.The first dose of TT
should be administered as soon as possible, preferably when the woman registers for ANC.
Data Source – Antenatal Register / Pregnancy Register / RCH register
1.2.2 Data Element -Number of PW given TT2
Definition: Total number of pregnant women who have received the second dose of TT immunization during
the reporting month.
Guideline: The second dose of TT is to be administered one month after TT first dose (TT1) but, preferably,
at least one month before the expected date of delivery
Data Source – Antenatal Register / Pregnancy Register
1.2.3 Data Element -Number of PW given TT Booster
Definition: Total number of pregnant women who have received Booster dose of TT immunization
during the reporting month.
Guideline: If the woman has been previously immunised with two TT doses during a previous
pregnancy (within the past 3 years), a single dose of TT is administered and would be counted as TT
Booster.
1.2.4 Data Element -Total number of PW given 180 Iron Folic Acid (IFA) tablets
Definition: Total number of pregnant women who have given 180 IFA tablets (equivalent to 100 mg of
elemental iron and 0.5 mg of folic acid per tablet daily) during the re-porting month.
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Guideline: The number of pregnant women who were given 180 IFA tablets are to be reported and
NOT the number of IFA tablets. If the number of IFA tablets given to a pregnant woman is less than 180,
then she should not be reported till she is given 180th tablet. If more than 180 IFA tablets are given to any
pregnant woman, she should be counted when she had received 180 IFA tablet and should not be counted
for extra tablets given to her.
Any person other than pregnant woman given IFA tablets should not be reported here.
1.2.5 Data Element -Number of PW given 360 Calcium tablets
Definition: Total number of pregnant women who were given 360 tablets (one tablet, equivalent to 500 mg
of Calcium with 250 I.U. Vitamin D3, to be taken twice daily) during the reporting month.
Guideline: The number of pregnant women are to be reported and NOT the number of Calcium
tablets. If the number of Calcium tablets given to a woman is less than 360, then she should not be
reported. If more than 360 tablets are given to any pregnant woman, she should be counted when she had
received 360 tablets and should not be counted for extra tablets given to her.
Any person other than pregnant woman getting Calcium tablets should not be reported here.
1.2.6 Data Element -Number of PW given one Albendazole tablet after 1st trimester
Definition: Total number of pregnant women who were given one tablet of Albendazole (400 mg) after 1st
trimester for the reporting month.
Guideline: The number of pregnant women who were given one tablet of Albendazole (400 mg) is to be
reported and NOT the number of Albendazole tablets (400 mg).
Any person other than pregnant woman getting Albendazole tablets should not be reported here.
1.2.7 Data Element -Number of PW received 4 or more ANC check ups
Definition: Number of pregnant women who received the 4 or more ANC check-up during the
reporting month.
Guideline: The 4 ANC check-ups should be adequately spaced as per the schedule given in M1 above. If a
woman comes for the ANC check-up for the first time, in the late weeks of pregnancy it should NOT be
counted as 4th ANC check-up, it would be her 1st ANC check-up. Only those pregnant women who received
their 4th or more ANC check-up during the reporting month are to be reported.
1.2.8 Data Element -Number of PW given ANC Corticosteroids in Pre Term Labour
Definition: Number of pregnant women who were given single dose of corticosteroid (injectable)
Guideline: The health worker should identify whether the pregnant woman (between 24 and 34 weeks of
gestation) is in true labour or not. In case of true labour, single course of injection of Dexamethasone to be
administered to pregnant woman.
1.3 Pregnant women (PW) with Hypertension (BP>140/90mmHg)
1.3.1 Data Element -New cases of PW with hypertension detected
Definition: Number of antenatal women who have been detected with hypertension (Blood Pressure - more
than 140/90mmHg) for the FIRST TIME in their pregnancy during the reporting month.
Guideline: If a pregnant woman is detected with hypertension in her earlier antenatal check-up and is
detected with high BP in the current month as well, then she will not be reported again.
Data Source – Antenatal Register / Pregnancy Register / RCH Register
1.3.1.a Data Element -Out of the new cases of hypertension detected, cases managed at institution
Definition: Number of antenatal women who have been detected with hypertension (BP more than
140/90mmHg) for the FIRST TIME in their pregnancy and treatment/management has been initiated during
Guideline: If a pregnant woman is detected with hypertension in her earlier antenatal check-up and
treatment/management is already initiated, then she will not be reported again. Cases referred to higher
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institutions are not to be reported here.
1.4 Pregnant women (PW) with Anaemia
1.4.1 Data Element- Number of PW tested for Haemoglobin (Hb ) 4 or more than 4 times for respective
ANCs
Definition: Number of pregnant women tested for Haemoglobin (Hb) during the reporting month.
Guideline: In order to identify anaemia, HB test should be conducted for every pregnant woman. A woman
is categorized under any one of category based on her Hb level:
 More than 11 g/dl: absence of anaemia
 7–11 g/dl: Moderate anaemia
 Less than 7 g/dl: Severe anaemia
Only those pregnant women are to be reported whose Hb was measured using a Hemoglobinometer or by
any other acceptable laboratory method. Examination of eye/nails is not to be reported. In case multiple tests
are conducted on a single pregnant woman, it should be reported as one.
Data Source – Antenatal Register / Pregnancy Register / Laboratory Register / RCH register
1.4.2 Data Element- Number of PW having Hb level<11 (7.1 to 10.9 g/dl) (tested cases)
Definition: Number of pregnant women having Haemoglobin (Hb) less than 11g/dl detected using
Hemoglobinometer or any other acceptable laboratory method during the reporting month.
Guideline: Only those cases are to be reported where the Hb was measured by a Hemoglobinometer or any
other acceptable laboratory method and was found to be less than 11g/dl. Examination of eye/nails is not to
be reported. Only new cases should be considered
1.4.3 Data Element- Number of PW having Hb level<7 (tested cases)
Definition: Number of pregnant women tested and found with Haemoglobin (Hb.) less than 7g/dl during the
reporting month.
Guideline: Only those cases are to be reported where the Hb was measured by a Hemoglobinometer or any
other acceptable laboratory method and was found to be less than 7g/dl. Examination of eye/nails is not to
be reported. Only new cases should be considered
1.5 Pregnant Women (PW) with Syphilis
1.5.1 Point of care (POC) test conducted for Syphilis
1.5.1a Data Element: Number of PW tested using POC test for Syphilis
Definition: Total number of pregnant women who were tested for Syphilis using Point of care test for
syphilis.
Guidelines: The number of pregnant women who receives syphilis test at facility or in VHND using point of
care test for syphilis out of total number of Pregnant women registered during the month at these facility
Data Source: ANC Register/ANM Register at Sub-centre.
1.5.1b Data Element: Out of above, number of PW found sero positive for syphilis
Definition: Total number of pregnant women were found sero positive for syphilis using point of care test for
syphilis out of the total number of Pregnant women who were tested for syphilis using Point of care test at
facility during the month.
Guidelines: Out of the total number of pregnant women tested for syphilis using POC how many of them
were diagnosed (found Sero-positive) with syphilis.
Data Source: ANC Register/ANM Register at Sub-centre.
M2 Deliveries
2.1 Deliveries conducted at Home
2.1.1 Number of Home Deliveries attended by
2.1.1.a Data Element- Number of Home Deliveries attended by Skill Birth Attendant (SBA)
(Doctor/Nurse/ANM)
Definition: Number of home deliveries attended by a Doctor, Nurse or an ANM during the reporting month.
Guideline: SBA is a person who can handle common obstetric and neonatal emergencies and is able to
timely detect and recognise when a situation reaches a point beyond his/her capability, and refers the
woman/newborn to an appropriate facility without delay usually Doctor, Nurse, ANMs are considered as a
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Skilled Birth Attendant.
Data Source – Delivery Register / RCH register
2.1.1.b Data Element- Number of Home Deliveries attended by Non SBA (Trained Birth Attendant (TBA)
/Relatives/etc.)
Definition: Total number of home deliveries attended by anyone OTHER than a Skilled Birth Attendant
(TBA/Relatives/etc.) during the reporting month. Trained ‘dais’ will also come under this data element.
Guideline: The information on non-SBA home deliveries can come from AWW or ASHA but has to be
recorded in the register and reported by the ANM.
Data Source – Delivery Register / RCH register
2.1.2 Data Element- Number of PW given Tablet Misoprostol during home delivery
Definition: Total number of pregnant women who were administered three tablets of Misoprostol (200 mg).
in case of home delivery during the reporting month.
Guideline: Advance distribution of Misoprostol tablets needs to be made to those women who have been
identified as likely to deliver at home and have reached the 8th month of their pregnancy so that the tablets
are available with the pregnant woman after delivery for prevention of Postpartum Haemorrhage (PPH).
The numbers of pregnant women administered three tablets of Misoprostol (200 mg) are to be reported and
NOT the number of Misoprostol tablets (200 mg).
2.1.3 Data Element- No. of newborns receiving 7 Home Based Newborn Care (HBNC) visits in case of Home
delivery.
Definition: Under HBNC Programme, ASHAs are required to make 7 home visits on 1st,3rd , 7th , 14th ,
21st , 28th and 42nd days in case of home delivery during reported month.
Data Source – ASHA Register
2.2 Data Element- Number of Institutional Deliveries conducted
Definition: Total number of deliveries conducted at the facility during the reporting month.
Guideline: Home deliveries are not to be reported here. Also the deliveries conducted in private
nursing homes and the referred cases to any higher facility are also not to be reported here.
If a delivery is conducted in nearby PHC/CHC or any other facility, ANM will not include these
deliveries in the sub-Centre report.
Data Source – Labour Room Register/Delivery Register / RCH Register
2.2.1 Data Element- Out of total institutional deliveries number discharged within 48 hours of delivery
Definition: Out of the total deliveries conducted (as reported in data element above- 2.2) in the facility, the
number of women discharged within 48 hours of delivery, during the reporting month.
Guideline: It is important that a woman should stay in the facility for at least 48 hours after delivery.
Data Source – Labour Room Register/Delivery Register / RCH Register
2.2.2 Data Element- No. of newborns receiving 6 HBNC visits
Definition: Under HBNC Programme, ASHAs are required to make 6 home visits on 3rd , 7th , 14th , 21st ,
28th and 42nd days in case of institutional delivery during reported month.
Data Source – ASHA Register
M3 Pregnancy outcome & details of new-born
3.1 Pregnancy Outcome (in number)
Definition: Pregnancy outcome is the sum of live births, still-births, and spontaneous abortions.
Live birth: Complete expulsion or extraction of baby from its mother, irrespective of the duration of the
pregnancy, which shows any sign of life, such as movement, breathing, heartbeat, or pulsation of the
umbilical cord, crying, even for a short period (few seconds).
Still Birth: Complete expulsion or extraction of baby from its mother where the foetus does not breathe or
show any evidence of life, such as beating of the heart or a cry or movement of the limbs. In case the foetus
dies in the uterus after 20 week or during labour/delivery, it will be reported under still birth.
Abortion: Complete expulsion or extraction of the product of conception of a pregnant woman less than 20
weeks of gestation. An abortion can occur spontaneously due to complications during pregnancy or can be
induced. Spontaneous abortions (miscarriages) occur when an embryo or foetus is lost due to natural causes/
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accidents before the 20th week of gestation.
3.1.1 Live Birth
Total number of live births during the reporting month. In case of difficulty in attributing gender, make
a note of the same and attribute it to the nearest category. This is a calculated field hence the entry is not
to be made in this field.
3.1.1.a Data Element- Live Birth – Male
Definition: Number of male live births during the reporting month.
Data Source – ANC Register / Labour Room Register/ RCH Register
3.1.1.b Data Element- Live Birth – Female
Definition: Number of female live births during the reporting month.
3.1.2 Data Element- Number of Pre term newborns ( < 37 weeks of pregnancy)
Definition: Number of newborns born less than 37 weeks of pregnancy during the reporting month.
3.1.3 Data Element- Still Birth
Definition: Number of still births during the reporting month.
Guideline- Complete expulsion or extraction of baby from its mother where the foetus does not breathe or
show any evidence of life, such as beating of the heart or a cry or movement of the limbs. In case the foetus
dies in the uterus after 20 week or during labour/delivery, it will be reported under still birth
3.2 Data Element- Abortion (spontaneous)
Definition: Total number of spontaneous abortions occurred either at home (in the sub-Centre area) or at the
sub-Centre during the reporting month
Guideline: Here only the spontaneous abortions that took place or were reported to the health worker are to
be included. MTPs/induced abortions are not to be reported by the Sub-Centre but are to be reported by
the facility performing these.
Data Source – Delivery Register/Labour Room Register/ RCH Register
3.3 Details of Newborn children
3.3.1 Data Element- Number of newborns weighed at birth
Definition: Number of newborns (live births) weighed within 24 hours of birth during the reporting month.
Guideline: This would include neonates who were weighed either at sub-Centre or at home.
Data Source – Delivery Register/ Labour Room Register/ RCH Register
3.3.2 Data Element- Number of newborns having weight less than 2.5 kg
Definition: Total Number of new borns (live births) who were weighed (out of data element 3.3.1) and were
having weight of less than 2500 grams, during the reporting month.
Data Source – Pregnancy Register/ Labour Room Register/ RCH Register
3.3.3 Data Element -Number of Newborns breast fed within 1 hour of birth
Definition: Out of total number of Live births, newborns who were breastfed within one hour of delivery,
Guideline: This would include newborns delivered at sub-Centre or at home. In case of home deliveries, the
health worker (ASHA or AWW) has to record and report to the ANM of pertinent Subcenter for the reporting
month.
Data Source -Pregnancy Register/ Child Care Register/ RCH Register
M4 Post Natal Care (PNC)
The first six-weeks (42 days) after delivery is called post-partum/postnatal period.
4.1 Data Element -Women receiving 1st post-partum checkups within 48 hours of delivery of home
delivery
Definition: Total number of women who received first post-partum check-up within 48 hours of home
delivery (0-48 hours) during the reporting month.
Guideline: This would include the post-partum check–up given by ANM/ SBA trained/ ASHA, at home
within 48 hours of delivery.
Data Source Inpatient Register/Pregnancy Register
