Validation of Sentrong Sigla Criteria - Blank

Republic of the Philippines
COMMISSION ON AUDIT
Commonwealth Avenue, Quezon City
Local Government Sector

National Capital Region
Subject: Audit of Barangay Health Centers
VALIDATION REPORT
Audit Condition
Audit Criteria
(Sentrong Sigla Health Center Health Center Health Center Health Center
minimum requirements for
barangay health centers)
1. Infrastructure/Amenities
Conditions/Amenities:
1.1. Functional comfort rooms or

latrines for health staff and
clients with handrails for the
disabled
 Functional comfort
rooms?
 With handrails?
1.2. Examination table with clean
linen/paper?
 With clean linen?
 With clean paper?
1.3. With bench or stool for
examination table?
 With bench?
 With stool?
1.4. Treatment area/examination
area with visual and auditory
privacy
 Visual privacy?
 Auditory privacy?
1.5. Storage space/room for
supplies, drugs, and medicines
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Audit Condition
Audit Criteria
 Storage space/room for

supplies?
 Storage space/room for
drugs and medicines?
1.6. With cleaning/sterilizing
supplies for clinical
instruments
 With cleaning supplies?
 With sterilizing supplies?
Practices:
1.7. Clinic hours, services, and
whereabouts of staff posted in
a strategic area readable by all
clients and service providers?
 Directory of doctors with
clinic hours posted?
 Directory of doctors with
specialized fields posted?
 Organizational Chart of
the medical staff posted?
 Whereabouts of medical
staff posted?
1.8. The HC maintains occasional
hours during evenings and
weekends to accommodate
clients who are unable to
consult or visit during regular
clinical hours. The HC should
provide services during non-
traditional hours at least once
per month considering clients
who may not be available
during regular office or work
hours.
 Evenings?
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Audit Criteria
 Weekends?
2. Health Services
2.1 Expanded Program on
Immunization (CCT)
Practice:
2.1.1. Immunization sessions
conducted in the HC as regularly
as possible? Although Wednesday
has been adopted as the national
immunization day, immunization
days may be held on other days.
 Wednesday, immunization
day?
 Other day of the week,
except Wednesday?
2.1.2. Schedules should be
displayed to inform mothers of the
time and day at which
immunization services are to be
provided. However, clients who
request immunization on other
days should not be turned away.
Wastage of vaccine is a minimal
program cost and should not be
overemphasized or used as a
barrier to vaccine administration.
 Requests for immunization
during days not scheduled
are entertained?
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Audit Condition
Audit Criteria
2.1.3. The facility should practice

a one needle and one syringe
policy because of the danger of
transmitting Hepatitis B and AIDS
or HIV infection through unsterile
needles or syringes. Therefore,
one sterile syringe and needle
should be utilized for each
injection. Disposable syringes and
needle should be used only once
and then collected in a puncture
proof container to be burned and
buried.
 Practice a one needle and
one syringe policy
 Collected in a puncture
proof container to be
burned and buried
2.1.4. BCG, OPV, DPT, measles,
Hepatitis B and tetanus toxoid
vaccines should be available at all
times in the facility and should be
stored under proper cold chain
conditions.
 BCG, OPV, DPT, measles,
Hepatitis B and tetanus
toxoid vaccines should be
available at all times?
 Stored under proper cold
chain conditions?
2.1.5. The HC should conduct
patient counselling on
effectiveness, risks, benefits,
potential side effects and treatment
for side effects of each vaccine
 Effectiveness?
 Risks?
 Benefits?
 Potential side effects?
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Audit Condition
Audit Criteria
 Treatment for side effects?

