CEN

FORM 1: COMMUNI

NON-NHTS HOUSEHOLDS
Canelar District,
Zamboanga City

San Jose Cawa-Cawa

NON-NHTS
(2)

No. of Household
VISITED
Members with
(3)
Health Use Plan
(4)
112

CENTER FOR HEALTH DEVELOMENT - ZAMBOANGA PENINSULA

Upper Calarian, Zamboanga City Tel. No. (062-983-0314)

FORM 1: COMMUNITY HEALTH TEAMS COVERAGE & MATERNAL & NEONATAL DEATHS REPO
AS OF:
MARCH 2016__

USEHOLDS

CCT HOUSEHOLDS

NO. OF COMMUNITY

No. Of Trained CHT Navigat

No. of Families
No. of Household No. of Families
VISITED
with PhilHealth CCT (6)
Members with
with PhilHealth
(7)
BHW (10) BNS (11)
ID's (5)
Health Use Plan (8)
ID's (9)

28

51

51

120

51

ULA

AL DEATHS REPORT

. OF COMMUNITY HEALTH TEAM NAVIGATORS

Trained CHT Navigators

PL
(12)

Others
(13)

No. of
REASON FOR
Deployed CHT
VARIANCE*
Navigators
(15)
(14)
3

NO. OF
MATERNAL
DEATHS (16)

NO. OF
NEONATAL
DEATHS (17)

CENTER FOR HEALT

Upper Calarian,

FORM 2: CHT
A

No. of Household Mem

No. Seen & Referred
Canelar District,
Zamboanga City

San Jose Cawa-Cawa

HH Visited
(2)

112

Pregnant
Women (3)

Newborn
(4)

Underfive
Children (5)

13

17

ENTER FOR HEALTH DEVELOMENT - ZAMBOANGA PENINSULA

Upper Calarian, Zamboanga City Tel. No. (062-983-0314)

FORM 2: CHT's HOME VISITS REPORT (NON-NHTS)

AS OF : MARCH_2016__

o. of Household Members
& Referred

Senior
Citizens
(6)

34

No. of Households

Current Modern FP
No. of families
Users
enrolled into
With access
With
PhilHealth
to safe H20 Sanitary
(10)
(11)
Toilet (12)
PWD's (7)
Women
Men (8)
(9)
0

22

28

112

112

No. of Household Members

with Risks for

TB (13)

Malaria
(14)

NCDs (15)

Pregnant Women Among NON-NHTS F

As of March, 2016
San Jose Cawa-Cawa Health Cent
Canelar District, Zamboanga Cit
Community
Health Team
Members

DARJUAN

TURCO

SURBANO

No.

Pregnant Woman

1
2
3
4
5
6
7
8
11
12
13

SAMERAH USMAN-PUTONG
MATRA USANI
ABEGEIL FERNANDEZ SATIN
ARLYN ALBISO
NUR-IDA JAMAD ALI
SHERWINA MOHAMMAD ALI
MA. CELESTE FRANCISCO
SHIELA MAE DIAZ
REYNALYN ALBOLARIO
MARY FRANCES LAUMAN SEALONGO
DOLLY PALACIO SUSON

ong NON-NHTS Families

arch, 2016
Cawa Health Center
t, Zamboanga City

Age

AOG
(mos)

LMP

EDC

35y/o
35y/o
37yo
30y/o
36y/o
19y/o
33y/o
19y/o
26y/o
30y/o
20y/o

4 mos
7 mos
3 mos
4mos
5mos
8mos
5mos
1mo
5mos
2mos
2mos

11/18/2015
8/16/2015
12/18/2015
11/27/2015
10/29/2015
7/4/2015
10/23/2015
2/20/2016
10/20/2015
1/6/2016
1/15/2016

8/25/2016
5/23/2016
9/25/2016
8/5/2016
7/11/2016
4/11/2016
7/39/2016
11/27/2016
7/27/2016
10/13/2016
10/22/2016

Postpartum Women Among NON-N

As of March, 2016
San Jose Cawa-Cawa Health
Canelar District, Zamboang

Community Health Team

Members

No.

Postpartum Woman

A. Darjuan

1
2

NURSHAIBA HUSSEIN
REYNALOU TIZON

en Among NON-NHTS Families

of March, 2016
awa-Cawa Health Center
istrict, Zamboanga City

Age
32y/o
30y/o

Date of
Delivery

Place of
Delivery

3/5/2016
3/1/2016

ZCMC
ZCMC

Postpartum Visits
1st

2nd

/
/

/
/

LIST OF NO

S
C

Name of Community
Health Team

Name of CCT Women

San Jose Cawa-Cawa

Amalia Dajuan

Angielyn Surbano

Eilaine Feliciano
Monaira Orniza
Berna Tingkahan
Maricel Feliciano
Mary Grace Ann Rabor
Rahima Darjuan
Marjorie Ganih
Jerra Roca
Angelyn Surbano
Minoa Timbasar
Evelyn Coro
Ruby Anne Eroma
Evelyn Pantaleon
Lady Cristine Atilano
Jackylyn Surbano
Nasralin Girvan
Katleen general
Maricris Tan
Cristine importante
Marilou Escultor
Cristine Morales
Charina Agarita
Nessa Cruz

Janice Turco

TOTAL:

11

LIST OF NON-NHTS WOMEN WITH FP NEED (CURRENT USER)

As of MARCH 2016
SAN JOSE CAWA-CAWA HEALTH CENTER
CANELAR DISTRICT, ZAMBOANGA CITY

Family Planning Needs (Current User)