4.2 Data Element -Women receiving 1st Post partum check-up between 48 hours and 14 days
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Definition: Total number of women who received first post partum check-up between 48 hours and 14 days
after delivery during the reporting month.
Guideline:. This would not include the post partum checkups given before 48 hours.
Data Source Inpatient Register/Pregnancy Register
4.3 Data Element -Number of mothers provided full course of 180 IFA tablets after delivery
Definition: Total number of mothers who were given 180 IFA tablets (equivalent to 100 mg of elemental
iron and 0.5 mg of folic acid per tablet daily) during the reporting month.
Guideline: The number of mothers who were given 180 IFA tabletes are to be reported and NOT the
number of IFA tablets. If the number of IFA tablets given to a mother is less than 180, then she should not
be reported till she is given 180th tablet. If more than 180 IFA tablets are given to any mother, she should be
counted when she had received 180 IFA tablets and should not be counted for extra tablets given to her.
Any person other than woman (who has recently delivered) given IFA tablets should not be counted here.
Data Source –Pregnancy Register/Post natal Register
4.4 Data Element- Number of mothers provided 360 Calcium tablets after delivery
Definition: Total number of mothers who were given 360 tablets (one tablet, equivalent to 500 mg of
Calcium with 250 I.U. Vitamin D3, to be taken twice daily) during the reporting month.
Guideline: The number of mothers are to be reported and NOT the number of Calcium tablets. If the
number of Calcium tablets given to a mother is less than 360, then she should not be reported.. If more than
360 Calcium tablets are given to any mothers, she should be counted when she had received 360 tablets and
should not be counted for extra tablets given to her.
Any person other than woman (who has recently delivered) given Calcium tablets should not be reported
here.
Data Source –Pregnancy Register/Post natal Register
M5 Family Planning
Family planning methods regulate the number and spacing of children in a family through use of
contraceptives or other methods of birth control.
5.1 Intra Uterine Contraceptive Device (IUCD)
5.1 Data Element -Number of Interval IUCD Insertions (excluding PPIUCD and PAIUCD)Definition:
Total number of IUCD insertions (excluding PPIUCD and PAIUCD insertions) done at the SC during the
reporting month.
Data Source - IUCD Service delivery Register
5.2 Data Element -Number of Post Partum (within 48 hours of delivery) IUCD insertions
Definition: Total no. of PPIUCD insertions (the number of IUCD insertions to women within 48 hours of
delivery) during the reporting month
Data Source –Labour Room Register/ PPIUCD Service delivery Register
5.3 Data Element -Number of IUCD Removals
Definition: Total number of IUCDs removed during the reporting month.
Guideline: IUCDs removed at the facility are to be reported. Cases whose removal is referred to any other
facility should not be reported here.
Data Source - IUCD/PPIUCD follow up Register
5.4 Data Element – Complications following IUCD insertion
Definition: All cases of complications reported after IUCD (Interval PPIUCD & PAIUCD) insertion such as
abnormal bleeding cramps etc. by women in the facility.
Guideline:- IUCD is considered a safe and effective contraception method and serious complications from
IUCDs’ are rare. All the cases needs to verified/cross checked by a health provider and then to be reported
Data Source - IUCD/PPIUCD follow up Register
5.5 Data Element: Injectable Contraceptive-Antara Program- First Dose
Definition: Total number of eligible couples administered first dose of Injectable Contraceptive at the facility
during reporting month.
Data Source - MPA register /MPA Card
5.6 Data Element: Injectable Contraceptive-Antara Program- Second Dose
Definition: Total number of eligible couples administered second dose of Injectable Contraceptive at the
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facility during reporting month.
Guideline: Second dose of Injectable MPA should be administered after three months of first dose. If the
client is given Injectable MPA beyond 4 months from last injection (one month overdue from scheduled date)
then consider this client as new user and this dose as the first dose.
Data Source -MPA Register/MPA Card
5.7 Data Element: Injectable Contraceptive-Antara Program- Third Dose
Definition: Total number of eligible couples administered third dose of Injectable Contraceptive at the
facility during reporting month.
Guideline: Third dose of Injectable MPA should be administered after three months of second dose. If the
client is given Injectable MPA beyond 4 months from last injection (one month overdue from scheduled date)
then consider this client as new user and this dose as the first dose.
5.8 Data Element: Injectable Contraceptive-Antara Program- Fourth or more than fourth dose
Definition: Total number of eligible couples administered fourth dose or more than fourth dose of Injectable
Contraceptive at the Sub-Centre during reporting month.
Guideline: Injectable MPA should be administered every three months till the women wants contraceptive
benefit. If the client is given Injectable MPA beyond 4 months from last injection (one month overdue from
scheduled date) then consider this client as new user and this dose as the first dose
5.9 Data Element -Number of Combined Oral Pills cycles distributed
Definition: Total number of combined oral pill cycles (packets) distributed during the reporting month.
Guideline: Number of COC (Mala N) cycles distributed through ASHA and facility is to be reported
(Distribution means, distribution to actual beneficiaries and NOT inventory transfer from sub-Centre to
ASHA etc)
Here need to report only oral pills cycles distributed not the number of pills distributed.
The strips are stocked with ASHAs’, The ANM would have to ascertain from ASHA and report it.
Data Source -Family Planning Register/ Inventory Register
5.10 Data Element -Number of Condom pieces distributed
Definition: Total number of condom pieces distributed during the reporting month.
Guideline: Number of Condom pieces distributed through ASHA and facility is to be reported
(Distribution means, distribution to actual beneficiaries and NOT inventory transfer from sub-Centre to
ASHAs’ etc). This would include condoms taken by beneficiaries from distribution points in sub-Centre
and from condom boxes
The strips are stocked with ASHAs’, The ANM would have to ascertain from ASHA and report it.
Data Source -Family Planning Register/ Inventory Register
5.11 Data Element -Number of Centchroman (weekly) strips distributed
Definition: Total number of Centchroman (weekly) (Chhaya) strips distributed during the reporting month.
Guideline: This would include the total number of Centchroman (Chhaya) strips distributed and also those
distributed through ASHA and facility (Distribution means distribution to actual beneficiaries and NOT
inventory transfer from sub-Centre to ASHAs’ etc.).
Centchroman pills (Chhaya) are not to be confused with Oral Contraceptive Pills (Mala N) (data Element 5.9)
and they have to be reported separately. The ANM would have to ascertain from ASHA and report it.
Data Source -Family Planning Register/Inventory Register
5.12 Data Element -Number of Emergency Contraceptive Pills (ECP) given
Definition: Total number of emergency contraceptive pills distributed during the reporting month.
Guideline: This would include the total number of emergency contraceptive pills (i.e. pill which are taken
within 72 hours of unprotected sexual act to prevent an unwanted/ undesired pregnancy) distributed, and
those distributed through ASHA and facility. (Distribution means distribution to actual beneficiaries and NOT
inventory transfer from sub-Centre to ASHAs’ etc.). The ANM would have to ascertain from ASHA and
report it.
5.13 Data Element -Number of Pregnancy Test Kits (PTK) used
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Definition: Total number of pregnancy testing kits used in Subcenter and by ASHAs during the reporting
month.
Guideline: This would include the total number of pregnancy testing kits used in Subcenter and by ASHAs.
This will also include the pregnancy testing kits distributed by ASHAs in the community. (Distribution means
distribution to actual beneficiaries and NOT inventory transfer from sub-Centre to ASHAs’ etc.). The ANM
would have to ascertain from ASHA and report it
5.14 Quality in sterilization services
Number of complications following sterilization
Guideline: Total number of cases of complications following NSV/conventional vasectomy or female
sterilisation reported during the reporting month.
Any male/female having undergone sterilisation and reports or is diagnosed as having a complication related
to the sterilisation procedure is to be reported here.
Information through word of mouth needs to be cross checked and then reported by the ANM.
Data Source – Family Planning Register / OPD Register
5.14.1 Data Element -Complications following sterilization – Male
Definition: All male sterilisation acceptors who report or are diagnosed as having a complication related to
the sterilisation procedure during the reporting month.
Guideline: Complication after male sterilisation includes bleeding, infections, mild inflammatory reaction,
etc.
DO NOT report cases that ANM has only heard of (non verified/ non examined).
Data Source -Family Planning Register/OPD Register
5.14.2 Data Element -Complications following sterilization – Female
Definition: All the cases of complications following female Sterilisation (Minilap / Laparoscopic/ Post-
Partum) are to be reported here.
Guideline: Serious complications after female sterilisation are rare and are most likely to occur with
abdominal procedures. These include bleeding, infection, reaction to the anaesthetics, and injury to the
bowels or blood vessels rarely and require major surgical repair.
DO NOT report cases that ANM has only heard of (non verified/ non examined).
Data Source -Family Planning Register/OPD Register
M6 CHILD IMMUNISATION
6.1 Number of Infants 0 to 11 months old who received:
Total number of infants (0 to 11 months) who were immunized for a vaccine preventable disease during the
reporting month.
This would also include infants (aged 0-11 months) who had received their immunizations beyond the due
date due to any reason
Data Source – Immunisation Register/RCH Register
6.1.1 Data Element -Child immunisation - Vitamin K (Birth Dose)
Definition: Total number of newborns who were administered Vitamin K (Birth Dose) either at facility or at
home during the reporting month.
Guideline: Vitamin K should be administered to all newborns within 24 hours of birth.
Data Source – Immunisation Register
6.1.2 Data Element -Child immunisation – BCG
Definition: Total number of infants (0-11 months), administered BCG immunisation (at facility/ Outreach
sessions /Home) during the reporting month.
Guidelines: BCG ((Bacillus Calmette Guerin) vaccine should be administered to infants, preferably right
after birth or up to 1 year of birth.
Data Source -Immunisation Register
6.1.3 Data Element -Child immunisation - DPT1
Definition: Total number of infants (0 to 11 months) administered 1st dose of DPT immunisation (at facility/
Outreach sessions /Home) during the reporting month.
Guidelines: DPT (Diphtheria, Pertussis, and Tetanus combined vaccine) 1st Dose should be administered to
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infants, preferably at six weeks. Applicable to those States where pentavalent is not introduced.
Definition: Total number of infants (0-11 months), administered 2nd dose of DPT immunisation (at facility/
Outreach sessions /Home) during the reporting Month.
Guidelines: DPT (Diphtheria, Pertussis and Tetanus combined vaccine) 2nd dose should be administered to
an infant preferably at around 10 weeks after birth. Applicable to those States where pentavalent is not
introduced.
Definition: Total number of infants 0-11 months, administered 3rd dose of DPT immunisation (at facility/
Guidelines: (Diphtheria, Pertussis and Tetanus combined vaccine) 3rd dose should be administered to an
infant preferably at around 14 weeks after birth. Applicable to those States where pentavalent is not
introduced.
6.1.6 Data Element -Child immunisation - Pentavalent 1
Definition: Total number of infants (0-11 months), administered 1st dose of pentavalent vaccine (at facility/
Guidelines: Pentavalent vaccine includes Diphtheria, Pertussis, Tetanus (DPT), Hepatitis B and Haemophilus
influenza b (Hib). 1st dose of Pentavalent should be administered to an infant preferably at around 6 weeks
after birth.
Definition: Total number of infants (0-11 months), administered 2nd dose of pentavalent vaccine (at facility/
Outreach sessions /Home) during the reporting month
influenza b (Hib). 2nd dose of Pentavalent should be administered to an infant preferably at around 10 weeks
after birth.
Definition: Total number of infants (0-11 months), administered 3rd dose of pentavalent vaccine (at facility/
Outreach sessions /Home) during the reporting month
influenza b (Hib). 3rd dose of Pentavalent should be administered to an infant preferably at around 14 weeks
after birth.
6.1.9 Data Element -Child immunisation - OPV 0 (Birth Dose)
Definition: Total number of newborns who were given OPV (Oral Polio Vaccine) birth dose during the
reporting month.
Guidelines: The OPV doses given during Pulse Polio rounds are NOT to be counted.
6.1.10 Data Element -Child immunisation - OPV1
Definition: Total number of infants (0-11 months), who were given first dose of OPV during the reporting
month.
Guidelines: 1st dose of OPV should be given to an infant preferably at around 6 weeks after birth. The OPV
doses given during Pulse Polio rounds are NOT to be counted.
Definition: Total number of infants (0-11 months), who were given second dose of OPV during the reporting
month.
Guidelines: 2nd dose of OPV should be given to an infant preferably at around 10 weeks after birth. The OPV
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Definition: Total number of infants (0-11 months) who were given OPV third dose during the reporting
month.
Guidelines: 3rd dose of OPV should be given to an infant preferably at around 14 weeks after birth. The OPV
6.1.13 Data Element -Child immunisation - Hepatitis-B0 (Birth Dose)
Definition: Total number of newborns, who were administered Hepatitis-B0 (Birth Dose) at SC or at home
Guideline: Hepatitis-B0 (Birth Dose) should be administered to all newborns within 24 hours of birth.
6.1.14 Data Element -Child immunisation - Hepatitis-B1
Definition: Total number of infants (0-11 months) who were administered 1st dose of Hepatitis B vaccine
Guidelines: 1st dose of Hepatitis B vaccine should be administered to infants preferably at around six
weeks after birth. Applicable to those States where pentavalent is not introduced.
Definition: Total number of infants (0-11 months) who were administered 2nd dose of Hepatitis B vaccine
Guidelines: 2nd dose of Hepatitis B vaccine should be administered to infants preferably at around 10 weeks
after birth. Applicable to those States where pentavalent is not introduced.
Definition: Total number of infants (0-11 months) of age who were administered 3rd dose of Hepatitis B
vaccine during the reporting month.
Guidelines: 3rd dose of Hepatitis B vaccine should be administered to infants preferably at around 14 weeks
after birth. Applicable to those States where pentavalent is not introduced.
6.1.17 Child immunisation - Inactivated Injectable Polio Vaccine 1 (IPV 1)
Definition: Total number of infants (0-11 months) of age who were administered Injectable Polio Vaccine 1
(IPV 1) vaccine during the reporting month.
Guidelines: 1st dose of Injectable Polio Vaccine 1 (IPV 1) should be administered to infants preferably at