Conditions, Equipment,
Supplies:
2.1.6. Immunizations offered at
least once per week (depends on
catchment population)
2.1.7. Outreach immunization
services offered in hard to reach
areas
2.1.8. Expanded Program on
Immunization (EPI) Manual
2.1.9. Target client list or Master
List (updated weekly)
2.1.10 Adequate supplies of BCG,
OPV, DPT, measles Hepatitis B
and tetanus toxoid vaccines based
on average monthly consumption
(with at least one month supply at
any time)
 BCG?
 OPV?
 DPT?
 Measles?
 Hepatitis B?
 Tetanus toxoid vaccines?
2.1.11. Proper cold chain
maintained:
a. Refrigerator exclusively for
vaccine use and with voltage
regulator
 With refrigerator only?
 With refrigerator and
voltage regulator?
b. Vaccine thermometer (placed
inside the refrigerator) with
temperature maintained between
2-8oC
 With thermometer to
maintain temperature?
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Audit Condition
Audit Criteria
c. Daily am and pm temperature

monitoring charts posted and
updated
 With AM monitoring?
 With PM monitoring?
d. Written contingency plan for a
“power failure”
e. Vaccine carriers with ice-cold
packs
2.2. Disease Surveillance
Practice:
2.2.1. The HC should perform
disease surveillance to measure the
magnitude of the local health
problems and the effects of the
control programs delivered.
Surveillance data can be used by
the facility to improve strategies in
delivering health services and thus
prevent these from occurring e.g.
immunizable diseases like
diphtheria, pertussis, tetanus,
polio, measles, etc.
2.2.2. The HC staff and
community health volunteer
workers or CHVWs should be
involved in reporting,
investigating, and reporting to the
next higher level of health system
 Reporting?
 Investigating?
 Reporting to the next
higher level of health
system?
2.2.3 Surveillance data must be
complete, accurate and on time
 Complete?
 Accurate?
 On time?
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Audit Condition
Audit Criteria
Supplies:
2.2.4. Case definitions available
2.2.5. Notifiable disease reporting
forms available
2.2.6. Notifiable disease reporting
forms submitted weekly to
provincial or city or municipal
health office
2.2.7. Investigation of all acute
flaccid paralysis (AFP) cases,
neonatal deaths, and measles
outbreaks
 Accute flaccid paralysis
cases?
 Neonetal deaths?
 Measles?
2.2.8. Immediately reporting all
AFP and neonatal tetanus cases to
the regional offices (surveillance
personnel) through the fastest
possible means.
 All AFP cases?
 All neonatal tetanus cases?
2.2.9. Reported cases followed up
by HC for public health reasons
especially 60 days follow-up done
on all AFP cases detected.
2.3. Control of Acute
Respiratory Infections (CCT)
Practices:
2.3.1. The HC should have the
equipment and supplies necessary
to diagnose and treat common
acute respiratory illnesses
 Equipment?
 Supplies?
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Audit Condition
Audit Criteria
2.3.2. Cotrimoxazole and other

antibiotics should be available at
all times in the facility
 Cotrimoxazole?
 Other antibiotics?
2.3.3. Referral to other or higher
level facilities e.g. hospitals should
be done for clients needing further
management
Supplies:
2.3.4. Acute Respiratory Infections
(ARI) Chart posted
2.3.5. Thermometer
2.3.6. Tongue Depressors
2.3.7. Flashlights or pen lights
2.3.8. Timer or watch with second
hand
2.3.9. Cotrimaxazole (adult tabs, at
least 100 tablets)
2.3.10. Paracetamol (500 mg tabs,
at least 100 tablets)
2.3.11. In client or patient
education counselling messages
should include:
a. Home management of simple
coughs and colds without use of
cough/cold medicines
b. Detection of early pneumonia
using simple signs like rapid
breathing and chest in drawing
c. Information on when, where and
how to bring the child with
pneumonia for treatment
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Audit Condition
Audit Criteria
d. CHVWs as part of the health

service delivery network should
refer patients to higher levels of
the health care system e.g.
barangay health stations, health
centers and hospitals and conduct
follow up visits
e. Outreach activities should be
done in areas otherwise
inaccessible to health worker or to
regular health services
2.4 Control of Diarrheal Diseases