Pills

Condom

DMPA

IUD

BTL

NSV

NFP

/
/
/
/
/
/
/
3

1
/

/
/
/
/
/
/
4

/
3

1
/

/
/
/
/
/
/
4

/
2

23

R)

ds (Current User)
FP
counseling
/
/
/
/
/
/
/

Status

DOB

Age

Married
Married
Married
Married
Married
Married
Married

10/30/1982
1/7/1981
9/10/1987
8/8/1984
12/26/1988
10/15/1989
3/29/1982

32
34
27
30
26
28
33

Married
Married
Married
Married
Married
Married
Married
Married

11/20/1983
3/27/1987
4/1/1980
7/26/1980
7/21/1984
5/19/1982
7/28/1988
10/1/1974

31
28
35
34
30
33
26
40

Married
Married
Married
Married
Married
Married
Married
Married

6/6/1988
4/7/1975
12/26/1990
12/15/1993
10/21/1968
3/13/1996
10/29/1987
10/15/1973

27
40
24
21
46
19
27
41

/
/
/
/
/
/
/
/
8
/
/
/
/
/
/
/
/
8

LIST OF NON-NHTS W

SAN JOSE
CANELAR

Name of Community
Health Team
Name of CCT Women
San Jose Cawa-Cawa

A. Darjuan

A. Surbano

J. Turco

Pills
Erieana Doruelo
Beverly Doruelo
Shiela Lahaji
Lucera Galo
Mary jane galo
Jessica galo
Jocelyn narciso
Jonalyn Narciso
mary Joy san Miguel
Glorien sabturan
mary Dumagay
Claracel Dumagay
estrella galo
alelie galo
Sitti Moratilla
Ma.procy Cayanong
Cardine Adamas
Natalie Mendoza
Cristine Mendoza
Pilarita Dalaquit
Gloria tting
Nur-ainie Titing
Lorraine Surbano
Jonalyn Mendoza
Sheddie Solo
marie jane Yu
Catherine Gonzales
Marie jane Escultor
Jannibeth escultor
Fidela acquitan
irene Aranco
Ivy Aranco

TOTAL:

LIST OF NON-NHTS WOMEN WITH FP NEED (PROBABLE USER)

As of MARCH 2016
SAN JOSE CAWA-CAWA HEALTH CENTER
CANELAR DISTRICT, ZAMBOANGA CITY

Family Planning Needs (Probable User)

Condom

DMPA

IUD

BTL

NSV

NFP

FP
Counseling

Status

/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/

Married
Single
Married
Married
Single
Single
Single
Single
Single
Married
Married
Single
Married
Married
Single
Married
Married
Married
Married
Separated
Married
Single
Single
Married
Married
Married
Married
Single
Single
Married
Single
Single

32

DOB

Age

12/10/1967
8/14/1997
3/11/1976
3/15/1968
3/25/1992
6/17/1993
9/10/1970
11/11/1990
7/21/1985
5/3/1979
11/11/1997
11/11/1965
3/27/1972
7/24/1995
7/17/1987
1/27/1969
7/27/1978
12/19/1968
11/24/1992
10/28/1972
12/14/1969
11/22/1990
6/12/1999
4/8/1990
5/7/1982
9/7/1986
11/30/1979
9/7/1986
3/18/1988
3/23/1970
5/12/1986
10/31/1993

47
17
39
47
23
22
44
24
29
36
17
49
43
19
27
46
36
46
22
42
45
24
16
25
33
28
35
28
27
45
29
21

NON-NHTS UNDERFIVE HEIGHT AND WEIGHT MONITO

San Jose Cawa-Cawa Health Center, Canelar Distric
As of March 2016

NAME OF CHILD
1. Rabos, Angel
2. Sabturan, Zia
3. Feliciano, Queen Aisha
4. San Miguel, Andrea Mae
5. San Miguel, Lois William
6. Cruz, Rheam Genn
7. Orinza, Alvin II
8. Feliciano, Bianca Melisse
9. Feliciano, Ricky Wencell
10. Moratilla, Shanina Brielle
11. Bucoy, Samsey
12. Timbasal, Al-Javier
13. Eroma, Rhyzamiel
14. Surbano, Mc-quin
15. Girvan, Marriam
16. Girvan, Sophia
17. Girvan, Nia

DOB

AGE

10/14/2011
10/26/2012
10/23/2012
1/28/2013
2/13/2015
7/11/2012
2/4/2012
3/8/2012
3/29/2014
5/11/2012
11/7/2011
12/31/2013
7/30/2012
9/7/2011
5/31/2011
6/5/2014
2/5/2012

4y 4m
3y 4m
3y 4m
3y 1m
1y
3y 7m
4y
3y 11m
1y 11m
3y 9m
4y 3m
2y 2m
3y 7m
4y 5m
4y 9m
1y 8m
4y

ND WEIGHT MONITORING
enter, Canelar District
2016

HEIGHT

WEIGHT

SAM

MAM

NON COMMUNICABLE DISEASE

San Jose Cawa-Cawa Health Center, Canelar District
As of March 2016

NAME
1.
2.
3.
4.

Phillip Soreo
Reynerio Gregorio
Teodoro Dumagay
Alvin Pereyra

AGE

HPN

43
68
78
48

/
/
/

DM

OTHERS

EASE
Canelar District

MEDICATION TAKEN
Amlodipine
Amlodipine
Losartan
Metformin