around 6 weeks of birth along with DPT 1/Pentavalent 1/OPV1 . Note this is applicable only in those States
which have taken up this activity.
6.1.18 Data Element -Child immunisation - Inactivated Injectable Polio Vaccine 2 (IPV 2)
Definition: Total number of infants (0-11 months) of age, given Injectable Polio Vaccine 2 (IPV 2)
immunisation during the reporting month.
Guidelines: Injectable Polio Vaccine 2 (IPV 2) dose is given to a child under one year - preferably at around
14 weeks of birth along with DPT 3/Pentavalent 3 and OPV3 . Note this is applicable only in those States
which have taken up this activity.
6.1.19 Data Element -Child immunisation - Rotavirus 1
Definition: Total number of infants (0-11 months), who were given 1st dose of Rotavirus vaccine during the
reporting month.
Guidelines: 1st dose of Rotavirus should be given to an infant preferably at around 6 weeks after birth.
Definition: Total number of infants (0-11 months), who were given 2nd dose of Rotavirus vaccine during the
reporting month.
Guidelines: 2nd dose of Rotavirus should be given to an infant preferably at around 10 weeks after birth.
Definition:Total number of infants (0-11 months), who were given 3rd dose of Rotavirus vaccine during the
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reporting month.
Guidelines: 3rd dose of Rotavirus should be given to an infant preferably at around 14 weeks after birth.
6.2 Number of Children 9-11 months who received:
6.2.1 Data Element -Child immunisation - Measles & Rubella (MR)- 1st Dose
Definition: Total number of infants (0-11 months) who were administered 1st Dose of Measles & Rubella
(MR)- during the reporting month.
Guideline: 1st Dose of Measles & Rubella (MR) should be administered to an infant preferably at 9-11
months.
6.2.2 Data Element -Child immunisation - Measles-1st dose
Definition: Total number of infants (0-11 months) who were administered 1st Dose of Measles vaccine
Guidelines: 1st dose of Measles vaccine should be administered to an infant preferably at 9 to 11 months after
birth. Measles vaccine given to YOUNGER children during an outbreak should NOT be counted here.
6.2.3 Data Element -Child immunisation - JE 1st dose
Definition: Total number of infants (0-11 months) who were administered 1st Dose of Japanese Encephalitis
(JE) vaccine during the reporting month.
Guidelines: 1st dose of JE vaccine should be administered to an infant preferably at 9 to 11 months after birth
6.2.4 Total number of children aged between 9 and 11 months fully immunized (BCG+DPT123/
pentavalent123+OPV123+Measles) during the month
Definition: Total number of infants 9-11 months old who have completed routine immunisation during the
reporting month i.e., received BCG, all three doses of DPT/Pentavalent, three doses of OPV and measles. The
OPV doses given during Pulse Polio rounds are NOT to be counted. Separate break-up for males and females
has to be given.
Guideline: Full immunisation has to be reported from a specific column in the immunisation record register,
when all the doses for a given child are completed. It should not be calculated simply by adding BCG, three
doses of DPT, three doses of OPV and measles.
The child should only be counted ONCE as fully immunized when receiving the last vaccine-usually measles
at 9th month-AND there is evidence of receiving all the previous vaccines.
Data Source – Immunisation Register
6.2.4.a Data Element -Children aged between 9 and 11 months fully immunized- Male
Definition: Total number of Male Children 9-11 months old that have completed routine immunisation
during the reporting month i.e. who have received BCG, three doses of DPT, three doses of OPV and
measles. The OPV doses given during Pulse Polio rounds are NOT to be counted.
6.2.4.b Data Element -Children aged between 9 and 11 months fully immunized – Female
Definition: Total number of female Children 9-11 months old that have completed routine immunisation
during the reporting month i.e. who have received BCG, three doses of DPT, three doses of OPV and
measles. The OPV doses given during Pulse Polio rounds are NOT to be counted.
6.3 Children given following vaccination after 12 months
6.3.1 Data Element Child immunisation - Measles & Rubella (MR)- 1st Dose
Definition: Total number of children who were administered 1st Dose of Measles & Rubella (MR) after 12
months of birth during the reporting month.
Guideline: 1st dose of Measles & Rubella (MR) should be administered to an infant preferably at 9-11
months. The user should report only those children who have received their 1st dose of MR vaccine after 12
months of age i.e. delayed immunization for MR vaccine.
6.3.2 Data Element Child immunisation - Measles-1st dose
Definition: Total number of children who were administered 1st Dose of Measles after 12 months of birth
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Guideline: 1st dose of Measles should be administered to an infant preferably at 9-11 months. The user
should report only those children who have received their 1st dose of Measles vaccine after 12 months of age
i.e. delayed immunization for Measles vaccine.
6.3.3 Data Element Child immunisation - JE 1st dose
Definition: Total number of children who were administered 1st Dose of JE vaccine after 12 months of birth
Guideline: 1st dose of JE vaccine should be administered to an infant preferably at 9-11 months. The user
should report only those children who have received their 1st dose of JE vaccine after 12 months of age i.e.
delayed immunization for JE vaccine.
6.4 Number of Children more than 12 months who received:
6.4.1 Data Element-Child immunisation - Measles & Rubella (MR)- 2nd Dose (16-24 months)
Definition: Total number of children (16 -24 months of age) who were administered the 2nd dose of Measles
Guidelines: 2nd Dose of Measles & Rubella (MR) vaccine should be administered to a child preferably within
16-24 months of age.
6.4.2 Data Element-Child immunisation - Measles 2nd dose (More than 16 months)
Definition: Total number of children (16 -24 months of age) who were administered the 2nd dose of Measles
Guidelines: 2nd dose of Measles vaccine should be administered to a child preferably within 16-24 months of
age.
6.4.3 Data Element-Child immunisation - DPT 1st Booster
Definition: Total number of children who were administered 1st dose of DPT Booster vaccine during the
reporting month.
Guidelines: 1st dose of DPT Booster vaccine should be administered to a child preferably within 16-24
months of age.
6.4.4 Data Element-Child immunisation - OPV Booster
Definition: Total number of children who were given OPV Booster vaccine during the reporting month.
Guideline: OPV Booster vaccine should be given to a child preferably within 16-24 months of age.The OPV
doses given during pulse polio rounds are NOT to be counted.
6.4.5 Data Element-Child immunisation - Measles, Mumps, Rubella (MMR) Vaccine
Definition: Total number of children who were given MMR (Measles, Mumps, Rubella) vaccine during the
reporting month.
Guideline: For children who have NOT received measles immunisation before attaining the age of 1
year, MMR given after 1 year of age will also be counted here. This data element should not be
confused with data element 6.2.2 (Measles 1st dose)
6.4.6 Data Element-Number of children more than 16 months of age who received Japanese Encephalitis
(JE) vaccine
Definition: Total number of children, more than 16 months of age, who were administered 2nddose of
Japanese Encephalitis (JE) vaccine during the month.
Guideline: 2nd dose of JE vaccine should be administered to a child preferably within 16-24 months of age.
Data Source - Immunisation Register
6.5 Number of Children more than 23 months who received:
6.5.1 Data Element-Child immunisation - Typhoid
Definition: Total number of children more than 23 months of age who received Typhoid vaccine during the
month.
Guideline- Typhoid vaccine is not a part of Universal Immunization Programme. Wherever existing, it has
been introduced on state initiative.
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6.5.2 Data Element-Children more than 5 years received DPT5 (2nd Booster)
Definition: Total number of children of more than 5 years of age who were administered 2 nd dose of DPT
booster during the reporting month.
Guideline: DPT 2nd booster is to be administered to children aged 5-7 years as part of National Immunization
Schedule under Universal Immunization Programme.
6.5.3 Data Element-Children more than 10 years received TT10
Definition: Total number of children of more than 10 years of age who were administered Tetanus Toxoid
(TT) during the reporting month.
Guideline: One dose of TT vaccine is to be administered to children aged 10 years as part of National
Immunization Schedule under Universal Immunization Programme
6.5.4 Data Element-Children more than 16 years received TT16
Definition: Total number of children of more than 16 years of age who were administered Tetanus Toxoid
(TT) during the reporting month.
Guideline: One dose of TT vaccine is to be administered to children aged 16 years as part of National
Immunization Schedule under Universal Immunization Programme.
6.6 Adverse Event Following Immunisation (AEFI)
An adverse event following immunisation (AEFI) is defined as a medical incident that takes place after
immunisation, and is believed to be caused by immunisation.
Guideline: All non-serious and serious AEFIs are reported in HMIS formats. The serious and severe AEFIs
are also to be reported by health staff to Medical Officer In-charge who reports it on Preliminary Case
Investigation Form (PCIF) and is subsequently investigated by District AEFI Committee for its causality
Assessment.
6.6.1 Data Element- AEFI – Abscess
Definition: Total number of cases of abscess reported following immunisation during the reporting month.
Guidelines: An abscess is a collection of pus that has accumulated in a cavity formed by the tissue on
the basis of an infectious process.
Data Source -Immunisation Register/OPD Register/IPD Register
6.6.2 Data Element-AEFI – Death
Definition: Total number of cases of deaths reported following immunisation during the reporting month.
Guidelines: Total number of children who died following immunisation in the reporting month. Deaths
occurring at SC as well as at home are to be reported here. Any death following immunisation needs to be
investigated & confirmed by Medical Officer. A death within 6 days of any immunisation may be reported
without confirmation, if doctor was not able to make visit. If in case the child got immunised at home (in
periphery or at SC) but death occurs at PHC/CHC or any other facility, the same needs to be reported at that
facility where the death took place.
6.6.3 Data Element- AEFI – Others
Definition: Total number of cases of other complications attended at the facility following immunisation
Guidelines: Any of the mentioned symptoms following an immunisation should be reported: 1.Rash, 2.
Fever, 3. Fainting, 4. Anaphylactic shock, 5. Paralysis, 6. Weakness developing in any part of limbs etc.
Even if it does not conform to this pattern but occurs within a week, it should be noted and action to be
taken after investigation.
6.7 Number of Immunisation sessions during the month
6.7.1 Data Element-Immunisation sessions planned
Definition: Number of immunization sessions planned at the DH during the reporting month.
Guidelines: Immunization services are to be provided daily at the level of District Hospital. If the load for
immunization is less than the same may be reduced to weekly or monthly frequency
Data Source - Hospital Records
6.7.2 Data Element-Immunisation sessions held
Definition: Total number of immunisation sessions held at the DH during the reporting month.
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Guideline: Information of total number of sessions held may be taken from the Hospital
records/Immunization register.
Data Source - Hospital Records/Immunisation Register
6.7.3 Data Element-Number of sessions where ASHAs were present
Definition: Total number of immunisation sessions held at the SC during the reporting month in which
ASHA was present
Guidelines: It infers the involvement of ASHAs in the community immunisation activities. It may be noted
that the sessions where ASHA was present has to be reported not the number of ASHAs present. If more than
one ASHA was present at one immunisation session, it would still be counted as one session.
Data Source -Immunisation Planning Register
6.8 Children received Vitamin A Doses between 9 months and 5 years
Total number of children between 9 months and 5 years of age who were given Vitamin A dose during the
reporting month. In order to prevent night blindness Vitamin A is to be given to all children. It is
recommended to give 9 doses of Vitamin A given at the interval of 6 months up to the age of 5 years.
6.8.1 Data Element-Child immunisation - Vitamin A Dose – 1
Definition: Total number of children over 6 months but less than 1 year given Vitamin A 1st dose in SC
Guideline: Oral prophylactic dose of vitamin A one dose of 100,000 IU to infants (6-11 months) is
recommended
Data Source - Immunisation Planning Register
Definition: Total number of children under 3 years of age given 5th dose of Vitamin A in SC during the
reporting month.
Guideline- Oral prophylactic dose of 200,000 IU in every six months is recommended for children 1-3 years
of age
Definition: Total number of children under 5 years of age given 9th dose (booster) of Vitamin A, in SC during
Guideline: Oral prophylactic, Six months’ dose of 200,000 IU to children 1-5 years. Total 9 prophylactic
doses recommended for under 5 children to prevent Vitamin A deficiency.
6.9 Data Element-Number of children (6-59 months) provided 8-10 doses (1ml) of IFA syrup (Bi weekly)
NIPI
Definition: Total number of children, aged 6-59 months, who were given 8-10 doses of IFA syrup during the
reporting month.
Guideline: As per National Iron Plus Initiative (NIPI), children aged 6-59 months should be given one ml of
IFA syrup containing 20 mg of elemental iron and 100 mcg of folic acid biweekly for 100 doses in a year.
Those children who were given biweekly dose of IFA syrup for all weeks in the reporting month should be
reported.
Data Source: RCH Register
6.10 Data Element-Total Number of children (12-59 months) provided Albendazole
Definition: Total number of children, aged 12-59 months, who were given Albendazole (400 mg) tablet
Guideline: As per National Iron Plus Initiative (NIPI), children aged 12-59 months should be given 400 mg
Albendazole tablet.
6.11 Data Element-Number. of severe underweight children provided Health Checkup (0-5 yrs)
Definition-Number of severe underweight children (0-5 yrs) who were provided Health Checkup during the
reporting month
M7 Number of cases of Childhood Diseases (0-5 years)
This data element will include both the inpatients as well as outpatients cases.
7.1 Data Element- Childhood Diseases - Tuberculosis (TB)
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Definition: Total Number of cases of Tuberculosis (TB) reported in children below five years during the
reporting month.
Guideline: Tuberculosis (TB) is an ongoing (chronic) infection caused by bacteria. It usually infects the
lungs. But other organs such as the kidneys, spine, or brain may be affected. TB is most often spread through
droplets breathed or coughed into the air. A child can be infected with the TB bacteria and not have active
disease.
 Common symptoms of childhood TB are
 Cough;
 Feelings of sickness or weakness, lethargy, and/or reduced playfulness;
 Weight loss or failure to thrive;
 Fever; and/or.
 Night sweats.
 Confirmed TB diagnosis in children requires:
 Careful history (including TB contacts; symptoms consistent with TB), Physical examination
(including growth assessment),
 Tuberculin skin testing (TST), Other investigations relevant for pulmonary or extra pulmonary TB
(e.g. X-rays)
 Bacteriological confirmation
Data Source: OPD Register/IPD Register