(CCT)
Practices:
2.4.1. The HC should have the
to diagnose and treat diarrheal
diseases. Referral to other or
higher-level facilities should be
done for diarrheal clients needing
further management.
2.4.2. In the HC, all patients with
no dehydration or who have been
successfully rehydrated in the
facility should be given ORS to
take home to prevent dehydration.
2.4.3 Antibiotics should ONLY be
used for dysentery or for suspected
cholera cases with severe
dehydration; otherwise, these are
ineffective and should NOT be
given. Other DOH policies on anti-
parasitic drugs and anti-diarrheal
drugs should be followed based on
previously issued policies and
guidelines.
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Audit Condition
Audit Criteria
a. Ensure potability of drinking

water within the catchment area in
conjunction with the
Environmental Sanitation
Program;
b. Promote personal and domestic
hygiene through health education,
and
c. Assure adequate supply of oral
rehydration salts (ORS) sachets
Supplies:
2.4.4. CDD Case Management
Chart posted
2.4.5. Functional Oral Rehydration
Therapy (ORT) corner with
benches, table, glasses, pitcher,
spoon, calibrated container for
measuring potable water and ORS
2.4.6. ORS sachets available at all
times
2.4.7. Updated daily record of
diarrhea cases
2.4.8. In client or patient
education/counseling basic
messages should include:
a. Give the child more fluids than
usual to prevent dehydration;
b. Continue to feed the child; and
c. Take the child to the health
worker if child does not become
better in three days or earlier if the
child develops some
signs/symptoms like many
episodes of watery stools, repeated
vomiting, marked thirst, fever,
blood in the stool and eating or
drinking poorly.
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Audit Condition
Audit Criteria
2.5 Micronutrients
Supplementation/Nutrition
(CCT)
Practices:
2.5.1 The HC should have the
to prevent, detect and control
nutritional deficiencies and
specific micronutrient disorders.
Equipment
 Prevention of nutritional
deficiencies and specific
micronutrient disorders?
 Detection of nutritional
 Control of nutritional
Supplies
 Prevention of nutritional
 Detection of nutritional
 Control of nutritional
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Audit Condition
Audit Criteria
2.5.2. The HC should have iron,

iodized oil capsules/iodized salt
and vitamin A capsules available
at all times for supplementation of
target groups e.g. iron tablets for
all pregnant and lactating women;
iron drops for infants and iron
syrup for school children.
 Iron tablets for pregnant
and lactating women?
 Iodized Oil
capsules/iodized salt for
pregnant and lactating
women?
 Vitamin A capsules for
pregnant and lactating
women?
 Iron drops for infants?
 Iron syrup for school
children?
Supplies:
2.5.4. Guidelines for Micronutrient
Supplementation
2.5.5. Operation Timbang (OPl)
Records for the whole HC
catchment 
2.5.6. Updated Target Client List
(at least within the week) 
2.5.7. Under 5 growth
cards/Growth Monitoring Charts
(GMC)
2.5.8. CBPM-NP RHM
Guidebook 
2.5.9. Basic Three Food Groups
Brochures 
2.5.10. Salt Iodization Testing Kit 
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Audit Condition
Audit Criteria
2.5.11. Micronutrients available:

iron, iodine, vitamin A 
2.5.12. Functional balance beam or
other weighing scales 
2.5.13. In-client or patient nutrition
education/counseling, basic
messages should be emphasized
like importance of proper nutrition
including:
a. Balanced diet 
b. Desirable food habits 
c. Consumption of fortified foods 
d. Use of iodized salt 
e. Importance of breast-
feeding/weaning foods
2.6 Family Planning Program
(CCT)
Practice:
2.6.1. The HC should provide all
medically approved, safe, effective
and legally acceptable program
methods. These specific services
should include:
a. Pills, IUDs, NFP (in selected
facilities by referral), LAM,
Condoms and DMPA
b. Tubal Ligation and Vasectomy
in selected facilities where there
are trained personnel and in cases
where there are no trained staff,
referral must be in place
c. Relevant Laboratory Exams,
e.g., Pap smear, wet smear, gram
staining, pregnancy test and
urinalysis
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Audit Condition
Audit Criteria
d. Management of complications
and/or side effects that may arise
as a result of family planning
methods
2.6.2. The HC should ensure
availability of all program methods
at all times. When necessary, the
HC should refer clients to other
facilities or clinics that provide FP
services it cannot provide, such as
IUD or sterilization.
2.6.3. FP supplies should be
sufficient (one month allowed
stock level) and equipment should
be in working order.
2.6.4. HC staff should counsel
clients about the effectiveness,
risks, and benefits of the different
contraceptive methods. Staff
should provide information
neutrally, without allowing their
own biases to affect clients'
choices.
Supplies:
(one month)
2.6.6. FP Form 1 
LOOK FOR THE FORM
2.6.7. Contraceptives/Supplies
available:
a. Condoms 
b. Oral contraceptives-combination
and progesterone only
ASK THAT THIS IS
c. DMPA 
d. IUDs
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Audit Condition
Audit Criteria
2.7. Antiseptic solution