7.2 Data Element- Childhood Diseases - Acute Flaccid Paralysis(AFP)
Definition: Total Number of cases of Acute Flaccid Paralysis (AFP) reported in children below five years
Guideline: Poliomyelitis, or polio, is a viral infectious disease in children transmitted faecal-orally. It causes
acute flaccid paralysis (AFP), a clinical manifestation characterized by weakness of the
lower extremities with reduced muscle tone, which sometimes leads to lifelong residual paralysis or death.
Data Source: OPD Register/IPD Register
7.3 Data Element- Childhood Diseases – Measles
Definition: Total number of cases of Measles cases reported in children below five years during the reporting
month.
Guideline: Measles, or rubella, is a viral infection of the respiratory system. Measles is a very contagious
disease that can spread through contact with infected mucus and saliva. An infected child can release the
infection into the air when they cough or sneeze. A widespread skin rash is a classic sign of measles. This
rash can last up to seven days and generally appears within the first three to five days of exposure to the virus.
Symptoms of measles generally appear within 14 days of exposure to the virus. Symptoms include: cough,
fever, red eyes, light sensitivity, muscle aches, runny nose, sore throat, white spots inside the mouth
Data Source – OPD Register/IPD Register
7.4 Data Element- Childhood Diseases – Malaria
Definition: Total number of cases of Malaria (smear positive) reported in children below five years during
Guideline: Malaria is transmitted through the bite of an infected Anopheles mosquito. Infected mosquitoes
carry the Plasmodium parasite. When this mosquito bites, the parasite is released into the bloodstream of the
person. The symptoms of malaria typically develop within 10 days to four weeks.
Common symptoms of malaria include:
shaking chills that can range from moderate to severe, high fever, profuse sweating, headache,
nausea, vomiting, abdominal pain, diarrhea, anemia, muscle pain, convulsions, coma and bloody
stools
 Malaria is confirmed by blood test found positive for plasmodium parasite following the infection. In
some cases, symptoms may not develop for several months.
Data Source – OPD Register/IPD Register/Lab Register
7.5 Data Element- Childhood Diseases - Diarrhoea
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Definition: Total number of cases of Diarrhoea reported in children below five years during the reporting
month.
Guideline: Diarrhoea is defined as the passage of three or more loose or liquid stools per day (or more
frequent passage than is normal for the individual). Frequent passing of formed stools is not diarrhoea, nor is
the passing of loose, "pasty" stools by breastfed babies.
Childhood diarrhoea is most often caused by infection. Much less often, however, it is due to other causes -
eg, malabsorption, endocrine abnormalities, hormone-secreting tumours, and pancreatic and liver
dysfunction. Though most episodes of childhood diarrhoea are mild, acute cases can lead to significant fluid
loss and dehydration, which may result in death or other severe consequences if fluids are not replaced at the
first sign of diarrhoea.
Data Source – OPD Register/IPD Register/Lab Register
M8 National Vector Borne Disease Control Programme(NVBDCP)
8.1 Malaria
8.1.1 Rapid Diagnostic Test (RDT )
Definition: Rapid Diagnostic test are done to diagnose malaria. Blood for the test is commonly obtained from
finger-prick and result can be obtained in 20min.
8.1.1.a Data Element-RDT conducted for Malaria
Definition: Total number of RDT performed for malaria during the reporting month.
Guidelines: Malaria rapid diagnostic tests, sometimes called "dipsticks" or malaria rapid diagnostic devices
(MRDDs), assist in the diagnosis of malaria by providing evidence of the presence of malaria parasites in
human blood. Malaria RDTs detect specific antigens (proteins) produced by malaria parasites, that are present
in the infected blood or recently infected individuals. Blood for the test is commonly obtained from a finger-
prick. Bivalent RDTs are now used which detects both Pv and Pf malaria.
Data source: Malaria M4 format
8.1.1.b Data Element-Plasmodium Vivax test positive
Definition: Total number of cases tested positive for Plasmodium vivax (Pv) malaria by RDT, out of
total RDT conducted (8.1.1.a) during the reporting month
Guidelines: The bivalent RDT can detect positive Pv malaria cases
8.1.1.c Data Element-Plasmodium Falciparum test positive
Definition: Total number of cases tested positive for Plasmodium falciparum (Pf) malaria by RDT,
during the reporting month
Guidelines: The bivalent RDT can detect positive Pf malaria cases.
Part B Health Facility Services
M9 Patient Services
9.1 Out Patient Department (OPD) by disease/ health condition
9.1.1 Data Element-OPD – Diabetes
Definition: Total Number of new out-patients for Diabetes attended at the SC during the reporting month.
Data Source -OPD Register
9.1.2 Data Element-OPD – Hypertension
Definition: Total Number of new out-patients for Hypertension attended at the SC during the reporting
month.
9.1.3 Data Element-OPD - Stroke (Paralysis)
Definition: Total Number of new out-patients for Stroke (Paralysis) attended at the SC during the reporting
month.
9.1.4 Data Element-OPD - Acute Heart Diseases
Definition: Total Number of new out-patients for Acute Heart Diseases attended at the SC during the
reporting month.
9.1.5 Data Element-OPD - Mental illness
Definition: Total Number of new out-patients for Mental illness attended at the SC during the reporting
month.
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9.1.6 Data Element-OPD – Epilepsy
Definition: Total Number of new out-patients for Epilepsy attended at the SC during the reporting month.
9.1.7 Data Element-OPD - Ophthalmic Related
Definition: Total Number of new out-patients for Ophthalmic Related attended at the SC during the
reporting month.
9.1.8 Data Element-OPD – Dental
Definition: Total Number of new out-patients for Dental attended at the SC during the reporting month.
9.2 Outpatient attendance (All)
9.2.1 Data Element-Allopathic- OPD attendance
Definition: Total number of new and old out-patients (Allopathic- all types) attended at the SC during the
reporting month. OPD should include immunisation and routine ANC cases of SC.
Guidelines: Allopathic OPD attendance would include only allopathic prescriptions. It will not include
AYUSH OPD.
9.2.2 Data Element-AYUSH - OPD attendance
Definition: Total Number of new and old out-patients (AYUSH) attended at the SC during the reporting
month. Guidelines: AYUSH OPD attendance would include only AYUSH prescriptions. It will not include
allopathic OPD.
Data Source – AYUSH OPD Register
9.3 Data Element-Number of Anganwadi centres/ UPHCs reported to have conducted Village Health &
Nutrition Day (VHNDs)/ Urban Health & Nutrition Day (UHNDs)/ Outreach / Special Outreach
Definition: Regular Outreach-UHND/Special Outreach sessions and other structures envisaged to be
conducted under NUHM on the lines of VHNDs. The UPHCs reported to have conducted VHNDs during the
reporting month. For organizing outreach sessions in urban areas the Aanganwadi Centres, other community
structures can be utilized.
Guideline: Here the number of Aanganwadi Centres/UPHCs who have conducted VHNDs/UHNDs has
to be reported and not the number of sessions itself.
Data Source – VHND/UHND Register
M10 Laboratory Testing
10.1 Hb Tests Conducted
10.1.1 Data Element-Number of Hb tests conducted
Definition: Total number of Haemoglobin (Hb) tests conducted at SC during the reporting month.
Data Source - Lab Register
10.1.2 Data Element-Of which Number having Hb < 7 gm
Definition: Out of the total number of haemoglobin (Hb) test conducted during the reporting month, number
of test where Hb was found to be less than 7 gm/dl.
Guidelines: Only those cases are to be reported where the Hb was measured by a Hemoglobinometer or any
other acceptable laboratory method and was found to be less than 7g/dl. Examination of eye/nails is not to be
reported. Only new cases should be considered.
Data Source - Lab Register
10.2 (Human Immunodeficiency Virus)HIV tests conducted
10.2.1 Pregnant women screened for HIV
a Data Element-Number of pregnant women screened for HIV
Definition: Total number of Pregnant women screened for HIV using POC test or any other single test in the
reporting month.
Data Source - ANC Register/Labour room Register
b Data Element-Out of the above, number screened positive
Definition: Total number of Pregnant women tested positive for HIV using POC test or any other single test
in the reporting month.
Data Source - ANC Register/Labour room Register
M11 Stock Related Data
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11.1 Drugs
11.1.1 Last Date of Supply of essential drugs(DD/MM/YYYY)
11.1.2 Items
11.1.2.a Data Element-IFA Tablets
Definition: Availability of IFA Tablets for one month is to be reported during the reporting month.
Guideline: Availability of IFA Tablets has to be reported yes if stock is adequate for further one months of
reporting month i.e. if ANM is reporting for April month “Yes” then she has to ensure that stock is adequate
for May.
Data Source - Stock Register
11.1.2.b Data Element-IFA syrup with dispenser
Definition: Availability of IFA syrup with dispenser for one month is to be reported during the reporting
month.
Guideline: Availability of IFA syrup with dispenser has to be reported yes if stock is adequate for further
one months of reporting month i.e. if ANM is reporting for April month “Yes” then she has to ensure that
stock is adequate for May.
11.1.2.c Data Element-Vit A syrup
Definition: Availability of Vit A syrup for two months is to be reported during the reporting month.
Guideline: Availability of Vit A syrup has to be reported yes if stock is adequate for further one months of
for May.
11.1.2.d Data Element-ORS packets
Definition: Availability of ORS packets for two months is to be reported during the reporting month.
Guideline: Availability of ORS packets has to be reported yes if stock is adequate for further one months of
for May.
11.1.2.e Data Element-Zinc Tablets
Definition: Availability of Zinc Tablets for two months is to be reported during the reporting month.
Guideline: Availability of Zinc Tablets has to be reported yes if stock is adequate for further one months of
for May.
11.1.2.f Data Element-Inj. Magnesium Sulphate
Definition: Availability of Inj. Magnesium Sulphate for two months is to be reported during the reporting
month.
Guideline: Availability of Inj. Magnesium Sulphate has to be reported yes if stock is adequate for further
one months of reporting month i.e. if ANM is reporting for April month “Yes” then she has to ensure that
stock is adequate for May.
11.1.2.g Data Element-Inj. Oxytocin
Definition: Availability of Inj. Oxytocin for two months is to be reported during the reporting month.
Guideline: Availability of Inj.Oxytocin has to be reported yes if stock is adequate for further one months of
for May.
11.1.2.h Data Element-Misoprostol Tablets
Definition: Availability of Misoprostol Tablets for two months is to be reported during the reporting month.
Guideline: Availability of Misoprostol Tablets has to be reported yes if stock is adequate for further one
months of reporting month i.e. if ANM is reporting for April month “Yes” then she has to ensure that stock is
adequate for May.
11.1.2.i Data Element-Antibiotics
Definition: Availability of essential Antibiotics for two months is to be reported during the reporting month.
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Guideline: Availability of essential Antibiotics has to be reported yes if stock is adequate for further one
adequate for May.
11.1.2.j Data Element-Availability of drugs for common aliments e.g. PCM, Anti-allergic drugs etc.
Definition: Availability of drugs for common aliments for two months is to be reported during the
reporting month.
Guideline: Availability drugs for common aliments e.g. PCM, Anti-allergic drugs etc has to be reported yes
if stock is adequate for further one months of reporting month i.e. if ANM is reporting for April month “Yes”
then she has to ensure that stock is adequate for May.
11.1.2.k Data Element-IFA Tablets(Blue)
Definition: Availability of IFA Tablets (Blue) for two months is to be reported during the reporting month.
Guideline: Availability of IFA Tablets(Blue) has to be reported yes if stock is adequate for further one
adequate for May.
11.1.2.l Data Element-Tab. Albendazole
Definition: Availability of Tab. Albendazole for two months is to be reported during the reporting month.
Guideline: Availability of Tab. Albendazole has to be reported yes if stock is adequate for further one
adequate for May.
11.2 Contraceptives
11.2.1 Last Date of Supply of essential contraceptives (DD/MM/YYYY)
11.2.2 Items
11.2.2.a Data Element-IUCD
Definition: Availability of IUCD for one month is to be reported during the reporting month.
Guideline: Availability of IUCD has to be reported yes if stock is adequate for further one months of
for May.
11.2.2.b Data Element-Combined Oral Pills(In Cycles)
Definition: Availability of Combined Oral Pills (In Cycles) for one month is to be reported during the
reporting month.
Guideline: Availability of Combined Oral Pills(In Cycles) has to be reported yes if stock is adequate for
further one month of reporting month i.e. if ANM is reporting for April month “Yes” then she has to ensure
that stock is adequate for May.
11.2.2.c Data Element-Condom(In pieces)
Definition: Availability of Condom (In pieces) for one month is to be reported during the reporting month.
Guideline: Availability of Condom(In pieces) has to be reported yes if stock is adequate for further one
month of reporting month i.e. if ANM is reporting for April month “Yes” then she has to ensure that stock is
adequate for May.
11.2.2.d Data Element-Injectable Contraceptive MPA(vials)
Definition: Availability of Injectable Contraceptive MPA(vials)for one month is to be reported during the
reporting month.
Guideline: Availability of Injectable Contraceptive MPA(vials)has to be reported yes if stock is adequate
for further one month of reporting month i.e. if ANM is reporting for April month “Yes” then she has to
ensure that stock is adequate for May.
Part C. Mortality Details
This section deals with compiling data on deaths by major causes.
The probable cause of death is to be reported against ONE and ONLY ONE major cause. In certain cases,
19
death may have occurred due to multiple reasons or reasons unknown. In such cases, the information of the
deceased is to be captured by the nearest probable cause of death. Deaths occurring at home are to be reported
in the Health sub-Centre Form.
M12 Details of deaths reported during the month with probable causes:
12.1 Data Element-Infant deaths within 24 hrs(1 to 23 Hrs) of birth
Definition: Total number of newborn deaths within 23 hrs of birth in the facility during the reporting month.
Guidelines: At times, it is difficult to determine the cause of death when newborn/neonate dies within the
first 23 hours of birth. In such situation mention death within 23hrs of birth, however, refer to the definition
of still birth to distinguish still birth from newborn/neonatal death. Any cry & breathe or movement occurring
in first few seconds of birth and stopping subsequently should be considered newborn death & not still birth.
Even if the cause is known as sepsis, pneumonia, asphyxia, LBW but the death was with 23 hrs it should be
reported here.
Data Source - Death Register
12.2 Infant Deaths up to 4 weeks (1 to 28 days) due to
12.2.1 Data Element-Infant Deaths up to 4 weeks due to Sepsis
Definition: Total Infant Deaths due to sepsis during the reporting month.
Guideline: Sepsis is a blood infection that occurs in an infant younger than 90 days old. It is caused due
to bacterial infection.
Death due to sepsis refers to death of Newborn/neonate after 23hrs but within first 28 days of life due to any
infection. Newborn may have one or more signs and symptoms such as fever, refusal to take feeds, weak cry,
diarrhea, pneumonia, measles etc. When it is difficult to differentiate above mentioned infections indicate
cause of death as ‘sepsis. It is difficult to differentiate infections in first 28 days of life; therefore, death due to
any infection will be attributed to ‘death due to sepsis. Those counted in first 23 hrs. should not be counted
again here
12.2.2 Data Element-Infant Deaths up to 4 weeks due to Asphyxia
Definition: Total Infant Deaths due to asphyxia during the reporting month.
Guideline: If baby had signs of Asphyxia (meconium stained fluids, delay or failure in cry/ weak breathing &
movements, requirement of artificial breathing support, etc.) & then died after 23 hours but before 28 th day it
should be reported as death due to asphyxia. If the baby died within first 23hrs it should be counted in deaths
of infant within 23hrs of birth.
12.2.3 Data Element-Infant Deaths up to 4 weeks due to Other causes
Definition: Infant Deaths due to reasons other than those cited above, during the reporting month.
Guidelines: Any baby who died after first 23 hrs. and on/before 28th day and the cause did not confirm
with any of the above 2 causes (sepsis, asphyxia) should be indicated as death due to other causes.
Failure to attribute cause may be due to lack of skilled attendant or may be because it was some cause
other than these 2 or because the SBA was not sure. In case of co-morbidities, the SBA should indicate
the cause for which SBA feels is the most important contributing cause.
12.3 Infant Deaths Between 1 month (more than 28 days) and less than 12 months due to
12.3.1 Data Element-Infant Deaths (1 -12 months) – Pneumonia
Definition: Total Infant Deaths due to Pneumonia, during the reporting month.
Guideline: ‘Pneumonia’ is the cause of death for infants (over 28 days and 12 months old) who died due to
infection in the respiratory tract/lungs any clinical signs of pneumonia are also to be reported as such-even
without laboratory or radiological confirmation
12.3.2 Data Element-Infant Deaths (1 -12 months) – Diarrhoea
Definition: Total Infant Deaths due to Diarrhoea, during the reporting month.
Guideline: Any death in a child less than one year, but more than 28 days old, associated with passing loose
stools more than thrice a day. Usually dehydration would be prominent.
20
12.3.3 Data Element-Infant Deaths (1 -12 months) - Fever related
Definition: Total Infant Deaths due to Fever related reasons, during the reporting month.
Guideline: ‘Fever’ is the cause of death for infants (over 28 days and 12 months old) who died due to fever
and NOT due to Pneumonia, Diarrhoea and Measles.
12.3.4 Data Element-Infant Deaths (1 -12 months) – Measles
Definition: Total Infant Deaths due to Measles, during the reporting month.
Guideline: ‘Measles’ is the cause of death for infants (over 28 days and <12months old) who died due to
high fever with a typical rash. Other signs that indicate measles are: running nose, cough, red & watery eyes,
loss of appetite & loose stools. Another marker of measles is Koplik’s spots (small red spots with blue-white
centres that appear inside the mouth).
12.3.5 Data Element-Infant Deaths (1 -12 months) – Others
Definition: Total Infant Deaths due to to any other cause except Pneumonia, Diarrhoea, Fever related,
Measles during the reporting month..
12.4 Child Deaths between 1 year and less than 5 years due to
12.4.1 Data Element- Child Deaths (1 -5 years) – Pneumonia
Definition: Total children (1- 5 years) deaths due to Pneumonia, during the reporting month.
Guideline: ‘Pneumonia’ is the cause of death for children (1- 5 years) who died due to infection in the
respiratory tract/lungs any clinical signs of pneumonia are also to be reported as such-even without laboratory
or radiological confirmation
12.4.2 Data Element-Child Deaths (1 -5 years) –Diarrhoea
Definition: Total children (1- 5 years) due to Diarrhoea, during the reporting month.
Guideline: Any death in a child of one year to five years associated with passing loose stools more than
thrice a day. Usually dehydration would be prominent.
12.4.3 Data Element- Child Deaths (1 -5 years) - Fever related
Definition: Total children (1- 5 years) due to Fever related reasons, during the reporting month.
Guideline: ‘Fever’ is the cause of death for children (1- 5 years) who died due to fever and NOT due to
Pneumonia, Diarrhoea and Measles.
12.4.4 Data Element-Children Deaths (1 -5 years) – Measles
Definition: Total Children Deaths (1 -5 years) due to Measles, during the reporting month.
Guideline: ‘Measles’ is the cause of death for Children Deaths (1 -5 years) who died due to high fever with a
typical rash. Other signs that indicate measles are: running nose, cough, red & watery eyes, loss of appetite &
loose stools. Another marker of measles is Koplik’s spots (small red spots with blue-white centres that
appear inside the mouth).
12.4.5 Data Element-Child Deaths (1 -5 years) – Others
Definition: Total Children Deaths (1 -5 years) due to any other cause except Pneumonia, Diarrhoea, Fever
related and Measles, during the reporting month.
12.5 Maternal Deaths (15 to 49 yrs.) due to
Death of a pregnant woman from any cause related to or aggravated by pregnancy or its management, but not
from accidental or incidental causes, during antenatal period, labour or up to 6 weeks after pregnancy.
Data Source – Death Register
12.5.1 Data Element- Maternal Deaths – Bleeding
Definition: Total maternal deaths due to bleeding, during the reporting month.
Guideline: Indicate ‘bleeding’ as a cause of death if a woman dies due to severe bleeding (over 500 ml)
before, during or 42 days postpartum.
21
12.5.2 Data Element- Maternal Deaths - High fever
Definition: Total maternal deaths due to high fever, during the reporting month.
Guideline: Indicate ‘high fever’ as a cause of death if a woman dies due to high fever during pregnancy
or 42 days postpartum.
12.5.3 Data Element- Maternal Deaths – Abortion
Definition: Total maternal deaths due to abortions, during the reporting month.
Guideline: Complete expulsion or extraction of the product of conception of a pregnant woman less than 20
weeks of gestation due to any reason.
12.5.4 Data Element- Maternal Deaths - Obstructed/prolonged labour
Definition: Total maternal deaths due to obstructed/prolonged labour, during the reporting month.
Guideline: Indicate ‘obstructed/prolonged labor’ as a cause of death if a woman dies during labor
which lasted more than 12 hours or which required operative intervention to facilitate delivery.
12.5.5 Data Element- Maternal Deaths - Severe hypertesnion/fits
Definition: Total maternal deaths due to severe hypertension/fits, during the reporting month.
Guideline: Indicate ‘severe hypertension/fits’ as a cause of death if a woman dies due to high blood
pressure (BP>140/90) or fits during pregnancy, labor, or immediate postpartum.
12.5.6 Data Element- Maternal Deaths - Other Causes (including causes not known)
Definition: Total maternal deaths due to other causes (including cause not known), during the reporting
month.
Guideline: All ‘Other Causes’ are to be aggregated here.
12.6 Other Deaths (except Infant, Child & Maternal Deaths) 5 years and above due to
6-14 Yrs: Total Children/Adolescent deaths between 6 and 14 years of age during the reporting month.
15-55 Yrs: Total adolescent/adult deaths between 15-55 years of age during the reporting month.
Above 55 yrs: Total adult deaths above 55 years of age during the reporting month
12.6.1 Data Element- Deaths - Diarrhoeal diseases
Definition: Total adolescent & adult deaths due to diarrhoeal diseases, during the reporting month.
Guideline: Death associated with loose stools more than thrice per day.
12.6.2 Data Element- Deaths – Tuberculosis
Definition: Total adolescent & adult deaths due tuberculosis, during the reporting month. Guideline:
Death in a person who was confirmed as suffering from tuberculosis along with necessary diagnosis or
seen by a medical doctor and clinically diagnosed to be a case of tuberculosis.
12.6.3 Data Element- Deaths - Respiratory diseases including infections (other than TB)
Definition: Total adolescent & adult deaths due to respiratory diseases including infections
(other than TB), during the reporting month.
Guideline: Death in a person diagnosed clinically to be primarily due to respiratory infection, including
pneumonia, asthma etc.
12.6.4 Data Element- Deaths - Other Fever Related
Definition: Total adolescent & adult deaths due to ‘other fever related’ causes, during the re-porting month.
Guideline: Any death other than the three above and that was related to fever.
12.6.5 Data Element- Deaths - HIV/AIDS
Definition: Total adolescent & adult deaths due to HIV/AIDS, during the reporting month.
Guideline: Any death with laboratory supported diagnosis of HIV/AIDS.
22
12.6.6 Data Element- Deaths - Heart disease/Hypertension related
Definition: Total adolescent & adult deaths due to heart disease/hypertension related, during the reporting
month.
Guideline: Any death due to any cardio vascular disease – known cause.
12.6.7 Data Element- Deaths – Cancer
Definition: Total adolescent & adult deaths due to cancer during the reporting month.
Guideline: Any death due to any kind of cancer – known cause.
12.6.8 Data Element- Deaths - Neurological disease including strokes
Definition: Total adolescent & adult deaths due to neurological disease including strokes, during the
reporting month.
Guideline: Any death due to any neurological disease including cerebrovascular disease / strokes or fits or
paralysis of any sort etc.
12.6.9 Data Element- Deaths - Accidents/Burn cases
Definition: Any death due to Accidents/Burn during the reporting month.
12.6.10 Data Element- Deaths – Suicide
Definition: Any death due to suicide during the reporting month.
Guideline: Death which is self-inflicted- whatever the cause.
12.6.11 Data Element- Deaths - Animal bites and stings
Definition: Any death due to animal bites and stings during the reporting month.
Guideline: Death which is a result of any animal bites or stings- common ones being of snakes and scorpions
– but also dog bites, bear bites, crocodile bites and tigers in select areas.
12.6.12 Data Element- Deaths - Known Acute Disease
Definition: Any death due to known acute disease.
Guideline: Here only those deaths where there is a reasonable presumptive diagnosis made and where the
disease lasted less than 3 weeks as reported by patient or his attendees.
12.6.13 Data Element- Deaths - Known Chronic Disease
Definition: Any death due to known chronic disease.
Guideline: Here, only those deaths where there is a reasonable presumptive diagnosis made and where the
disease lasted more than 3 weeks as reported by patient or his attendees.
12.6.14 Data Element- Deaths - Causes not known
Definition: Any death that does not fit into any category above.
Guideline: Any death where the information known is too little to fit into any of the above categories.
12.7 Deaths due to Vector Borne Diseases ( all age groups)
12.7.1 Data Element- Deaths - Malaria- Plasmodium Vivax
Definition: Total number of deaths occurred due to Plasmodium Vivax (Malaria) during the reporting month.
Guidelines: Death of a patient with severe malaria, defined according to the criteria. A death can be
medically certified as due to malaria only if blood smear and/or RDT have been positive for P.v.
Data source: M4 format
12.7.2 Data Element-Deaths - Malaria- Plasmodium Falciparum
Definition: Number of deaths occurred due to Plasmodium Falciparum (Malaria) during the reporting month.
Guidelines: Death of a patient with severe malaria, defined according to the criteria. A death can be
medically certified as due to malaria only if blood smear and/or RDT have been positive for P.f.
23
Data source: M4 format
MIS format for SC is provided in Annexure-1
Annexure-1
Ministry of Health & Family Welfare

(Monitoring & Evaluation Division)
Monthly Format for Sub Center and Equivalent Institutions
Due for Submission

State: on 5th of following
Month
Mon
District:
th
Block: Year
City/
Town/
Village:
24
Facility
name
Facility Public
type Private
Rural
Location
Urban
Numbers
reported during Ref No.
the month
REPRODUCTIVE AND
Part A CHILD HEALTH
M1 Ante Natal Care (ANC)
1.1 Total number of pregnant women 1.1
registered for ANC
1.1.1 Out of the total ANC registered, number 1.1.1
registered within 1st trimester (within 12
weeks)
1.2 ANC services 1.2
1.2.1 Number of PW given TT1 1.2.1
1.2.2 Number of PW given TT2 1.2.2
1.2.3 Number of PW given TT Booster 1.2.3
1.2.4 Number of PW given 180 Iron Folic Acid 1.2.4
(IFA) tablets
1.2.5 Number of PW given 360 Calcium tablets 1.2.5
1.2.6 Number of PW given one Albendazole 1.2.6
tablet after 1st trimester
1.2.7 Number of PW received 4 or more ANC 1.2.7
check ups
1.2.8 Number of PW given ANC Corticosteroids in 1.2.8
Pre Term Labour
1.3 Pregnant women (PW) with Hypertension (BP>140/90) 1.3
1.3.1 New cases of PW with hypertension 1.3.1
detected
1.3.1.a Out of the new cases of PW with 1.3.1.a
hypertension detected, cases managed at
institution
1.4 Pregnant women (PW) with Anaemia 1.4
25
1.4.1 Number of PW tested for Haemoglobin (Hb 1.4.1
) 4 or more than 4 times for respective
ANCs
1.4.2 Number of PW having Hb level<11 (tested 1.4.2
cases)(7.1 to 10.9)
1.4.3 Number of PW having Hb level<7 (tested 1.4.3
cases)
1.5 Pregnant Women (PW) with Syphilis 1.6
1.5.1 Point of Care (POC) tests conducted for Syphilis 1.6.1
1.5.1.a Number of PW tested using POC test for 1.6.1.a
Syphilis
1.5.1.b Out of above, number of PW found sero 1.6.1.b
positive for syphilis
M2 Deliveries M2
2.1 Deliveries conducted at Home 2.1
2.1.1 Number of Home Deliveries attended by 2.1.1
2.1.1.a Number of Home Deliveries attended by 2.1.1.a
Skill Birth Attendant(SBA)
(Doctor/Nurse/ANM)
2.1.1.b Number of Home Deliveries attended by 2.1.1.b
Non SBA (Trained Birth Attendant(TBA)
/Relatives/etc.)
2.1.2 Number of PW given Tablet Misoprostol 2.1.2
during home delivery
2.1.3 Number of newborns received 7 Home 2.1.3
Based Newborn Care (HBNC) visits in case of
Home delivery
2.2 Number of Institutional Deliveries 2.2
conducted
2.2.1 Out of total institutional deliveries number 2.2.1
of women discharged within 48 hours of
delivery
2.2.2 Number of newborns received 6 HBNC 2.2.2
visits after Institutional Delivery
M3 Pregnancy outcome & details of new-born M4
3.1 Pregnancy Outcome (in number) 4.1