(povidone iodine; cidex) and
chlorine 75%
a. Sterilized Equipment available
b. Forceps -- alligator, pick-up,
ovum, tenaculun, uterine
c. Forceps container 
2.8. Kelly pad/linen for
examination table 
2.9. Examination table with linen
or paper and changed between
clients 
 With Linen
 With paper
2.10. Examination table 
2.11. Light source (gooseneck
lamp, flashlight) 
2.12. NFP charts for distribution
(in selected facilities) 
2.13. Other leaflets/handouts on
FP for distribution 
2.14. Referral Form for
sterilization 
2.15. Patient counseling on
information about all methods,
effectiveness, risks, and benefits
of various methods
2.16. Tuberculosis Control
Program
Supplies:
2.16.1. Updated Target Client
List/National Tuberculosis
Program (NTP) TB Register (at
least within the week)
2.16.2. Updated microscopy
logbook/NTP Laboratory Register
(within the week)  
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Audit Condition
Audit Criteria
2.16.3. In designated microscopy

centers, the facility should have:
a. Microscope  
b. Medical technologist or
designated microscopist
c. Laboratory supplies: 1) AFB
reagent, 2) sputum cups, and  3)
glass slides
2.16.4. For other health facilities
(non-microscopy centers):
a. Sputum cups 
b. Glass slides 
c. Designated sputum collection
and staining area
2.16.5. Anti-TB Drugs:
a. Type I (good for at least 5
patients)
b. Type II (good for at least 5
patients)  
c. Ethambutol, in blister packs
d. Streptomycin Sulfate
2.17. Environmental Sanitation
Program
Practice:
2.17.1 The HC should practice
strict personal and environmental
hygiene to reduce disease
transmission within the facility.
 personal hygiene?
 environmental hygiene?
2.17.2 Practices that should be
followed within the facility include
the following:
a. Hand-washing with soap and
water before and after each client
contact and use of comfort room
b. Examination table disinfected
daily 
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Audit Condition
Audit Criteria
2.17.3 The HC should provide

water testing/quality monitoring
services
 Water testing?
 Water quality monitoring
2.17.4 The HC should have an
updated list of water sources and
food establishments within its
catchment area.
 List of water sources?
 Food establishments?
2.17.5 The HC should have
available toilet bowls for
distribution to households without
toilets or at least toilet bowl molds.
Supplies:
2.17.6. Copy of Sanitation Code of
the Philippines and Implementing
Rules and Regulations
 Sanitation Code of the
Philippines
 Implementing Rules and
Regulations
2.17.7. Adequate chlorine granules
for disinfection of water supply
facilities
2.17.8. Environmental Sanitation
Kit containing tools for water and
food facilities testing/monitoring
2.10.9. Updated list of status of
water supply and
sanitation facilities within the area
of coverage of the facility (one
month)
2.17.10. List of food
establishments with sanitary
permits and their updated
sanitation conditions (one month)
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Audit Condition
Audit Criteria
 List of food establishments

with permits?
 Updated sanitation
conditions of the food
establishments within the
HC
2.17.11. Information and education
materials on environmental
sanitation.
2.17.12. Updated list of
households with or without
sanitary toilet facilities.
2.17.13. Adequate supply of toilet
bowls for distribution to
households without toilets or at
least toilet bowl molds.
2.18. Cancer Control Program –
Cervical Cancer Screening
Program (CCT)
Practice:
2.18.1 The HC should promote
that all women of reproductive age
should receive a pelvic exam and
pap smear annually for three (3)
years in a row. If all three are
negative, clients need to go to the
facility only every three years for a
pap smear. For abnormal smears
(Class II - IV) the client should be
referred to higher levels for further
management.
2.18.2. The HC staff should
counsel patients as to the risk
factors for contracting cervical
malignancy, not using condoms,
frequent STDs, multiple partners,
etc.
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Audit Condition
Audit Criteria
2.18.3. The HC staff should be