3.1.1 Live Birth 4.1.1
3.1.1.a Live Birth - Male 4.1.1.a
3.1.1.b Live Birth - Female 4.1.1.b
3.1.2 Number of Pre term newborns ( < 37 weeks 4.1.2
of pregnancy)
3.1.3 Still Birth 4.1.3
26
3.2 Abortion (spontaneous) 4.2
3.3 Details of Newborn children 4.4
3.3.1 Number of newborns weighed at birth 4.4.1
3.3.2 Number of newborns having weight less 4.4.2
than 2.5 kg
3.3.3 Number of Newborns breast fed within 1 4.4.3
hour of birth
M4 Post Natal Care (PNC) M6
4.1 Women receiving 1st post partum checkup 6.1
within 48 hours of home delivery
4.2 Women receiving 1st post partum checkup 6.2
between 48 hours and 14 days
4.3 Number of mothers provided full course of 6.3
180 IFA tablets after delivery
4.4 Number of mothers provided 360 Calcium 6.4
tablets after delivery
M5 Family Planning M8
5.1 Number of Interval IUCD Insertions 8.3

(excluding PPIUCD and PAIUCD)
5.2 Number of Post Partum (within 48 hours of 8.4
delivery) IUCD insertions
5.3 Number of IUCD Removals 8.6
5.4 Number of complications following IUCD 8.7
Insertion
5.5 Injectable Contraceptive-Antara Program- 8.8
First Dose
Second Dose
Third Dose
Fourth or more than fourth
5.9 Number of Combined Oral Pill cycles 8.12
distributed
5.10 Number of Condom pieces distributed 8.13
5.11 Number of Centchroman (weekly) pill strips 8.14
distributed
5.12 Number of Emergency Contraceptive Pills 8.15
(ECP) given
5.13 Number of Pregnancy Test Kits (PTK) used 8.16
5.14 Quality in sterilization services 8.17
5.14.1 Complications following male sterilization 8.17.1
27
5.14.2 Complications following female sterilization 8.17.2
M6 CHILD IMMUNISATION M9
6.1 Number of Infants 0 to 11 months old who received: 9.1
6.1.1 Child immunisation - Vitamin K1 (Birth 9.1.1
Dose)
6.1.2 Child immunisation - BCG 9.1.2

6.1.3 Child immunisation - DPT1 9.1.3
6.1.6 Child immunisation - Pentavalent 1 9.1.6
6.1.9 Child immunisation - OPV 0 (Birth Dose) 9.1.9
6.1.10 Child immunisation - OPV1 9.1.10
6.1.13 Child immunisation - Hepatitis-B0 (Birth 9.1.13
Dose)
6.1.14 Child immunisation - Hepatitis-B1 9.1.14
6.1.17 Child immunisation - Inactivated Polio 9.1.17
Vaccine 1 (IPV 1)
6.1.18 Child immunisation - Inactivated Polio 9.1.18
Vaccine 2 (IPV 2)
6.1.19 Child immunisation - Rotavirus 1 9.1.19
6.2 Number of Children 9-11 months who received: 9.2
6.2.1 Child immunisation (9-11months) - Measles 9.2.1
& Rubella (MR)- 1st Dose
6.2.2 Child immunisation (9-11months) - Measles 9.2.2
1st dose
6.2.3 Child immunisation (9-11months) - JE 1st 9.2.3
dose
6.2.4 Number of children aged between 9 and 11 months fully 9.2.4
immunized (BCG+DPT123/ pentavalent123+OPV123+Measles/
28
MR)
6.2.4.a Children aged between 9 and 11 months 9.2.4.a
fully immunized- Male
6.2.4.b Children aged between 9 and 11 months 9.2.4.b
fully immunized - Female
6.3 Children given following vaccination after 12 months 9.3
6.3.1 Child immunisation - Measles & Rubella 9.3.1
(MR)- 1st Dose
6.3.2 Child immunisation - Measles-1st dose 9.3.2
6.3.3 Child immunisation - JE 1st dose 9.3.3
6.4 Number of Children more than 12 months who received: 9.4
6.4.1 Child immunisation - Measles & Rubella 9.4.1
(MR)- 2nd Dose (16-24 months)
6.4.2 Child immunisation - Measles 2nd dose 9.4.2
(More than 16 months)
6.4.3 Child immunisation - DPT 1st Booster 9.4.3
6.4.4 Child immunisation - OPV Booster 9.4.4
6.4.5 Child immunisation - Measles, Mumps, 9.4.5
Rubella (MMR) Vaccine
6.4.6 Number of children more than 16 months 9.4.6
of age who received Japanese Encephalitis
(JE) vaccine
6.5 Number of Children more than 23 months who received: 9.5
6.5.1 Child immunisation - Typhoid 9.5.1
6.5.2 Children more than 5 years received DPT5 9.5.2
(2nd Booster)
6.5.3 Children more than 10 years received TT10 9.5.3
6.5.4 Children more than 16 years received TT16 9.5.4
6.6 Adverse Event Following Immunisation (AEFI) 9.6