trained on and have the necessary
equipment and supplies to perform
a pap smear and collect the
specimen for reading by a higher
level facility (hospital).
Supplies:
2.19. Updated Target Client
List/log book of clients (at least
within the week)  
2.20. Pap smear: for collection of
specimen
a. Glass slides
b. Wooden spatula (Ayer's
spatula) or cervical brush
c. Fixative (95% ethanol or others)
d. Pencil 
2.21. Referral facility for pap
smear reading  
2.22. Referral forms of Individual
patient record of Pap Smear
Results 
2.23.IEC materials on Cervical
Cancer (leaflets, posters)  and
self-breast examination (SHE)
2.24. Maternal Care (CCT)
Practice:
2.24.1. The HC should provide a
whole range of maternal care
services to include providing
tetanus immunization to
clients/mothers, pre-natal, natal
(delivery) and post-partum care.
 Tetanus Immunization?
 Pre-natal?
 Natal (delivery)?
 Post-partum care?
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Audit Condition
Audit Criteria
Supplies:
book (at least within the week)
2.24.3. IT vaccines and syringes &
needles 
 IT vaccines?
 Syringes?
2.24.4. Records of pre-
natal/natal/post-natal visits
conducted o Records of home
visits made by HC staff/CHVW
 Pre-natal records?
 Post-natal records?
2.24.5. Available forms for:
a. birth certificates
b. death/fetal birth certificates
c. other pertinent records 
2.24.6. Home Based Maternal
Records (HBMR) for distribution
to new clients
2.24.7. Information, Education,
Communication (IEC) materials
2.24.8. OB Emergency Manual
&Algorithm
3. Attitude and Behavior of
Health Workers
The HC staff are expected to:
3.1. Greet the patient verbally as
he/she arrives in order to establish
rapport.
3.2. Exhibit technical competence
in articulating information to
patients by:
3.2.1. Maintaining 2 way
communication
3.2.2. Being a good listener
3.2.3. Being non-judgmental
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Audit Condition
Audit Criteria
3.2.4. Not giving false

reassurances
3.2.5. Giving appropriate
instructions to patients by
explaining prescriptions clearly,
explaining laboratory results
correctly and facilitating follow-up
of clients
3.3. Be women-friendly by:
3.3.1. Being courteous and always
explain any procedure
3.3.2. Ask permission before
proceeding
3.3.3. Avoid gender slurs/insults
and discriminating words against
women
3.3.4. Being careful in examining
women patients. This is especially
true when examining women
during obstetrical
and gynecological examinations
and as survivors of abuse/violence
3.3.5. Not blaming victim/survivor
of abuse/violence
3.4. Be caring and gender-sensitive
by:
3.4.1. Respecting patient's decision
without compromising overall
patient management
3.4.2. Assuring patient's privacy
and confidentiality of given
information at all times
3.4.3. Promptly responding to
patient's request for care
3.4.4. Speaking politely and with
modulated tone
3.5. Be culture-sensitive by:
3.5.1. Respecting patients' culture
and religion
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Audit Condition
Audit Criteria
3.5.2. Providing for patients needs

that are influenced by culture and
religion
3.5.3. Offering choices/options to
patients
4. Health Human Resources
4.1. The HC should have at least
one:
a. Physician
b. Nurse
c. Midwife
d. Sanitary Inspector
4.2. The HC staff should be trained
in specific DOH mandated courses
to include:
a. Basic EPI Skills Training
b. Disease Surveillance
Training
c. Pneumonia Case
Management
d. ARI Case Management
e. CDD Case Management
f. Community-Based
Planning and Management
of Nutrition Program
(CBPM-NP)
g. Basic Family Planning
Course
h. Comprehensive Family
Planning
i. DMPA Training
j. Training on National
Tuberculosis Control
Program - DOTS
k. Training on Microscopy
l. Training on Basic
Counselling for
STD/AIDS
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Audit Condition
Audit Criteria
m. Syndromic Management
of STD/AIDS
n. Training on
Environmental Health
Programs and Regulations
o. Skills Training on Pap
Smear Collection
p. Gender Sensitivity
Training
q. Training on Counselling
Skills on Violence Against
Women
4.3. Continuing education and
updates for HC staff should be
implemented for
appropriate/rational use of
technology on diagnostic and
treatment modalities
4.4. There should be regular
"competency-based"
assessments of staff to determine
their technical proficiencies in
performing their duties and
responsibilities.
4.5. Facility staff should spend a
minimum of 10 minutes with each
client in history-taking (new
clients), examination, treatment
and health education.
Clients can be seen by midwives,
nurses, doctors, or any
combination of staff depending on
their complaint.
 History-Taking
 Examination?
 Treatment?
 Health Education?
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Audit Condition
Audit Criteria
4.6. Supervisors should also ensure

that they regularly assess job
satisfaction either through
surveys, interviews, or focused
group discussions.
5. Equipment
a. Stethoscope
b. Weighing scales-adult and
infant (beam or Ming
scale)
c. Sphygmomanometer with
adult and pediatric cuff
d. Vaccine Carrier with ice
packs
e. Sterilizer or covered pan
and stove
f. Inventory of equipment
and supplies
g. Examination table with
clean linen/paper
h. Bench or stool for
examination table
i. Kelly pad/clean
linen/plastic lining
j. Light source for
examination like goose
neck lamp with bulb and
flashlight with batteries
k. Speculums-large and small
6. Drugs, Medicines & Supplies
6.1. Eight essential drugs:
a. Cotrimoxazole
b. Amoxicillin
c. INH
d. Rifampicin
e. Pyrazinamide
f. Paracetamol
g. ORS
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Audit Condition
Audit Criteria
h. Nifedipine
6.2. Available basic supplies for
examination, emergency medical
and simple surgical cases:
a. alcohol/disinfectant
b. cotton
c. disposable gloves
d. lubricant (KY Jelly) or
clean water
e. disposable needles
f. disposable syringes
g. sutures
h. slides and coverslips
i. gauze/bandages/plaster or
adhesive tape
j. sharps containers
6.3. Adequate supply of
disinfectants, antiseptics and/or
insecticides to include cleaning
supplies for the facility and for
clinical instruments.
7. Health Information System
7.1.3. Completed/updated (within
one week) Field Health
Information Systems
(FHSIS) forms and target client
lists (TCLs).
7.2. Properly filled up records and
reports and filed for easy retrieval
and reference
8. Community Interventions
8.1. The HC should have active
community health volunteer
workers (CHVWs).
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Audit Condition
Audit Criteria
8.2. CHVWs are essential partners

in delivering basic health services
at the community level. There
should be programs and
activities to encourage their
participation.
8.3. The HC, in coordination with
organized patient groups/
community organization and
NGO's should, whenever needed,
organize outreach services to
communities being served
especially on areas otherwise
inaccessible to health workers or
regular health services.
8.4. HC staff and CHVWs should
encourage and support community
participation and partnership for
health interventions like Barangay
Assemblies, Dengue Linis
Brigade, Patients Classes,
Breastfeeding Support Groups,
etc.
Prepared by: Noted:
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Validation of Sentrong Sigla Criteria - Blank

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Republic of the Philippines

Local Government Sector

Subject: Audit of Barangay Health Centers

1.1. Functional comfort rooms or

 Storage space/room for

2.1.3. The facility should practice

 Treatment for side effects?

c. Daily am and pm temperature

2.3.2. Cotrimoxazole and other

d. CHVWs as part of the health

2.4 Control of Diarrheal Diseases

a. Ensure potability of drinking

2.5.2. The HC should have iron,

2.5.11. Micronutrients available:

2.7. Antiseptic solution

2.16.3. In designated microscopy

2.17.3 The HC should provide

 List of food establishments

2.18.3. The HC staff should be

3.2.4. Not giving false

3.5.2. Providing for patients needs

4.6. Supervisors should also ensure

8.2. CHVWs are essential partners

Prepared by: Noted:

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