6.6.1 Number of cases of AEFI - Abscess 9.6.1
6.6.2 Number of cases of AEFI - Death 9.6.2
6.6.3 Number of cases of AEFI - Others 9.6.3
6.7 Number of Immunisation sessions 9.7
6.7.1 Immunisation sessions planned 9.7.1
6.7.2 Immunisation sessions held 9.7.2
6.7.3 Number of Immunisation sessions where 9.7.3
ASHAs were present
6.8 Children received Vitamin A Doses between 9 months and 5 9.8
years
29
6.8.1 Child immunisation - Vitamin A Dose - 1 9.8.1
6.9 Number of children (6-59 months) provided 9.9
8-10 doses (1ml) of IFA syrup (Bi weekly)
6.10 Number of children (12-59 months) 9.10
provided Albendazole
6.11 Number of severely underweight children 9.11
provided Health Checkup (0-5 yrs)
M7 Number of cases of Childhood Diseases (0-5 years) M10
7.1 Childhood Diseases - Tuberculosis (TB) 10.7
7.2 Childhood Diseases - Acute Flaccid 10.8
Paralysis(AFP)
7.3 Childhood Diseases - Measles 10.9
7.4 Childhood Diseases - Malaria 10.10
7.5 Childhood Diseases - Diarrhoea 10.11
M8 National Vector Borne Disease Control Programme (NVBDCP) M11
8.1 Malaria 11.1
8.1.1 Rapid DiagNumberstic Test (RDT ) 11.1.1
8.1.1.a RDT conducted for Malaria 11.1.2.a
8.1.1.b Malaria (RDT) - Plasmodium Vivax test 11.1.2.b
positive
8.1.1.c Malaria (RDT) - Plamodium Falciparum test 11.1.2.c
positive
Part B Health Facility Services
Part B.
M9 Patient Services M14
9.1 Out Patient Department (Outpatients) by disease/ health 14.1
condition
9.1.1 Outpatient - Diabetes 14.1.1
9.1.2 Outpatient - Hypertension 14.1.2
9.1.3 Outpatient - Stroke (Paralysis) 14.1.3
9.1.4 Outpatient - Acute Heart Diseases 14.1.4
9.1.5 Outpatient - Mental illness 14.1.5
9.1.6 Outpatient - Epilepsy 14.1.6
9.1.7 Outpatient - Ophthalmic Related 14.1.7
9.1.8 Outpatient - Dental 14.1.8
9.2 Outpatient attendance (All) 14.2
30
9.2.1 Allopathic- Outpatient attendance 14.2.1
9.2.2 Ayush - Outpatient attendance 14.2.2
9.3 Number of Anganwadi centres/ UPHCs 14.16
reported to have conducted Village Health
& Nutrition Day (VHNDs)/ Urban Health &
Nutrition Day (UHNDs)/ Outreach / Special
Outreach
M10 Laboratory Testing M15
10.1 Hb Tests Conducted 15.2
10.1.1 Number of Hb tests conducted 15.2.1
10.1.2 Out of the total number of Hb tests done, 15.2.2
Number having Hb < 7 mg
10.2 (Human Immunodeficiency Virus) HIV tests conducted 15.3
10.2.1 Pregnant women screened for HIV 15.3.3
10.2.1.a Number of pregnant women screened for 15.3.3.a
HIV
10.2.1.b Out of the above, number screened positive 15.3.3.b
M11 Stock Related Data
11.1 Drugs
11.1.1 Last Date of Supply of essential
drugs(DD/MM/YYYY)
11.1.2 Items Adequate/
Inadequate
11.1.2.a IFA tablets
11.1.2.b IFA syrup with dispenser
11.1.2.c Vit A syrup
11.1.2.d ORS packets
11.1.2.e Zinc tablets
11.1.1.f Inj Magnesium Sulphate
11.1.1.g Inj Oxytocin
11.1.1.h Misoprostol tablets
11.1.1.i Antibiotics
11.1.1.j Availability of drugs for common ailments
e.g PCM, anti- allergic drugs etc.
11.1.1.k IFA tablets (Blue)
11.1.1.l Tab. Albendazole
11.2 Contraceptives
31
11.2.1 Last Date of Supply of essential
contraceptives (DD/MM/YYYY)
11.2.2 Items Adequate/
Inadequate
11.2.2.a IUCD
11.2.2.b Combined Oral Pills (in cycles)
11.2.2.c Condom (in pieces)
11.2.2.d Injectable Contraceptive
MPA (vials)
Part C Mortality Details
Part C.
M12 Details of deaths reported with probable causes: M16
12.1 Infant deaths within 24 hrs(1 to 23 Hrs) of 16.1
birth
12.2 Infant Deaths up to 4 weeks (1 to 28 days) due to 16.2
12.2.1 Infant Deaths up to 4 weeks due to Sepsis 16.2.1
12.2.2 Infant Deaths up to 4 weeks due to 16.2.2
Asphyxia
12.2.3 Infant Deaths up to 4 weeks due to Other 16.2.3
causes
12.3 Infant Deaths Between 1 month (more than 28 days) and less 16.3
than 12 months due to
12.3.1 Number of Infant Deaths (1 -12 months) 16.3.1
due to Pneumonia
due to Diarrhoea
due to Fever related
due to Measles
due to Others
12.4 Child Deaths between 1 year and less than 5 years due to 16.4
12.4.1 Number of Child Deaths (1 -5 years) due to 16.4.1
Pneumonia
Diarrhoea
Fever related
Measles
Others
12.5 Maternal Deaths (15 to 49 yrs.) due to 16.5
32
12.5.1 Number of Maternal Deaths due to 16.5.1
Bleeding
12.5.2 Number of Maternal Deaths due to High 16.5.2
fever
Abortion
Obstructed/prolonged labour
12.5.5 Number of Maternal Deaths due to Severe 16.5.5
hypertesnion/fits
12.5.6 Number of Maternal Deaths due to Other 16.5.6
Causes (including causes Not known)
12.6 Other Deaths (except Infant, Child & Maternal Deaths) 5 years 16.7
and above due to
12.6.1 Number of Adolscent / Adult deaths due to 16.7.1
Diarrhoeal diseases
Tuberculosis
Respiratory diseases including infections
(other than TB)
Other Fever Related
HIV/AIDS
Heart disease/Hypertension related
Cancer
Neurological disease including strokes
Accidents/Burn cases
Suicide
Animal bites and stings
known Acute Disease
known Chronic Disease
Causes Not known
12.7 Deaths due to Vector Borne Diseases ( all age groups) 16.8
12.7.1 Number of Deaths due to Malaria- 16.8.1
Plasmodium Vivax
33
12.7.2 Number of Deaths due to Malaria- 16.8.2
Plasmodium Falciparum
34

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DEFINITIONAND GUIDELINE OF DATA ELEMENTS IN SUB CENTER MONTHLY FORMAT

Part A REPRODUCTIVE AND CHILD HEALTH

1.2.1 Data Element - Number of PW given TT1

Data Source: OPD Register/IPD Register

MIS format for SC is provided in Annexure-1

Ministry of Health & Family Welfare

Due for Submission

3.1 Pregnancy Outcome (in number) 4.1

5.1 Number of Interval IUCD Insertions 8.3

6.1.2 Child immunisation - BCG 9.1.2

6.6 Adverse Event Following Immunisation (AEFI) 9.6

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